HESI LPN
Pediatric HESI 2023
1. What should the nurse advise the parents of a child with asthma on preventing asthma attacks?
- A. Avoid exposure to allergens
- B. Encourage regular exercise
- C. Provide a high-protein diet
- D. Increase fluid intake
Correct answer: A
Rationale: The correct answer is to advise the parents to avoid exposure to allergens. Asthma attacks are commonly triggered by allergens such as pollen, dust mites, pet dander, and mold. By minimizing the child's contact with these triggers, the likelihood of asthma attacks can be reduced. Encouraging regular exercise can be beneficial for overall health but may not directly prevent asthma attacks. Providing a high-protein diet and increasing fluid intake are important for general health but are not specific preventive measures for asthma attacks.
2. 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, making breathing easier and relieving acute symptoms of asthma. Antihistamines are not the first-line treatment for asthma exacerbations; they are more commonly used for allergic reactions. Corticosteroids are beneficial in reducing inflammation in asthma but are usually administered after bronchodilators to provide long-term control. Oxygen therapy may be necessary in severe cases of asthma exacerbation, but bronchodilators take precedence in improving airway patency and respiratory distress.
3. After surgery to correct hypertrophic pyloric stenosis (HPS) in a 3-week-old infant who had been formula-fed, which postoperative feeding order is appropriate?
- A. Thickened formula 24 hours after surgery
- B. Withholding feedings for the first 24 hours
- C. Regular formula feeding within 24 hours after surgery
- D. Additional glucose feedings as desired after the first 24 hours
Correct answer: C
Rationale: After surgery for hypertrophic pyloric stenosis (HPS), it is appropriate to resume regular formula feeding within 24 hours postoperatively to promote recovery. Choice A, thickened formula after surgery, may be too heavy for the infant's digestive system at this early stage. Withholding feedings for the first 24 hours (Choice B) is not recommended as early feeding helps with recovery. Additional glucose feedings (Choice D) are not necessary and may not provide the balanced nutrition required after surgery.
4. Your assessment of a mother in active labor reveals that a limb is protruding from the vagina. Management of this condition should include:
- A. Positioning the mother in a semi-Fowler's position, administering oxygen, and providing transport
- B. Positioning the mother in a head-down position with her hips elevated, administering oxygen, and providing transport
- C. Applying gentle traction to the protruding limb to remove pressure of the fetus from the umbilical cord
- D. Giving the mother 100% oxygen and attempting to manipulate the protruding limb so that delivery can occur
Correct answer: B
Rationale: In a situation where a limb is protruding from the vagina during active labor, the correct management includes positioning the mother in a head-down position with her hips elevated. This position helps relieve pressure on the umbilical cord and improves oxygenation to the fetus. Administering oxygen is important to ensure adequate oxygen supply to both the mother and the baby. Providing transport is necessary for prompt transfer to a medical facility for further management. Applying gentle traction to the protruding limb is not recommended as it can cause harm to the baby and should be avoided. Giving 100% oxygen and attempting to manipulate the protruding limb is not the correct approach and can potentially lead to further complications.
5. When describing urticaria, what would an instructor include?
- A. It is a type IV hypersensitivity reaction.
- B. Histamine release leads to vasodilation.
- C. Wheals appear first followed by erythema.
- D. The nonpruritic rash blanches with pressure.
Correct answer: B
Rationale: The correct answer is B. Urticaria is a type I hypersensitivity reaction where histamine release leads to vasodilation and the formation of characteristic wheals. Choice A is incorrect as urticaria is associated with type I hypersensitivity, not type IV. Choice C is incorrect because in urticaria, erythema typically appears before the development of wheals. Choice D is incorrect as urticaria is typically pruritic and does not blanch with pressure.
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