HESI LPN
Pediatric HESI 2024
1. Based on developmental norms for a 5-year-old child, at what apical pulse did the nurse decide to withhold a scheduled dose of digoxin (Lanoxin) elixir and notify the health care provider?
- A. 60 beats/min
- B. 70 beats/min
- C. 90 beats/min
- D. 100 beats/min
Correct answer: C
Rationale: For a 5-year-old child, an apical pulse below 90 beats/min is a reason to withhold digoxin. Digoxin is a medication commonly used to treat heart conditions, and its administration is based on heart rate parameters. A pulse rate below 90 beats/min indicates bradycardia. In pediatric patients, bradycardia below this threshold may be a sign of toxicity or potential adverse effects of digoxin, necessitating withholding the medication and informing the healthcare provider. Choices A, B, and D are incorrect as they represent pulse rates above the threshold for withholding digoxin in a 5-year-old child.
2. A nurse is providing care to a child diagnosed with sickle cell anemia. What is the priority nursing intervention?
- A. Administering pain medication
- B. Ensuring adequate hydration
- C. Providing nutritional support
- D. Monitoring vital signs
Correct answer: A
Rationale: In sickle cell anemia, pain management is a priority due to vaso-occlusive crises that cause severe pain. Administering pain medication helps alleviate discomfort and improve the child's quality of life. Ensuring adequate hydration, although important, is secondary to addressing the immediate pain issue. Providing nutritional support is beneficial for overall health but does not address the acute pain experienced. Monitoring vital signs is essential but not the immediate priority when managing pain in sickle cell anemia.
3. An infant with hypertrophic pyloric stenosis (HPS) is admitted to the pediatric unit. What does the nurse expect when palpating the infant’s abdomen?
- A. A distended colon
- B. Marked tenderness around the umbilicus
- C. An olive-sized mass in the right upper quadrant
- D. Rhythmic peristaltic waves in the lower abdomen
Correct answer: C
Rationale: When palpating the abdomen of an infant with hypertrophic pyloric stenosis (HPS), the nurse would expect to feel an olive-sized mass in the right upper quadrant. This finding is characteristic of HPS due to the hypertrophied pylorus muscle. Choices A, B, and D are incorrect. A distended colon is not typically associated with HPS. Marked tenderness around the umbilicus is not a specific finding of HPS. Rhythmic peristaltic waves in the lower abdomen are not expected in HPS, as the condition primarily affects the pylorus region of the stomach.
4. When you attempt to assess a 22-year-old woman who has been sexually assaulted, and she orders you not to touch her, your most appropriate initial action should be to
- A. ask the patient to sign a release form
- B. ask a female EMT-B to attempt to assess the patient
- C. explain to the patient that she must be examined
- D. transport the patient without performing an assessment
Correct answer: B
Rationale: In this scenario, the patient has requested not to be touched, indicating a need for sensitivity and understanding. Asking a female EMT-B to attempt to assess the patient is the most appropriate initial action as it respects the patient's need for privacy, comfort, and potentially reduces re-traumatization. Asking the patient to sign a release form (Choice A) is not suitable as it disregards the patient's immediate concerns. Explaining to the patient that she must be examined (Choice C) may further distress her and violate her autonomy. Transporting the patient without performing an assessment (Choice D) ignores the patient's expressed wishes and may lead to inadequate care.
5. 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.
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