HESI LPN
Pediatric HESI 2023
1. The parents of an infant ask the nurse why their baby is scheduled to receive the intramuscular polio vaccine rather than the oral vaccine. What is the nurse’s best response?
- A. The American Academy of Pediatrics recommends the intramuscular vaccine because it is safer.
- B. The consensus is that either can be used, since both produce the same results and are equally safe.
- C. The oral vaccine is more expensive, so the intramuscular vaccine is preferred unless it is 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 because it has a better safety profile compared to the oral vaccine. Choice B is incorrect because the AAP specifically recommends the intramuscular vaccine over the oral vaccine. Choice C is incorrect as cost is not the primary reason for preferring the intramuscular vaccine. Choice D is incorrect as the recommendation is based on safety rather than the immunocompromised status of the infant or family members.
2. A child with sickle cell anemia develops severe chest pain, fever, a cough, and dyspnea. What should the nurse do first?
- A. Administer 100% oxygen to relieve hypoxia
- B. Administer pain medication to relieve symptoms
- C. Notify the practitioner because chest syndrome is suspected
- D. Notify the practitioner because the child may be having a stroke
Correct answer: C
Rationale: The correct action to take first when a child with sickle cell anemia presents with severe chest pain, fever, cough, and dyspnea is to notify the practitioner because acute chest syndrome is suspected. This condition is a medical emergency requiring prompt intervention. Administering oxygen or pain medication may be necessary interventions but should not precede notifying the practitioner. Stroke is not typically associated with these symptoms in sickle cell anemia.
3. A parent brings an 18-month-old toddler to the clinic. The parent states, 'My child is so difficult to please, has temper tantrums, and annoys me by throwing food from the table.' What is the nurse’s best response?
- A. “Toddlers need discipline to prevent the development of antisocial behaviors.â€
- B. “Toddlers are learning to assert independence, and this behavior is expected at this age.â€
- C. “It is best to leave the toddler alone in the crib after calmly explaining why the behavior is unacceptable.â€
- D. “This is the way a toddler expresses needs, and this behavior is acceptable during the initiative stage of development.â€
Correct answer: B
Rationale: The correct answer is B: “Toddlers are learning to assert independence, and this behavior is expected at this age.†At 18 months, toddlers are in the stage of developing autonomy and independence. They may exhibit behaviors like temper tantrums and defiance as they assert their independence and test limits. It is crucial for parents and caregivers to understand that these behaviors are typical for toddlers at this age. Choice A is incorrect because discipline should be age-appropriate and focus on positive reinforcement rather than preventing antisocial behaviors. Choice C is inappropriate as leaving a toddler alone in a crib after explaining unacceptable behavior is not a recommended approach and can lead to feelings of abandonment. Choice D is inaccurate as the described behavior is more related to asserting independence rather than the initiative stage of development.
4. A nurse plans to talk to the parents of a toddler about toilet training. What should the nurse explain is the most important factor in the process of toilet training?
- A. Parents’ attitude towards it
- B. Child’s motivation to remain dry
- C. Child’s ability to sit independently on the toilet
- D. Parents’ commitment to work on the toilet training
Correct answer: D
Rationale: The most crucial factor in successful toilet training is the parents' commitment to consistently work with their child. While parents' attitude and willingness are important, the key is their dedication to the process. The child's motivation and ability are also significant but rely heavily on parental guidance and support. Therefore, the correct choice is the parents' commitment to work on toilet training.
5. A 6-year-old child comes to the school nurse reporting a sore throat, and the nurse verifies that the child has a fever and a red, inflamed throat. When a parent of the child arrives at school to take the child home, the nurse urges the parent to seek treatment. The nurse is aware that the causative agent may be beta-hemolytic streptococcus, and the illness may progress to inflamed joints and an infection in the heart. What illness is of most concern to the nurse?
- A. Tetanus
- B. Influenza
- C. Scarlet fever
- D. Rheumatic fever
Correct answer: D
Rationale: The correct answer is D, Rheumatic fever. Rheumatic fever can develop as a complication of untreated strep throat caused by beta-hemolytic streptococcus. It is characterized by inflamed joints and can lead to serious complications such as heart infections. Tetanus (choice A) is caused by a bacterial toxin affecting the nervous system, Influenza (choice B) is a viral respiratory illness, and Scarlet fever (choice C) is also caused by streptococcus but is characterized by a sandpaper-like rash and strawberry tongue. However, in the scenario described, the nurse is most concerned about the child developing rheumatic fever due to the potential serious consequences associated with it.
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