HESI LPN
Pediatric HESI 2024
1. What should be the focus of nursing activity for the mother of an 8-year-old girl with a broken arm, who is the nurturer in the family?
- A. Teaching proper care procedures
- B. Dealing with insurance coverage
- C. Determining the success of treatment
- D. Transmitting information to family members
Correct answer: A
Rationale: The correct answer is A: Teaching proper care procedures. In this scenario, focusing on teaching the mother proper care procedures is crucial as she is the nurturer in the family and will likely be the primary caregiver for the child. This will empower her to provide appropriate care and support for her daughter during the recovery process. Choices B, C, and D are not the most appropriate activities for the mother in this situation. Dealing with insurance coverage, determining treatment success, and transmitting information to family members are important but not as directly relevant to the immediate care needs of the child's broken arm.
2. An infant is diagnosed with Hirschsprung disease. What nursing intervention is essential before surgery?
- A. Administering antibiotics
- B. Ensuring bowel rest
- C. Performing regular enemas
- D. Maintaining NPO status
Correct answer: D
Rationale: The correct nursing intervention essential before surgery for an infant with Hirschsprung disease is maintaining NPO (nothing by mouth) status. This is important to prevent aspiration during and after the surgical procedure. Administering antibiotics (Choice A) may be necessary in some cases but is not the priority intervention before surgery. Ensuring bowel rest (Choice B) is not directly related to preparing for surgery and may not be the most critical intervention. Performing regular enemas (Choice C) is not recommended before surgery for Hirschsprung disease as it can aggravate the condition.
3. A 2-week-old infant is admitted with a tentative diagnosis of a ventricular septal defect. The parents report that their baby has had difficulty feeding since coming home after birth. What should the nurse consider before responding?
- A. Feeding problems are common in neonates.
- B. Inadequate sucking is not significant in the absence of cyanosis.
- C. Ineffective sucking and swallowing may be early indications of a heart defect.
- D. Many neonates retain mucus, which may interfere with feeding for several weeks.
Correct answer: C
Rationale: In this scenario, the nurse should consider that ineffective sucking and swallowing in a 2-week-old infant could be early signs of a heart defect such as a ventricular septal defect. This is crucial information as it can guide further assessment and management. Choice A is incorrect because while feeding problems can be common in neonates, in this case, the specific context of a suspected heart defect should be prioritized. Choice B is incorrect as inadequate sucking can indeed be significant, especially when considering potential underlying heart issues, regardless of the presence of cyanosis. Choice D is incorrect as while mucus retention can affect feeding, in this case, the focus should be on the possibility of a heart defect rather than a temporary issue like mucus interference.
4. Why does a cleft lip predispose an infant to infection, concerning a nurse caring for the infant?
- A. Waste products accumulate along the defect.
- B. There is inadequate circulation in the defective area.
- C. Nutrition is inadequate due to ineffective feeding.
- D. Mouth breathing dries the oropharyngeal mucous membranes.
Correct answer: D
Rationale: Mouth breathing due to a cleft lip can dry the mucous membranes, increasing their susceptibility to infection. While waste product accumulation (Choice A) and inadequate circulation (Choice B) may contribute to complications, they are not directly related to infection in this context. Inadequate nutrition (Choice C) may affect overall health but is not the primary reason for infection predisposition in this case.
5. Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 90 beats/min. What is the most appropriate initial management for this newborn?
- A. Begin positive pressure ventilations
- B. Provide blow-by oxygen with oxygen tubing
- C. Assess the newborn's skin condition and color
- D. Start chest compressions and contact medical control
Correct answer: A
Rationale: In a newborn, a heart rate below 100 beats/min indicates the need for positive pressure ventilation to improve oxygenation. Providing blow-by oxygen or assessing skin condition/color may not address the primary issue of inadequate oxygenation due to the low heart rate. Starting chest compressions and contacting medical control is not warranted as the newborn is breathing spontaneously and only has a slightly low heart rate, which can be managed initially with positive pressure ventilations.
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