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. When a mother confides in the nurse that she is contemplating divorce, which suggestion by the nurse would help minimize the effects on the child?
- A. Tell the child together using appropriate terms.
- B. Reassure the child that no one loves him more than his parents.
- C. Engage in special activities with the child to compensate for the divorce.
- D. Discuss your feelings with the child.
Correct answer: A
Rationale: The correct answer is A. It is essential for both parents to inform the child about the divorce together, using age-appropriate language. This approach can help minimize the negative impact on the child by providing a sense of unity and understanding. Choice B is incorrect because offering false reassurance about love may not address the child's concerns effectively, as the situation is complex. Choice C is not suitable as engaging in special activities cannot substitute for the emotional stability that the child may lose due to the divorce. Choice D is incorrect because sharing the parent's feelings may burden the child with adult emotions, which could be overwhelming and confusing for their developmental stage.
3. When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?
- A. Skeletal traction
- B. Physical therapy
- C. Orthotics
- D. Occupational therapy
Correct answer: A
Rationale: In caring for a child with cerebral palsy, skeletal traction is least likely to be a part of the treatment plan. Cerebral palsy is a neurological disorder affecting movement and muscle coordination, and skeletal traction, which involves applying a pulling force on a bone to correct alignment, is not a common intervention for this condition. Physical therapy, orthotics, and occupational therapy are more commonly used in the management of cerebral palsy. Physical therapy helps improve mobility and strength, orthotics assist in supporting and aligning the body, and occupational therapy focuses on enhancing daily living skills and independence. Therefore, skeletal traction is the least likely treatment option among the choices provided.
4. A child has undergone surgery using steel bar placement to correct pectus excavatum. What position would the nurse instruct the parents to avoid?
- A. Semi-Fowler
- B. Supine
- C. High Fowler
- D. Side-lying
Correct answer: D
Rationale: The correct answer is D: Side-lying. After surgery using steel bar placement to correct pectus excavatum, the nurse should instruct the parents to avoid placing the child in a side-lying position. This position should be avoided to prevent displacement of the steel bar. Choices A, B, and C are incorrect. Semi-Fowler, Supine, and High Fowler positions are generally safe and commonly used in postoperative care, but in this specific case, side-lying should be avoided to ensure the effectiveness of the surgical correction.
5. At 0345, you receive a call for a woman in labor. Upon arriving at the scene, you are greeted by a very anxious man who tells you that his wife is having her baby 'now.' This man escorts you into the living room where a 25-year-old woman is lying on the couch in obvious pain. Which of the following statements regarding crowning is true?
- A. Crowning represents the end of the second stage of labor.
- B. Crowning always occurs immediately after the amniotic sac has ruptured.
- C. It is safe to transport the patient during crowning if the hospital is close.
- D. Gentle pressure should be applied to the baby's head during crowning.
Correct answer: D
Rationale: During crowning, it is essential to apply gentle pressure to the baby's head to prevent rapid delivery, which can lead to potential injuries to both the mother and the baby. Choice A is incorrect because crowning signifies the beginning, not the end, of the second stage of labor. Choice B is incorrect as crowning can occur before or after the amniotic sac ruptures. Choice C is incorrect as transporting the patient during crowning, even if the hospital is close, can be unsafe due to the risk of rapid delivery and complications.
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