which is instituted for the therapeutic management of minimal change nephrotic syndrome
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Nursing Elites

HESI LPN

Pediatric HESI 2023

1. What is the primary treatment for minimal change nephrotic syndrome?

Correct answer: A

Rationale: Corticosteroids are the mainstay of treatment for minimal change nephrotic syndrome due to their immunosuppressive effects, which help reduce proteinuria and control the disease progression. Antihypertensive agents are not the primary treatment for this condition and are typically used to manage hypertension that may result from nephrotic syndrome. Long-term diuretics are not indicated in the treatment of minimal change nephrotic syndrome as they do not address the underlying cause. Increasing fluids to promote diuresis is not a recommended treatment for minimal change nephrotic syndrome, as it can exacerbate edema and fluid overload in these patients.

2. The healthcare professional is preparing a presentation to a local community group about genetic disorders and the types of congenital anomalies that can occur. What would the professional include as a major congenital anomaly?

Correct answer: D

Rationale: Cleft palate is considered a major congenital anomaly due to its significant impact on feeding, speech, and overall health. Overlapping digits (Option A) are a physical anomaly but not typically considered a major congenital anomaly. Polydactyly (Option B) refers to having extra fingers or toes, which is a congenital anomaly but not as major as a cleft palate. Umbilical hernia (Option C) involves a protrusion of abdominal contents through the umbilical ring but is not typically classified as a major congenital anomaly compared to cleft palate.

3. What factor predisposes the urinary tract to infection in children?

Correct answer: B

Rationale: The short urethra in young girls is a significant factor that predisposes them to urinary tract infections. Girls have a shorter urethra than boys, making it easier for bacteria to travel up the urinary tract, leading to infections. Increased fluid intake (Choice A) is actually a preventive measure as it helps flush out bacteria from the urinary tract. Prostatic secretions in males (Choice C) do not predispose the urinary tract to infection in children. Frequent emptying of the bladder (Choice D) is also a good practice to prevent urinary tract infections by reducing the chances of bacterial growth in the urinary tract.

4. The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?

Correct answer: B

Rationale: Vomiting and poor appetite can be symptoms of neuroblastoma, a malignancy that affects the adrenal glands and sympathetic nervous system. A maculopapular rash on the palms (Choice A) is not typically associated with neuroblastoma. Irritability and poor weight gain (Choice C) may be non-specific findings and do not specifically point towards neuroblastoma. Auscultation findings of wheezing with diminished lung sounds (Choice D) are more indicative of respiratory conditions rather than neuroblastoma.

5. Based on developmental norms for a 5-year-old child, a healthcare professional decides to withhold a scheduled dose of digoxin (Lanoxin) elixir and notify the healthcare provider. Below what apical pulse did the healthcare professional withhold the medication?

Correct answer: C

Rationale: For a 5-year-old child, an apical pulse below 90 beats/min is an indicator to withhold digoxin. Digoxin is a medication that affects the heart, and in pediatric patients, monitoring the pulse rate is crucial due to the risk of bradycardia (slow heart rate) as a potential side effect. In this case, an apical pulse of 90 beats/min or lower indicates a heart rate that may be too slow for a child of this age, warranting the withholding of digoxin and prompt notification of the healthcare provider. Choices A, B, and D are not within the critical range specified for withholding digoxin in a 5-year-old child and would not necessitate withholding the medication.

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