HESI LPN
Pediatric HESI 2024
1. A group of students is reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration.
- A. Lispro
- B. Regular
- C. NPH
- D. Glargine
Correct answer: D
Rationale: The correct answer is Glargine (Lantus) as it has the longest duration of action among the insulins listed, lasting 12 to 24 hours. Lispro (Humalog) and Regular (short-acting) insulins have shorter durations of action, typically lasting 3 to 6 hours. NPH (Neutral Protamine Hagedorn) insulin has an intermediate duration of action, lasting around 12 to 18 hours. Therefore, choices A, B, and C are incorrect in the context of insulin duration.
2. A nurse is teaching the parents of a child with a diagnosis of epilepsy about seizure precautions. What should the nurse include in the teaching?
- A. Keep a diary of seizure activity
- B. Administer antiepileptic medication only when a seizure occurs
- C. Restrict the child's activities to prevent seizures
- D. Teach seizure first aid to family members
Correct answer: D
Rationale: Teaching seizure first aid to family members is essential as it empowers them to respond effectively during a seizure. Keeping a diary of seizure activity is important for tracking patterns and triggers but is not directly related to immediate safety. Administering antiepileptic medication only when a seizure occurs is not recommended as medications should be administered as prescribed by healthcare providers. Restricting the child's activities to prevent seizures is not appropriate as children with epilepsy should be encouraged to lead active lives while taking necessary precautions.
3. What should be included in the teaching plan for parents of an infant diagnosed with phenylketonuria (PKU)?
- A. Mental retardation occurs if PKU is untreated.
- B. Testing for PKU is done immediately after birth.
- C. Treatment for PKU includes lifelong dietary management.
- D. PKU is transmitted as an autosomal recessive trait.
Correct answer: A
Rationale: The correct answer is A: 'Mental retardation occurs if PKU is untreated.' Phenylketonuria (PKU) is a metabolic disorder that results in the inability to metabolize phenylalanine properly. Without proper dietary management, high levels of phenylalanine can lead to severe mental retardation and other neurological problems. Therefore, educating parents about the importance of early and consistent treatment to prevent mental retardation is crucial. Choice B is incorrect because testing for PKU is typically done shortly after birth, not immediately. Choice C is incorrect because treatment for PKU primarily involves strict dietary management to control phenylalanine intake, not lifelong medications. Choice D is incorrect because PKU is inherited in an autosomal recessive pattern, not as an autosomal dominant gene.
4. What is the most important intervention for a nurse to implement for a child with sickle cell anemia admitted to the hospital during a vaso-occlusive crisis?
- A. Administering oxygen
- B. Ensuring adequate hydration
- C. Monitoring vital signs
- D. Administering pain medication
Correct answer: B
Rationale: Ensuring adequate hydration is crucial during a vaso-occlusive crisis in sickle cell anemia as it helps to reduce the viscosity of the blood and prevent further sickling of the cells. While administering oxygen may be necessary in some cases, ensuring hydration takes precedence as it directly impacts the underlying pathophysiology of the crisis. Monitoring vital signs is important for ongoing assessment but does not directly address the crisis as hydration does. Administering pain medication is important for pain relief but does not address the primary issue of vaso-occlusion and is not the most crucial intervention in this scenario.
5. Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. Management should include
- A. oxygen, uterine massage, and transport
- B. oxygen, placement on the left side, and transport
- C. oxygen, treatment for shock, and uterus massage during transport
- D. oxygen, internal vaginal pads, and treatment of shock during transport
Correct answer: C
Rationale: Postpartum hemorrhage can lead to shock due to excessive bleeding. Oxygen should be provided to support oxygenation. Treatment for shock, which includes maintaining vital signs and perfusion, is crucial. Uterine massage helps prevent further bleeding by promoting uterine contraction. This combination of interventions is essential for managing postpartum hemorrhage effectively. Choices A, B, and D lack the comprehensive approach needed for managing postpartum hemorrhage, as they do not address the treatment of shock, which is vital in this scenario.
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