HESI LPN
HESI Pediatrics Quizlet
1. A child with a cardiac malformation associated with left-to-right shunting is being cared for by a nurse. What does the nurse consider to be the major characteristic of this type of congenital disorder?
- A. Elevated hematocrit
- B. Severe growth retardation
- C. Clubbing of the fingers and toes
- D. Increased blood flow to the lungs
Correct answer: D
Rationale: The major characteristic of a cardiac malformation associated with left-to-right shunting is increased blood flow to the lungs. This increased flow can lead to pulmonary hypertension and heart failure if left untreated. Elevated hematocrit (Choice A) is not a typical characteristic of this condition. Severe growth retardation (Choice B) is not directly associated with left-to-right shunting. Clubbing of the fingers and toes (Choice C) is more commonly seen in conditions involving chronic hypoxia.
2. 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.
3. A home care nurse is visiting a family for the first time. The 4-week-old infant had surgery for exstrophy of the bladder and creation of an ileal conduit soon after birth. When the nurse arrives, the mother appears tired, and the baby is crying. After an introduction, which is the most appropriate statement by the nurse?
- A. “Tell me about your daily routine.â€
- B. “You look tired. Is everything alright?â€
- C. “When was the last time the baby had a bottle?â€
- D. “Oh, it looks like you two are having a bad day.â€
Correct answer: A
Rationale: Asking about the daily routine is the most appropriate statement by the nurse in this scenario. It allows the nurse to gather important information about the family's schedule, feeding patterns, and overall care routine for the infant. This open-ended question helps the nurse assess the family's situation comprehensively and identify any areas where support may be needed. Choices B, C, and D are less appropriate as they do not focus on gathering relevant information about the family's routine and needs but rather make assumptions or ask about specific isolated events.
4. A child is being assessed for suspected appendicitis. What clinical manifestation is the healthcare professional likely to observe?
- A. Right lower quadrant pain
- B. Left lower quadrant pain
- C. Rebound tenderness
- D. Epigastric pain
Correct answer: A
Rationale: Right lower quadrant pain is a classic symptom of appendicitis. The appendix is typically located in the right lower quadrant of the abdomen, so pain in this area is commonly associated with appendicitis. Choices B, C, and D are incorrect because left lower quadrant pain, rebound tenderness, and epigastric pain are not typical manifestations of appendicitis. Left lower quadrant pain is not associated with appendicitis since the appendix is situated in the right lower quadrant. Rebound tenderness is more commonly linked with peritonitis rather than appendicitis. Epigastric pain is not a typical presentation of appendicitis as the pain is usually localized to the right lower quadrant.
5. What factor predisposes the urinary tract to infection in children?
- A. increased fluid intake
- B. short urethra in young girls
- C. prostatic secretions in males
- D. frequent emptying of the bladder
Correct answer: B
Rationale: The short urethra in young girls predisposes them to urinary tract infections. In young girls, the proximity of the urethra to the anus and the shorter urethra compared to boys make it easier for bacteria to travel up the urinary tract, increasing the risk of infection. Increased fluid intake and frequent emptying of the bladder are actually helpful in preventing urinary tract infections by flushing out bacteria. Prostatic secretions in males are not a factor in predisposing the urinary tract to infection in children.
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