the nurse is assessing a 3 year old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen what
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HESI LPN

Pediatric HESI 2024

1. The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?

Correct answer: B

Rationale: Vomiting and poor appetite are common symptoms of neuroblastoma, a malignancy that arises from neural crest cells in the adrenal glands or sympathetic nervous system. This tumor can cause abdominal swelling due to its location and size, leading to symptoms like vomiting and decreased appetite. The presence of a maculopapular rash on the palms (Choice A) is not a typical finding associated with neuroblastoma. Irritability and failure to thrive (Choice C) are nonspecific symptoms that can be seen in various conditions but are not specifically indicative of neuroblastoma. Auscultation revealing wheezing with diminished lung sounds (Choice D) may suggest respiratory conditions rather than neuroblastoma.

2. A healthcare provider is discussing the care of an infant with colic with the parents. What should the healthcare provider explain is the cause of colicky behavior?

Correct answer: B

Rationale: Colicky behavior in infants is primarily characterized by paroxysmal abdominal pain, resulting in excessive crying and fussiness. The pain episodes are often unpredictable and can be distressing for both the infant and the parents. Inadequate peristalsis (Choice A) refers to weak or ineffective bowel movements and is not the typical cause of colic. While some infants may experience colic due to an allergic response to certain proteins in milk (Choice C), this is not the primary cause of colic behavior in all infants. Choice D, a protective mechanism designed to eliminate foreign proteins, is not a recognized cause of colic. Therefore, the correct explanation for the cause of colicky behavior in infants is paroxysmal abdominal pain.

3. A healthcare provider is preparing a 2-year-old child for surgery. What preoperative teaching should be provided to this child?

Correct answer: B

Rationale: Using a doll to demonstrate the procedure is the most appropriate preoperative teaching method for a 2-year-old child. It helps them understand what to expect in a non-threatening way by providing a visual representation of the upcoming surgery. Explaining the procedure in simple terms may be too abstract for a child of this age, as they may not fully comprehend verbal explanations. Showing pictures of the hospital environment may not be as effective as using a doll, as it may not provide a concrete understanding of the actual procedure. Allowing the child to play with medical equipment is unsafe and does not adequately prepare them for the surgery, as it may lead to misunderstandings or fear regarding the equipment's actual use during the surgery.

4. A child has been diagnosed with classic hemophilia. A nurse teaches the child’s parents how to administer the plasma component factor VIII through a venous port. It is to be given 3 times a week. What should the nurse tell them about when to administer this therapy?

Correct answer: B

Rationale: Administering factor VIII in the morning on scheduled days is the correct choice. This timing ensures that the factor VIII levels remain stable throughout the day when the child is active and at risk of bleeding. Choice A is incorrect because factor VIII should be given on a regular schedule rather than only when a bleed is suspected. Choice C is not ideal as the child may be more active during the day, increasing the risk of bleeding. Choice D is also incorrect as the administration should follow a specific schedule to maintain therapeutic levels of factor VIII in the child's system.

5. A healthcare professional is teaching parents about why most children should be immunized against varicella (chickenpox) and why some receiving specific medications should not. Which medication should be included in the discussion?

Correct answer: B

Rationale: The correct answer is B: Steroids. Children receiving steroids should not receive the varicella vaccine as it can increase the risk of severe infection due to the immunosuppressive effects of steroids. Insulin (Choice A) is not a medication that contraindicates varicella vaccination. Antibiotics (Choice C) and anticonvulsants (Choice D) are also not medications that would impact the decision to immunize against varicella.

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