HESI LPN
Pediatrics HESI 2023
1. The healthcare provider notes that a child has lost 8 pounds after 4 days of hospitalization for acute glomerulonephritis. This is most likely the result of
- A. poor appetite
- B. increased potassium intake
- C. reduction of edema
- D. restriction to bed rest
Correct answer: C
Rationale: In acute glomerulonephritis, weight loss is most likely due to the reduction of edema. Edema is a common symptom of glomerulonephritis, which causes fluid retention and swelling in the body. As treatment progresses and the condition improves, the reduction of edema leads to weight loss. Choices A, B, and D are incorrect as they do not directly address the underlying pathophysiology of acute glomerulonephritis and its impact on weight loss.
2. A child with a diagnosis of cystic fibrosis is admitted to the hospital. What is the priority nursing intervention?
- A. Administering pancreatic enzymes
- B. Providing respiratory therapy
- C. Providing nutritional support
- D. Encouraging physical activity
Correct answer: A
Rationale: The correct answer is administering pancreatic enzymes. In cystic fibrosis, there is a deficiency in pancreatic enzymes, leading to poor digestion and malabsorption of nutrients. Administering pancreatic enzymes is essential to ensure proper digestion and absorption of nutrients. Providing respiratory therapy and nutritional support are important aspects of care for a child with cystic fibrosis, but addressing the pancreatic enzyme deficiency takes priority in this scenario. Encouraging physical activity is beneficial for overall health but is not the priority intervention in this case.
3. A 6-year-old child with asthma is admitted to the hospital with an acute exacerbation. What is the priority nursing intervention?
- A. Administering a bronchodilator
- B. Administering an antihistamine
- C. Administering a corticosteroid
- D. Administering oxygen
Correct answer: A
Rationale: Administering a bronchodilator is the priority intervention for a child experiencing an acute asthma exacerbation. Bronchodilators help to dilate the airways quickly, providing immediate relief by opening up the narrowed air passages in asthma. Antihistamines are not the first-line treatment for asthma exacerbations and may not address the underlying bronchoconstriction. Corticosteroids are important for long-term control of asthma but may take longer to have an effect compared to bronchodilators. Administering oxygen is essential for hypoxemia in asthma exacerbations, but the priority is to relieve bronchoconstriction promptly with a bronchodilator.
4. Parents of a sick infant talk with a nurse about their baby. One parent says, “I am so upset; I didn’t realize our baby was ill.” What major indication of illness in an infant should the nurse explain to the parent?
- A. Grunting respirations
- B. Excessive perspiration
- C. Longer periods of sleep
- D. Crying immediately after feedings
Correct answer: C
Rationale: Longer periods of sleep than usual can be a sign of illness in infants. When an infant sleeps more than usual, it may indicate that the baby is conserving energy due to an underlying condition. Grunting respirations (choice A) can be a sign of respiratory distress, excessive perspiration (choice B) may indicate overheating or fever, and crying immediately after feedings (choice D) can be a sign of gastrointestinal discomfort, such as colic or reflux. However, in this scenario, the emphasis is on changes in sleep patterns as a potential indicator of illness.
5. The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching?
- A. We should avoid aspirin and medications like ibuprofen.
- B. He can resume participation in football in 2 weeks.
- C. Swimming would be a great activity.
- D. Our son cannot take any antihistamines.
Correct answer: B
Rationale: Choice B indicates a need for further teaching because participation in contact sports like football should be avoided in children with idiopathic thrombocytopenia due to the increased risk of bleeding. Choices A, C, and D are correct. Avoiding aspirin and medications like ibuprofen helps prevent bleeding complications. Swimming is a safe physical activity that can be recommended. Antihistamines do not pose a significant risk in this case and can be used if needed.
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