HESI LPN
Pediatric HESI 2023
1. Why is the infant scheduled to receive the intramuscular polio vaccine instead of the oral vaccine, as asked by the parents?
- A. The American Academy of Pediatrics recommends the intramuscular vaccine because it is safer.
- B. Both vaccines produce the same results and are equally safe, according to consensus.
- C. The intramuscular vaccine is preferred over the oral vaccine due to cost considerations, unless contraindicated.
- D. The U.S. Centers for Disease Control and Prevention recommends the intramuscular vaccine unless the infant or a family member is immunocompromised.
Correct answer: A
Rationale: The American Academy of Pediatrics recommends the intramuscular polio vaccine over the oral vaccine due to its superior safety profile. Intramuscular administration ensures better immunogenicity and protection against poliovirus. Choice B is incorrect as the intramuscular vaccine is preferred for safety reasons. Choice C is incorrect because the recommendation is based on safety, not cost. Choice D is incorrect as the CDC recommendation is not solely based on immunocompromised status but rather on the overall safety and efficacy of the vaccine.
2. A nurse is caring for an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS). What is most important for the nurse to assess?
- A. Quality of the cry
- B. Signs of dehydration
- C. Coughing up feedings
- D. Characteristics of the stool
Correct answer: B
Rationale: The correct answer is B: Signs of dehydration. Infants with hypertrophic pyloric stenosis (HPS) are at high risk of dehydration due to frequent vomiting. Assessing for signs of dehydration, such as decreased urine output, dry mucous membranes, and sunken fontanelles, is crucial for early intervention and management. Choices A, C, and D are not the most critical assessments for HPS. The quality of the cry (choice A) may not provide as much relevant information in this case. Coughing up of feedings (choice C) may be a symptom but is not as crucial as assessing for dehydration. Characteristics of the stool (choice D) are important but assessing for signs of dehydration takes precedence due to the immediate risk it poses to the infant's health.
3. A nurse on the pediatric unit is observing the developmental skills of several 2-year-old children in the playroom. Which child should the nurse continue to evaluate?
- A. Cannot stand on one foot
- B. Builds a tower of 7 blocks
- C. Uses echolalia when speaking
- D. Colors outside the lines of a picture
Correct answer: C
Rationale: The correct answer is C. Using echolalia, which is the repetition of words or phrases, is not typical for a 2-year-old child and may indicate the need for further evaluation. Choices A, B, and D are all within the expected developmental skills for a 2-year-old. While most 2-year-olds may not be able to stand on one foot, it is not a cause for concern at this age. Building a tower of 7 blocks and coloring outside the lines of a picture are both appropriate for a 2-year-old's developmental skills.
4. A healthcare professional is preparing to administer an oral medication to a 4-year-old child. What is the best approach to gain the child's cooperation?
- A. Explain the importance of the medication to the child
- B. Allow the child to play with a favorite toy while taking the medication
- C. Offer a reward after the medication is taken
- D. Give the medication mixed with a small amount of the child's favorite food
Correct answer: B
Rationale: Allowing the child to play with a favorite toy while taking the medication is the best approach to gain cooperation. This strategy can help distract and calm the child during the medication administration process. Choice A may not be as effective with a young child who may not fully understand the explanation. Offering a reward (choice C) may reinforce negative behavior and create a dependency on rewards for cooperation. Giving the medication with food (choice D) may not always be appropriate and may not address the cooperation aspect.
5. 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.
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