HESI LPN
Pediatrics HESI 2023
1. The healthcare professional is developing a teaching plan for a child who is to have their cast removed. What instruction would the professional most likely include?
- A. Applying petroleum jelly to the dry skin.
- B. Rubbing the skin vigorously to remove the dead skin.
- C. Soaking the area in warm water every day.
- D. Washing the skin with diluted peroxide and water.
Correct answer: C
Rationale: Soaking the area in warm water is the most appropriate instruction for a child who is having their cast removed. This method helps to gently remove dead skin without causing irritation. Applying petroleum jelly to dry skin (Choice A) is not recommended as it may not effectively aid in the removal of dead skin. Rubbing the skin vigorously (Choice B) can lead to skin irritation and should be avoided. Washing the skin with diluted peroxide and water (Choice D) may be too harsh, causing unnecessary irritation to the skin post-cast removal.
2. A child with a diagnosis of leukemia is receiving chemotherapy. What is the most important nursing intervention?
- A. Monitor for signs of infection
- B. Monitor for signs of bleeding
- C. Monitor for signs of dehydration
- D. Monitor for signs of pain
Correct answer: A
Rationale: The correct answer is to monitor for signs of infection. When a child is undergoing chemotherapy, their immune system is compromised, making them more susceptible to infections. Monitoring for signs of infection is crucial to promptly identify and treat any potential infections. Choices B, C, and D are incorrect because although monitoring for bleeding, dehydration, and pain are important aspects of care, the priority for a child receiving chemotherapy is to prevent and detect infections due to their increased vulnerability.
3. When evaluating the laboratory report of a 1-year-old infant’s hematocrit, a healthcare provider compares it with the expected hematocrit range for this age group. What is the hematocrit of a healthy 12-month-old infant?
- A. 19% to 32%
- B. 29% to 41%
- C. 37% to 47%
- D. 42% to 69%
Correct answer: C
Rationale: The correct hematocrit range for a healthy 12-month-old infant is between 37% to 47%. At this age, this range reflects the normal blood volume and red blood cell (RBC) levels in infants. Choice A (19% to 32%) is too low for a healthy hematocrit level in a 12-month-old. Choice B (29% to 41%) is also below the typical range for a 12-month-old. Choice D (42% to 69%) includes an upper limit that is higher than expected for a healthy infant, making it an incorrect option.
4. An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department, and her arm placed in a cast. At 11 p.m., her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority?
- A. Notifying the doctor immediately
- B. Applying ice
- C. Elevating the arm
- D. Giving additional pain medication as ordered
Correct answer: A
Rationale: The correct action would be to notify the doctor immediately. Unrelenting pain despite medication can indicate compartment syndrome, which is a medical emergency requiring immediate attention. Applying ice or elevating the arm may not address the potential serious underlying issue of compartment syndrome. Giving additional pain medication without further assessment could delay necessary intervention and potentially worsen the condition.
5. The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?
- A. Absence of a urethral opening is noted
- B. Penis appears shorter than usual for age
- C. The urethral opening is along the dorsal surface of the penis
- D. The urethral opening is along the ventral surface of the penis
Correct answer: D
Rationale: In hypospadias, the urethral opening is located along the ventral surface of the penis. This congenital condition results in the urethral meatus opening on the underside of the penis, rather than at the tip. Choice A is incorrect as there is typically a urethral opening present, though in an abnormal location. Choice B is not a characteristic feature of hypospadias. Choice C is incorrect as the urethral opening in hypospadias is not along the dorsal surface but rather along the ventral surface of the penis.
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