HESI LPN
Pediatrics HESI 2023
1. What is an important nursing responsibility when a dysrhythmia is suspected?
- A. order an immediate electrocardiogram
- B. count the radial pulse every 1 minute for five times
- C. count the apical pulse for 1 full minute, and compare the rate with the radial pulse rate
- D. have someone else take the radial pulse simultaneously with the apical pulse
Correct answer: C
Rationale: When a dysrhythmia is suspected, an important nursing responsibility is to count the apical pulse for 1 full minute and then compare this rate with the radial pulse rate. This method helps in identifying dysrhythmias as it allows for a direct comparison of the heart's rhythm at two different pulse points. Ordering an immediate electrocardiogram (Choice A) may be necessary but should not be the first step. Counting the radial pulse multiple times (Choice B) is not as accurate as comparing rates directly. Having someone else take the radial pulse simultaneously (Choice D) may introduce errors and inconsistencies in the measurement.
2. After eating, a child with a diagnosis of gastroesophageal reflux disease (GERD) should be placed in what position as recommended by the nurse?
- A. Supine
- B. Prone
- C. Semi-Fowler's
- D. Trendelenburg
Correct answer: C
Rationale: Placing the child in a semi-Fowler's position after eating is beneficial for reducing symptoms of gastroesophageal reflux. This position helps prevent gastric contents from flowing back into the esophagus. The supine position (choice A) may worsen reflux symptoms by allowing gravity to assist in reflux, leading to discomfort and regurgitation. Prone position (choice B) is not recommended after eating as it may cause discomfort and increase the risk of aspiration due to pressure on the stomach. Trendelenburg position (choice D), with the head lower than the rest of the body, is not indicated for managing GERD after eating and may not provide the desired benefits in this context.
3. What should the nurse include when teaching an adolescent about tinea pedis?
- A. Keep your feet moist and open to the air as much as possible.
- B. Dry the area between your toes thoroughly.
- C. Wear nylon or synthetic socks every day.
- D. Go barefoot when you are in the school locker room.
Correct answer: B
Rationale: The correct way to prevent tinea pedis is by keeping the feet dry, especially between the toes, to decrease the risk of fungal infection. Choice A is incorrect as keeping the feet moist can promote fungal growth. Choice C is incorrect because nylon or synthetic socks can trap moisture, contributing to the growth of fungi. Choice D is incorrect as going barefoot in public, especially in areas like locker rooms, increases the risk of contracting tinea pedis.
4. A healthcare professional is teaching parents about why most children should be immunized against varicella (chickenpox) and why some receiving specific medications should not. Which medication should be included in the discussion?
- A. Insulin
- B. Steroids
- C. Antibiotics
- D. Anticonvulsants
Correct answer: B
Rationale: The correct answer is B: Steroids. Children receiving steroids should not receive the varicella vaccine as it can increase the risk of severe infection due to the immunosuppressive effects of steroids. Insulin (Choice A) is not a medication that contraindicates varicella vaccination. Antibiotics (Choice C) and anticonvulsants (Choice D) are also not medications that would impact the decision to immunize against varicella.
5. Why should the nurse closely monitor the IV flow rate for a 5-month-old infant with severe diarrhea receiving IV fluids?
- A. Limiting output
- B. Replacing lost fluids
- C. Avoiding IV infiltration
- D. Preventing cardiac overload
Correct answer: D
Rationale: The correct answer is D: Preventing cardiac overload. Infants are highly vulnerable to fluid overload, making it essential to carefully monitor IV flow rates to prevent complications such as cardiac overload. Rapid administration of IV fluids can lead to an excessive increase in circulating volume, potentially causing cardiac strain or heart failure in infants. Choices A, B, and C are incorrect. Monitoring the IV flow rate is not primarily aimed at limiting output, replacing lost fluids, or avoiding IV infiltration in this scenario. The key concern is to prevent the risk of cardiac overload due to the infant's susceptibility to fluid imbalances.
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