HESI LPN
Pediatric HESI 2024
1. 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 uterine massage during transport
- D. Oxygen, internal vaginal pads, and treatment for shock during transport
Correct answer: C
Rationale: In this scenario, the 21-year-old mother is showing signs of hemorrhagic shock with increased heart rate, diaphoresis, and vaginal bleeding. The appropriate management includes providing oxygen to support tissue perfusion, treating for shock to restore adequate circulation, and performing uterine massage to help control bleeding during transport. Options A, B, and D do not address the comprehensive management needed for postpartum hemorrhage in this situation.
2. What should the nurse include in the discharge teaching for a 3-year-old child diagnosed with acute otitis media?
- A. Encourage the child to drink plenty of fluids
- B. Encourage the child to eat a balanced diet
- C. Administer pain medication as needed
- D. Apply warm compresses to the affected ear
Correct answer: A
Rationale: The correct answer is to encourage the child to drink plenty of fluids. This helps to relieve symptoms and prevent dehydration in children with acute otitis media. Encouraging a balanced diet is important for overall health but may not directly impact otitis media symptoms. While administering pain medication as needed can help manage discomfort, it is not a primary discharge teaching for this condition. Applying warm compresses to the affected ear is not typically recommended in acute otitis media cases as it can potentially worsen the infection.
3. What are the most common signs and symptoms of leukemia related to bone marrow involvement?
- A. petechiae, infection, fatigue
- B. headache, papilledema, irritability
- C. muscle wasting, weight loss, fatigue
- D. decreased intracranial pressure, psychosis, confusion
Correct answer: A
Rationale: The correct answer is A: petechiae, infection, fatigue. In leukemia, bone marrow involvement leads to a decrease in normal blood cell production, resulting in petechiae (small red or purple spots on the skin), increased susceptibility to infections due to decreased white blood cells, and fatigue from anemia. Choices B, C, and D are incorrect because they do not directly relate to the typical signs and symptoms of leukemia with bone marrow involvement. Headache, papilledema, irritability, muscle wasting, weight loss, decreased intracranial pressure, psychosis, and confusion are not typically associated with leukemia and bone marrow involvement.
4. What is a common finding that the nurse can identify in most children with symptomatic cardiac malformations?
- A. Mental retardation
- B. Inherited genetic factors
- C. Delayed physical growth
- D. Clubbing of the fingertips
Correct answer: C
Rationale: Delayed physical growth is a common finding in most children with symptomatic cardiac malformations. This occurs due to inadequate oxygenation and nutrient supply to tissues as a result of the cardiac defect. Mental retardation (Choice A) is not typically associated with cardiac malformations unless there are complications affecting brain function. Inherited genetic factors (Choice B) may contribute to the development of cardiac malformations but are not a direct common finding in affected children. Clubbing of the fingertips (Choice D) is more commonly associated with chronic respiratory or cardiac conditions, not specifically cardiac malformations in children.
5. A parent asks the nurse what to do when their toddler has temper tantrums. What play materials should the nurse suggest to offer the child as another way of expressing anger?
- A. Ball and bat
- B. Wad of clay
- C. Punching bag
- D. Pegs and pounding board
Correct answer: D
Rationale: Pegs and pounding boards are recommended as play materials for toddlers to express their anger in a constructive manner. These tools provide a safe and effective outlet for the child's emotions through physical activity. Options A, B, and C do not offer the same interactive and expressive qualities that pegs and pounding boards provide. A ball and bat may encourage aggressive behavior, a wad of clay is more suitable for creative expression rather than anger management, and a punching bag may promote violent behavior which is not appropriate for toddlers.
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