HESI LPN
Pediatric HESI Test Bank
1. An infant who has had diarrhea for 3 days is admitted in a lethargic state and is breathing rapidly. The parent states that the baby has been ingesting formula, although not as much as usual, and cannot understand the sudden change. What explanation should the nurse give the parent?
- A. Cellular metabolism is unstable in young children.
- B. The proportion of water in the body is less than in adults.
- C. Renal function is immature in children until they reach school age.
- D. The extracellular fluid requirement per unit of body weight is greater than in adults.
Correct answer: D
Rationale: The correct answer is D. Infants have a higher extracellular fluid requirement per unit of body weight, making them more susceptible to dehydration and electrolyte imbalances during illnesses such as diarrhea. Choice A is incorrect as cellular metabolism instability does not directly relate to the infant's condition described. Choice B is inaccurate as the proportion of water in the body is not the primary issue causing the infant's symptoms. Choice C is incorrect as renal function being immature does not explain the sudden change in the infant's health status; it is more related to fluid balance and dehydration.
2. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about insulin administration. What should the nurse emphasize?
- A. Rotate injection sites
- B. Administer insulin before meals
- C. Store insulin in the refrigerator
- D. Administer insulin at bedtime
Correct answer: A
Rationale: The correct answer is to rotate injection sites. Rotating injection sites is crucial in insulin administration to prevent lipodystrophy, which is the breakdown of subcutaneous fat at the injection site. It also helps ensure consistent insulin absorption. Administering insulin before meals (choice B) is important to match insulin peak action with the rise in blood glucose after eating. Storing insulin in the refrigerator (choice C) is correct to maintain its potency and stability. Administering insulin at bedtime (choice D) may not be suitable for all patients and is not a universal recommendation for insulin administration.
3. An infant who has had diarrhea for 3 days is admitted in a lethargic state and is breathing rapidly. The parent states that the baby has been ingesting formula, although not as much as usual, and cannot understand the sudden change. What explanation should the nurse give the parent?
- A. Cellular metabolism is unstable in young children.
- B. The proportion of water in the body is less than in adults.
- C. Renal function is immature in children until they reach school age.
- D. The extracellular fluid requirement per unit of body weight is greater than in adults.
Correct answer: D
Rationale: The correct answer is D. Infants have a higher extracellular fluid requirement per unit of body weight, making them more susceptible to dehydration and electrolyte imbalances during illnesses such as diarrhea. Choice A is incorrect because cellular metabolism being unstable is not the primary explanation for the symptoms described. Choice B is incorrect as the proportion of water in the body alone does not fully explain the increased risk of dehydration in infants. Choice C is incorrect because while renal function is immature in children, it is not the most relevant factor in this scenario compared to the increased fluid requirements.
4. The parents of a child who is scheduled for open-heart surgery ask why their child must be subjected to chest tubes after surgery. What should the nurse consider before responding in language the parents will understand?
- A. They will increase tidal volumes.
- B. Drainage of air and fluid will be facilitated.
- C. They will maintain positive intrapleural pressure.
- D. Pressure on the pericardium and chest wall will be regulated.
Correct answer: B
Rationale: Chest tubes are necessary after open-heart surgery to facilitate the drainage of air and fluid from the chest cavity. These tubes help prevent complications such as pneumothorax (accumulation of air in the pleural space) or cardiac tamponade (build-up of fluid in the pericardial sac), which can be serious postoperative issues. Options A, C, and D are incorrect because chest tubes are primarily used for draining purposes and not for increasing tidal volumes, maintaining positive intrapleural pressure, or regulating pressure on the pericardium and chest wall.
5. A major developmental milestone of a toddler is the achievement of autonomy. What should the parents do to enhance their toddler’s need for autonomy?
- A. Teach the child to share with others.
- B. Help the child learn society’s roles.
- C. Teach the child to accept external limits.
- D. Help the child develop internal controls.
Correct answer: D
Rationale: Toddlers striving for autonomy need to develop internal controls to foster their independence. Teaching the child to share (Choice A) focuses more on social skills rather than autonomy. Helping the child learn society’s roles (Choice B) is important but not directly related to enhancing autonomy. Teaching the child to accept external limits (Choice C) is contrary to promoting autonomy as it emphasizes conformity to external rules rather than internal self-regulation.
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