HESI LPN
Pediatric HESI 2024
1. What should be included in the nursing plan of care for a 6-month-old infant admitted to the pediatric unit with a diagnosis of respiratory syncytial virus (RSV)?
- A. Place the infant in a warm, dry environment.
- B. Allow parents and siblings to visit.
- C. Maintain standard and contact precautions.
- D. Administer prescribed antibiotics immediately.
Correct answer: C
Rationale: The correct answer is C: Maintain standard and contact precautions. RSV is highly contagious, primarily spread through respiratory secretions. Therefore, it is crucial to implement infection control measures such as standard and contact precautions to prevent the spread of the virus to other patients, staff, and visitors. Choice A is incorrect because warmth and dryness are not specific interventions for RSV; the focus should be on infection control. Choice B may increase the risk of exposing others to RSV, so limiting visitors is recommended. Choice D is unnecessary because RSV is a viral infection, and antibiotics are not effective against viruses.
2. 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 by an autosomal recessive gene.
Correct answer: A
Rationale: The correct answer is A: 'Mental retardation occurs if PKU is untreated.' Phenylketonuria (PKU) is a metabolic disorder that, if left untreated with dietary management, can lead to severe mental retardation due to the accumulation of phenylalanine. It is crucial for parents to understand the potential consequences of untreated PKU to emphasize the importance of early and consistent treatment. Choice B is incorrect because testing for PKU is typically done through newborn screening shortly after birth, not immediately. Choice C is incorrect as treatment for PKU primarily involves strict dietary management that restricts phenylalanine intake, not lifelong medications. Choice D is incorrect as PKU is inherited in an autosomal recessive pattern, meaning that both parents must pass on a mutated gene for the disorder to manifest.
3. A 3-year-old child with a history of frequent respiratory infections is being evaluated for cystic fibrosis. What diagnostic test should the nurse anticipate will be ordered?
- A. Chest X-ray
- B. Sweat chloride test
- C. Pulmonary function test
- D. Sputum culture
Correct answer: B
Rationale: The sweat chloride test is the gold standard diagnostic test for cystic fibrosis as it measures the concentration of chloride in sweat. In cystic fibrosis, there is an abnormal transport of chloride across epithelial membranes, leading to elevated sweat chloride levels. A chest X-ray may show characteristic changes in the lungs associated with cystic fibrosis, but it is not a definitive diagnostic test. Pulmonary function tests assess lung function but do not specifically diagnose cystic fibrosis. Sputum culture may identify respiratory infections but does not confirm the diagnosis of cystic fibrosis.
4. A healthcare professional is teaching parents about why most children should be immunized against varicella (chickenpox) and why some receiving specific medications should not. Which medication should be included in the discussion?
- A. Insulin
- B. Steroids
- C. Antibiotics
- D. Anticonvulsants
Correct answer: B
Rationale: The correct answer is B: Steroids. Children receiving steroids should not receive the varicella vaccine as it can increase the risk of severe infection due to the immunosuppressive effects of steroids. Insulin (Choice A) is not a medication that contraindicates varicella vaccination. Antibiotics (Choice C) and anticonvulsants (Choice D) are also not medications that would impact the decision to immunize against varicella.
5. The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?
- A. abdominal rigidity and pain on palpation
- B. rounded abdomen and hypoactive bowel sounds
- C. visible peristalsis and weight loss
- D. distention of the lower abdomen and constipation
Correct answer: C
Rationale: Visible peristalsis and weight loss are classic clinical manifestations of pyloric stenosis. The obstruction at the pyloric sphincter causes visible peristalsis as the stomach tries to push food through the narrowed opening, leading to the appearance of waves across the abdomen. Weight loss occurs due to poor feeding and frequent vomiting associated with pyloric stenosis. Choices A, B, and D are incorrect. Abdominal rigidity and pain on palpation, rounded abdomen and hypoactive bowel sounds, as well as distention of the lower abdomen and constipation are not typically seen in pyloric stenosis.
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