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 (A) and Regular (B) are rapid-acting insulins with shorter durations of action. NPH (C) is an intermediate-acting insulin with a duration of action of about 12-16 hours. Therefore, Glargine is the correct choice for the insulin with the longest duration.
2. A nurse is developing a teaching plan for an 8-year-old child who has recently been diagnosed with type 1 diabetes. What developmental characteristic of a child this age should the nurse consider?
- A. Child is in the concrete operational stage of cognition.
- B. Child’s dependence on peer influence is increasing.
- C. Child will welcome opportunities for participation in self-care.
- D. Child’s developmental stage involves achieving a sense of autonomy.
Correct answer: C
Rationale: The correct answer is C. At the age of 8, children are typically in the stage of industry vs. inferiority according to Erikson's psychosocial theory. This stage is characterized by a desire to engage in productive activities and take on responsibilities. Thus, the child will likely welcome opportunities for participation in self-care related to their diabetes management. Choices A, B, and D are incorrect. Choice A is inaccurate as children at this age are usually in the concrete operational stage of cognitive development, not abstract. Choice B is incorrect because while peer influence is significant, it has not reached its peak at this age. Choice D is wrong as achieving a sense of identity is a developmental task more commonly associated with adolescence, not 8-year-old children.
3. 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.
4. 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.
5. The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?
- A. The child has a maculopapular rash on his palms.
- B. The parents report that their son is vomiting and not eating well.
- C. The parents report that their son is irritable and not gaining weight.
- D. Auscultation reveals wheezing with diminished lung sounds.
Correct answer: B
Rationale: Vomiting and poor appetite are common symptoms of neuroblastoma, a malignancy that arises from neural crest cells in the adrenal glands or sympathetic nervous system. This tumor can cause abdominal swelling due to its location and size, leading to symptoms like vomiting and decreased appetite. The presence of a maculopapular rash on the palms (Choice A) is not a typical finding associated with neuroblastoma. Irritability and failure to thrive (Choice C) are nonspecific symptoms that can be seen in various conditions but are not specifically indicative of neuroblastoma. Auscultation revealing wheezing with diminished lung sounds (Choice D) may suggest respiratory conditions rather than neuroblastoma.
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