HESI LPN
Pediatric Practice Exam HESI
1. The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn?
- A. Absence of a urethral opening is noted
- B. Penis appears shorter than usual for age
- C. The urethral opening is along the dorsal surface of the penis
- D. The urethral opening is along the ventral surface of the penis
Correct answer: D
Rationale: In hypospadias, the urethral opening is located along the ventral surface of the penis. This congenital condition results in the urethral meatus opening on the underside of the penis, rather than at the tip. Choice A is incorrect as there is typically a urethral opening present, though in an abnormal location. Choice B is not a characteristic feature of hypospadias. Choice C is incorrect as the urethral opening in hypospadias is not along the dorsal surface but rather along the ventral surface of the penis.
2. What behavior is essential for preventing in a child postoperatively after undergoing heart surgery to repair defects associated with tetralogy of Fallot?
- A. Crying
- B. Coughing
- C. Straining at stool
- D. Unnecessary movement
Correct answer: C
Rationale: Preventing straining at stool is crucial postoperatively after heart surgery for tetralogy of Fallot to avoid increasing intrathoracic pressure and placing stress on the surgical site. This can help prevent complications and promote faster healing. While crying, coughing, and unnecessary movement are common postoperative behaviors, they are not specifically linked to worsening outcomes in this context. Straining at stool is particularly emphasized due to its potential to impact the surgical site and overall recovery process.
3. A parent asks a nurse how to tell the difference between measles (rubeola) and German measles (rubella). What should the nurse tell the parent about rubeola that is different from rubella?
- A. High fever and Koplik spots
- B. Rash on the trunk with pruritus
- C. Nausea, vomiting, and abdominal cramps
- D. Characteristics of a cold, followed by a rash
Correct answer: A
Rationale: The correct answer is A: 'High fever and Koplik spots.' Rubeola (measles) is characterized by a high fever and the presence of Koplik spots, which are not seen in rubella (German measles). Choice B, rash on the trunk with pruritus, is more indicative of rubella. Choice C, nausea, vomiting, and abdominal cramps, are not specific to either rubeola or rubella. Choice D, characteristics of a cold followed by a rash, is not a typical presentation of rubeola or rubella.
4. The school nurse is caring for a boy with hemophilia who fell on his arm during recess. What supportive measures should the nurse use until factor replacement therapy can be instituted?
- A. Apply warm, moist compresses
- B. Apply pressure for at least 1 minute
- C. Elevate the area above the level of the heart
- D. Begin passive range-of-motion unless the pain is severe
Correct answer: C
Rationale: The correct supportive measure for the school nurse to use for a boy with hemophilia who fell on his arm during recess is to elevate the area above the level of the heart. Elevating the affected area helps reduce bleeding and swelling in a child with hemophilia until factor replacement therapy can be provided. Applying warm, moist compresses (Choice A) may worsen bleeding by dilating blood vessels. Applying pressure for at least 1 minute (Choice B) is not recommended for hemophilia as it can lead to increased bleeding. Beginning passive range-of-motion (Choice D) should be avoided as it can exacerbate bleeding and further injury in a child with hemophilia.
5. When caring for an alert 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color, what should be included?
- A. Back blows, abdominal thrusts, transport
- B. Oxygen, avoiding agitation, transport
- C. Assisting ventilations, back blows, transport
- D. Chest thrusts, finger sweeps, transport
Correct answer: B
Rationale: The correct approach for a child with a mild airway obstruction, respiratory distress, and normal skin color includes providing oxygen to support breathing, avoiding agitation that could worsen the situation, and arranging for transport to a healthcare facility. Option A is incorrect because abdominal thrusts are not recommended in a mild airway obstruction scenario, and back blows are typically used for choking. Option C is incorrect because assisting ventilations may not be necessary in a child with a strong cough and normal skin color. Option D is incorrect because chest thrusts are not recommended for a mild airway obstruction, and finger sweeps are used for foreign body airway obstructions.
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