HESI LPN
Pediatric HESI 2024
1. Why should the nurse closely monitor the IV flow rate for a 5-month-old infant with severe diarrhea receiving IV fluids?
- A. Limiting output
- B. Replacing lost fluids
- C. Avoiding IV infiltration
- D. Preventing cardiac overload
Correct answer: D
Rationale: The correct answer is D: Preventing cardiac overload. Infants are highly vulnerable to fluid overload, making it essential to carefully monitor IV flow rates to prevent complications such as cardiac overload. Rapid administration of IV fluids can lead to an excessive increase in circulating volume, potentially causing cardiac strain or heart failure in infants. Choices A, B, and C are incorrect. Monitoring the IV flow rate is not primarily aimed at limiting output, replacing lost fluids, or avoiding IV infiltration in this scenario. The key concern is to prevent the risk of cardiac overload due to the infant's susceptibility to fluid imbalances.
2. 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 correct answer is the sweat chloride test. This test is crucial in diagnosing cystic fibrosis as it measures the amount of chloride in sweat, which is typically elevated in individuals with cystic fibrosis. A chest X-ray (Choice A) may show characteristic findings like hyperinflation or bronchiectasis, but it is not a definitive diagnostic test for cystic fibrosis. Pulmonary function tests (Choice C) may help assess lung function but are not specific for cystic fibrosis. Sputum culture (Choice D) may be used to identify specific pathogens causing respiratory infections but is not a primary diagnostic test for cystic fibrosis.
3. 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.
4. A nurse is caring for a child with a diagnosis of acute lymphoblastic leukemia (ALL). What is the priority nursing intervention?
- A. Administering chemotherapy
- B. Preventing infection
- C. Monitoring for signs of bleeding
- D. Providing nutritional support
Correct answer: B
Rationale: The correct answer is preventing infection. In caring for a child with acute lymphoblastic leukemia (ALL), preventing infection is the priority nursing intervention. Children with ALL are immunocompromised due to the disease and its treatment, making them more susceptible to infections. Administering chemotherapy, while important, is not the priority as preventing infection takes precedence to avoid complications. Monitoring for signs of bleeding and providing nutritional support are also essential components of care for a child with ALL, but preventing infection is the priority to ensure the child's safety and well-being.
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 can be symptoms of neuroblastoma, a malignancy that affects the adrenal glands and sympathetic nervous system. A maculopapular rash on the palms (Choice A) is not typically associated with neuroblastoma. Irritability and poor weight gain (Choice C) may be non-specific findings and do not specifically point towards neuroblastoma. Auscultation findings of wheezing with diminished lung sounds (Choice D) are more indicative of respiratory conditions rather than neuroblastoma.
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