HESI LPN
Pediatric HESI 2024
1. The nurse is assessing a 9-year-old girl with a history of tuberculosis at age 6 years. She has been losing weight and has no appetite. The nurse suspects Addison disease based on which assessment findings?
- A. Arrested height and increased weight
- B. Thin, fragile skin and multiple bruises
- C. Hyperpigmentation and hypotension
- D. Blurred vision and enuresis
Correct answer: C
Rationale: The correct answer is C: Hyperpigmentation and hypotension. These findings are classic signs of Addison disease, caused by adrenal insufficiency. Hyperpigmentation results from increased ACTH stimulating melanin production, and hypotension occurs due to mineralocorticoid deficiency. Choices A, B, and D are incorrect. Arrested height and increased weight are not typical of Addison disease. Thin, fragile skin and multiple bruises are seen in conditions like Cushing's syndrome, not Addison disease. Blurred vision and enuresis are not characteristic symptoms of Addison disease.
2. The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the healthcare provider to order?
- A. Corticosteroids.
- B. Antifungals.
- C. Antibiotics.
- D. Retinoids.
Correct answer: B
Rationale: Antifungal agents are the appropriate treatment for candidal diaper rash as it is a fungal infection. Corticosteroids, antibiotics, and retinoids are not indicated for this condition. Corticosteroids may worsen fungal infections, antibiotics are used for bacterial infections, and retinoids are typically used for acne and skin conditions unrelated to candidal diaper rash.
3. What information should be included in the preoperative plan of care for an infant with myelomeningocele?
- A. Positioning the infant supine with a pillow under the buttocks
- B. Covering the sac with saline-soaked nonadhesive gauze
- C. Wrapping the infant snugly in a blanket
- D. Applying a diaper to prevent fecal soiling of the sac
Correct answer: B
Rationale: Covering the sac with saline-soaked nonadhesive gauze is essential in the preoperative care of an infant with myelomeningocele. This practice helps prevent infection and maintains moisture around the sac before surgery, promoting optimal healing outcomes. Positioning the infant supine with a pillow under the buttocks may be uncomfortable and unnecessary. Wrapping the infant snugly in a blanket does not address the specific care needs of the myelomeningocele. Applying a diaper over the sac can increase the risk of infection and should be avoided in this case.
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. The nurse is preparing a presentation to a local community group about genetic disorders and the types of congenital anomalies that can occur. What would the nurse include as a major congenital anomaly?
- A. Overlapping digits
- B. Polydactyly
- C. Umbilical hernia
- D. Cleft palate
Correct answer: D
Rationale: Cleft palate is considered a major congenital anomaly because it involves a gap or split in the roof of the mouth, which can significantly impact feeding, speech development, dental health, and overall well-being. Overlapping digits (Choice A) and polydactyly (Choice B) are examples of limb abnormalities rather than major congenital anomalies affecting vital functions. Umbilical hernia (Choice C) is a common condition where abdominal organs protrude through the belly button and is typically not considered a major congenital anomaly in the same way as cleft palate.
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