HESI LPN
Pediatric HESI Test Bank
1. At 7 AM, a nurse receives the information that an adolescent with diabetes has a 6:30 AM fasting blood glucose level of 180 mg/dL. What is the priority nursing action at this time?
- A. Encourage the adolescent to start exercising.
- B. Ask the adolescent to obtain an immediate glucometer reading.
- C. Inform the adolescent that a complex carbohydrate such as cheese should be eaten.
- D. Tell the adolescent that the prescribed dose of rapid acting insulin should be administered.
Correct answer: D
Rationale: Rapid acting insulin will help lower the elevated blood glucose level quickly.
2. At 0345, you receive a call for a woman in labor. Upon arriving at the scene, you are greeted by a very anxious man who tells you that his wife is having her baby 'now.' This man escorts you into the living room where a 25-year-old woman is lying on the couch in obvious pain. After determining that delivery is not imminent, you begin transport. While en route, the mother tells you that she feels the urge to push. You assess her and see the top of the baby's head bulging from the vagina. What is your most appropriate first action?
- A. allow the head to deliver and check for the location of the cord
- B. advise your partner to stop the ambulance and assist with the delivery
- C. tell the mother to take short, quick breaths until you arrive at the hospital
- D. prepare the mother for an emergency delivery and open the obstetrics kit
Correct answer: B
Rationale: The correct action in this scenario is to advise your partner to stop the ambulance and assist with the delivery. When the mother feels the urge to push and you see the baby's head bulging from the vagina, it indicates an imminent delivery. Stopping the ambulance allows for a safer environment for the delivery of the baby and ensures that immediate assistance can be provided to both the mother and the newborn. Allowing the head to deliver before checking for the cord (Choice A) may delay necessary interventions in case of complications. Instructing the mother to take short, quick breaths (Choice C) is not appropriate when the baby's head is already visible. Preparing for an emergency delivery and opening the obstetrics kit (Choice D) is important but should come after stopping the ambulance and assisting with the imminent birth.
3. A child who had surgery for a congenital heart defect is being discharged. What is an important aspect of the discharge teaching?
- A. Teaching the parents about signs of infection
- B. Providing instructions on wound care
- C. Scheduling follow-up appointments
- D. Explaining the use of prescribed medications
Correct answer: D
Rationale: Explaining the use of prescribed medications is crucial as it helps ensure the proper management of the child's condition post-discharge. Understanding how and when to administer medications is essential for the child's recovery. While teaching the parents about signs of infection, providing wound care instructions, and scheduling follow-up appointments are also important aspects of care, ensuring the correct use of prescribed medications takes precedence to prevent complications and promote the child's well-being.
4. The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the mother indicates a need for further teaching?
- A. I need to avoid pushing or pulling on an arm or leg.
- B. I must avoid lifting the baby from under the armpits.
- C. I should not bend an arm or leg into an awkward position.
- D. We must avoid lifting the legs by the ankles to change diapers.
Correct answer: B
Rationale: Lifting the baby from under the armpits can cause fractures in infants with osteogenesis imperfecta. The correct approach is to support the baby's body and head carefully, avoiding pressure on vulnerable areas prone to fractures. Choices A, C, and D demonstrate proper awareness of caring for an infant with osteogenesis imperfecta by emphasizing caution to prevent fractures.
5. At 7 AM, a healthcare professional receives the information that an adolescent with diabetes has a 6:30 AM fasting blood glucose level of 180 mg/dL. What is the priority nursing action at this time?
- A. Encourage the adolescent to start exercising.
- B. Ask the adolescent to obtain an immediate glucometer reading.
- C. Inform the adolescent that a complex carbohydrate such as cheese should be eaten.
- D. Tell the adolescent that the prescribed dose of rapid-acting insulin should be administered.
Correct answer: D
Rationale: The correct priority nursing action in this situation is to administer the prescribed dose of rapid-acting insulin. Rapid-acting insulin is necessary to help lower the elevated blood glucose level quickly, thereby preventing potential complications of hyperglycemia. Encouraging exercise, obtaining a glucometer reading, or suggesting consumption of complex carbohydrates like cheese may not address the immediate need to bring down the high blood glucose level effectively. Exercise could potentially raise blood glucose levels, obtaining a glucometer reading may delay necessary treatment, and consuming complex carbohydrates can further elevate blood glucose levels in this scenario.
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