HESI LPN
Pediatric HESI Test Bank
1. The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion?
- A. Deep-breathing exercises
- B. Upright positioning
- C. Coughing
- D. Chest percussion
Correct answer: B
Rationale: Upright positioning is the most appropriate intervention to promote maximum chest expansion in a child with Duchenne muscular dystrophy. By keeping the child in an upright position, lung expansion is maximized, which improves breathing efficiency. Deep-breathing exercises may help with overall lung function but do not directly promote chest expansion. Coughing and chest percussion are more related to airway clearance and do not specifically address maximizing chest expansion.
2. A child sitting on a chair in a playroom starts to have a tonic-clonic seizure with a clenched jaw. What is the nurse’s best initial action?
- A. Attempt to open the jaw.
- B. Place the child on the floor.
- C. Call out for assistance from staff.
- D. Place a pillow under the child’s head.
Correct answer: B
Rationale: The correct initial action during a tonic-clonic seizure is to place the child on the floor to prevent injury. This action helps protect the child from falling off the chair and provides a safer environment for the seizure to occur. Attempting to open the jaw can cause harm or injury. Calling out for assistance is important but should follow the immediate action of moving the child to the floor. Placing a pillow under the child’s head is not recommended as it may lead to airway obstruction or further injury during the seizure.
3. A 6-year-old child with a diagnosis of juvenile idiopathic arthritis (JIA) is being discharged. What should the nurse include in the discharge teaching?
- A. Encourage participation in physical activity
- B. Provide a high-calorie diet
- C. Provide a low-sodium diet
- D. Administer intravenous fluids
Correct answer: A
Rationale: Encouraging regular physical activity is essential in managing symptoms and improving joint function in juvenile idiopathic arthritis. Physical activity helps maintain joint mobility, muscle strength, and overall function. Providing a high-calorie diet may not be necessary unless there are specific concerns about the child's nutritional status. A low-sodium diet is not typically a priority in the management of JIA unless the child has comorbid conditions requiring sodium restriction. Administering intravenous fluids is not a standard discharge teaching for JIA unless there are specific medical indications necessitating it.
4. A child with a diagnosis of cystic fibrosis is under the care of a nurse. What is the priority nursing intervention?
- A. Administering pancreatic enzymes
- B. Providing respiratory therapy
- C. Encouraging physical activity
- D. Encouraging frequent handwashing
Correct answer: A
Rationale: The priority nursing intervention for a child with cystic fibrosis is administering pancreatic enzymes. This is crucial for managing the condition as it helps in proper digestion of nutrients. Providing respiratory therapy and encouraging physical activity are important aspects of care for cystic fibrosis, but administering pancreatic enzymes takes precedence due to its direct impact on the child's ability to digest and absorb essential nutrients. Encouraging frequent handwashing is a good practice for infection control but is not the priority intervention in this scenario.
5. Before starting kindergarten, the child should receive boosters of which primary immunizations to ensure ongoing protection?
- A. IPV, HepB, Td.
- B. DTaP, HepB, Td.
- C. MMR, DTaP, Hib.
- D. DTaP, IPV, MMR.
Correct answer: D
Rationale: Before starting kindergarten, the child should receive boosters of DTaP, IPV, and MMR. DTaP provides protection against diphtheria, tetanus, and pertussis, IPV protects against polio, and MMR immunization covers measles, mumps, and rubella. These boosters are essential to maintain immunity and protect the child from these diseases as they enter school. Choices A, B, and C are incorrect because they do not include the recommended boosters for kindergarten entry and may leave the child susceptible to certain infections.
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