HESI LPN
Pediatric HESI 2023
1. .A nurse is performing a physical examination on an infant with Down syndrome. For what anomaly should the nurse assess the child?
- A. Bulging fontanels
- B. Stiff lower extremities
- C. Abnormal heart sounds
- D. Unusual pupillary reactions
Correct answer: C
Rationale: Abnormal heart sounds could indicate a congenital heart defect, which is common in infants with Down syndrome.
2. .A child with type 1 diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?
- A. Monitor blood glucose levels once a day
- B. Follow a strict meal plan
- C. Administer insulin only when blood glucose is high
- D. Recognize signs of hypoglycemia
Correct answer: D
Rationale: Recognizing signs of hypoglycemia is crucial for managing type 1 diabetes mellitus and preventing complications.
3. The nurse is conducting a physical examination of a 9-month-old baby with a flat, discolored area on the skin. The nurse documents this as a:
- A. Papule
- B. Macule
- C. Vesicle
- D. Scale
Correct answer: B
Rationale: A macule is defined as a flat, discolored area on the skin that is different from surrounding tissue due to a change in color. In this case, the baby has a flat, discolored area on the skin, which fits the description of a macule. A papule is a small, raised solid bump, a vesicle is a small fluid-filled blister, and a scale is a flake of skin that is often dry and rough. Therefore, choices A, C, and D do not accurately describe the flat, discolored area on the baby's skin, making them incorrect.
4. The nurse is reviewing the laboratory test results of a child with Addison's disease. What would the nurse expect to find?
- A. Hypernatremia
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hypercalcemia
Correct answer: B
Rationale: In Addison's disease, adrenal insufficiency leads to decreased aldosterone production. This results in impaired sodium retention and potassium excretion, leading to hyperkalemia. Therefore, the correct answer is hyperkalemia (choice B). Hypernatremia (choice A) is less likely because of the loss of sodium in Addison's disease. Hyperglycemia (choice C) and hypercalcemia (choice D) are not typically associated with Addison's disease and are less likely to be present in this condition.
5. You are called to a residence for a "sick" 5-year-old child. When you arrive and begin your assessment, you note that the child is unconscious with a respiratory rate of 8 breaths/min and a heart rate of 50 beats/min. Management of this child should consist of
- A. 100% oxygen via a non-rebreathing mask and rapid transport
- B. positive pressure ventilations with a BVM device and rapid transport
- C. chest compressions, artificial ventilations, and rapid transport
- D. back blows and chest thrusts while attempting artificial ventilations
Correct answer: C
Rationale: In a pediatric patient with an unconscious state, a respiratory rate of 8 breaths/min, and a heart rate of 50 beats/min, the appropriate management involves chest compressions, artificial ventilations, and rapid transport. These signs indicate severe respiratory and circulatory compromise, requiring immediate intervention to support breathing and circulation. Choice A (100% oxygen via a non-rebreathing mask) is not sufficient in this critical situation as the child requires more than just oxygen supplementation. Choice B (positive pressure ventilations with a BVM device) may be needed, but chest compressions are crucial in this scenario due to the presence of bradycardia. Choice D (back blows and chest thrusts) are not indicated for an unconscious child with respiratory and circulatory compromise; instead, immediate chest compressions are necessary to provide circulatory support.
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