HESI LPN
Pediatrics HESI 2023
1. What should the nurse recommend to reduce the risk of sudden infant death syndrome (SIDS) in a 6-month-old infant?
- A. Place the infant on their back to sleep
- B. Use a pacifier during sleep
- C. Have the infant sleep on their side
- D. Keep the infant's room cool
Correct answer: A
Rationale: Placing the infant on their back to sleep is the correct recommendation to reduce the risk of sudden infant death syndrome (SIDS). This sleep position has been shown to significantly decrease the incidence of SIDS. Using a pacifier during sleep (Choice B) can also help reduce the risk, but it is secondary to the back sleeping position. Having the infant sleep on their side (Choice C) is not recommended, as it increases the risk of SIDS. Keeping the infant's room cool (Choice D) may provide a comfortable sleeping environment but does not directly reduce the risk of SIDS.
2. In planning care for a 7-year-old boy with diabetes insipidus, what is the priority nursing diagnosis?
- A. Deficient fluid volume related to dehydration
- B. Excess fluid volume related to edema
- C. Deficient knowledge related to fluid intake regimen
- D. Imbalanced nutrition, more than body requirements related to excess weight
Correct answer: A
Rationale: The priority nursing diagnosis for a 7-year-old boy with diabetes insipidus is deficient fluid volume related to dehydration. Diabetes insipidus leads to excessive urination and fluid loss, which can result in dehydration. This diagnosis should take precedence as restoring fluid balance is crucial in managing this condition. Choices B, C, and D are less of a priority in this case. Excess fluid volume related to edema is not typically associated with diabetes insipidus. Deficient knowledge about fluid intake and imbalanced nutrition related to excess weight may be important but addressing the dehydration and fluid volume deficit is the most critical aspect in the immediate care of a child with diabetes insipidus.
3. Following corrective surgery for hypertrophic pyloric stenosis (HPS), an infant is returned to the pediatric unit with an IV infusion in place. What is the priority nursing action?
- A. Apply adequate restraints.
- B. Administer a mild sedative.
- C. Assess the IV site for infiltration.
- D. Attach the nasogastric tube to wall suction.
Correct answer: C
Rationale: The priority nursing action after a corrective surgery for hypertrophic pyloric stenosis (HPS) is to assess the IV site for infiltration. This is crucial to ensure proper fluid administration and prevent complications such as extravasation or infiltration. Applying restraints (Choice A) is not indicated in this scenario and can compromise the infant's comfort and safety. Administering a mild sedative (Choice B) is not necessary and should only be done based on specific clinical indications. Attaching the nasogastric tube to wall suction (Choice D) may be important for certain conditions but is not the priority immediately post-surgery; assessing the IV site is more urgent to prevent potential complications related to IV therapy.
4. A premature infant with respiratory distress syndrome (RDS) receives artificial surfactant. How does the nurse explain surfactant therapy to the parents?
- A. Surfactant improves the ability of your baby’s lungs to exchange oxygen and carbon dioxide.
- B. The drug prevents your baby from requiring excessive sedation.
- C. Surfactant is used to reduce episodes of periodic apnea.
- D. Your baby needs this medication to combat a potential respiratory tract infection.
Correct answer: A
Rationale: The correct answer is A. Surfactant therapy is explained to parents as a treatment that enhances the lungs' ability to exchange oxygen and carbon dioxide. This is essential for premature infants with respiratory distress syndrome (RDS) as it helps improve their respiratory function. Choices B, C, and D are incorrect because surfactant therapy primarily focuses on addressing lung function and is not related to sedation, apnea reduction, or fighting respiratory tract infections.
5. A nurse is evaluating a 3-year-old child’s developmental progress. The inability to perform which task indicates to the nurse that there is a developmental delay?
- A. Copying a square
- B. Hopping on one foot
- C. Catching a ball reliably
- D. Using a spoon effectively
Correct answer: A
Rationale: The correct answer is A: Copying a square. At 3 years old, children should be able to copy a square as part of their fine motor skill development. The inability to perform this task may indicate a developmental delay in fine motor skills. Choice B, hopping on one foot, typically develops around 4-5 years of age, so it is not a reliable indicator of a delay at 3. Choice C, catching a ball reliably, involves coordination skills that develop later in childhood, making it less relevant for a 3-year-old assessment. Choice D, using a spoon effectively, is more related to self-care and feeding skills rather than fine motor development, so it is not the best indicator of a developmental delay in this context.
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