HESI LPN
Pediatric Practice Exam HESI
1. After clearing the airway of a newborn who is not in distress, what is the most important action for you to take?
- A. Apply free-flow oxygen
- B. Clamp and cut the cord
- C. Keep the newborn warm
- D. Obtain an APGAR score
Correct answer: C
Rationale: Keeping the newborn warm is crucial as newborns are at high risk of hypothermia due to their large body surface area and limited subcutaneous fat. Hypothermia can lead to complications such as respiratory distress, hypoglycemia, and metabolic acidosis. Providing warmth helps maintain the newborn's body temperature and supports physiological processes, promoting overall well-being. Applying free-flow oxygen is not necessary if the newborn is not in distress. Clamping and cutting the cord can be done after addressing the immediate need for warmth. Obtaining an APGAR score is important for assessing the newborn's overall condition but ensuring warmth takes precedence to prevent complications related to hypothermia.
2. How should you care for an alert 4-year-old child with a mild airway obstruction, who has respiratory distress, a strong cough, and normal skin color?
- 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 an alert 4-year-old child with a mild airway obstruction, respiratory distress, a strong cough, and normal skin color is to provide oxygen, avoid agitation, and arrange for transport. Oxygen helps support breathing, avoiding agitation prevents worsening of the obstruction, and transport ensures the child receives further medical evaluation and treatment. Choices A, C, and D involve techniques that are not recommended for a mild airway obstruction in this scenario. Back blows, abdominal thrusts, chest thrusts, and finger sweeps are interventions used for different situations and not suitable for a child with the described symptoms.
3. A child with a diagnosis of acute glomerulonephritis is admitted to the hospital. What is the priority nursing intervention?
- A. Monitoring for hypertension
- B. Providing pain relief
- C. Restricting fluid intake
- D. Encouraging fluid intake
Correct answer: A
Rationale: The correct answer is monitoring for hypertension. Acute glomerulonephritis involves inflammation of the kidney's glomeruli, potentially leading to impaired kidney function and elevated blood pressure. Monitoring for hypertension is crucial as it is a common complication of this condition. Providing pain relief (choice B) may be necessary for comfort but is not the priority. While fluid restriction (choice C) is important in some kidney conditions, in acute glomerulonephritis, maintaining adequate hydration to support kidney function is typically recommended. Encouraging fluid intake (choice D) may exacerbate fluid overload, making it an inappropriate intervention in this scenario.
4. When a mother confides in the nurse that she is contemplating divorce, which suggestion by the nurse would help minimize the effects on the child?
- A. Tell the child together using appropriate terms.
- B. Reassure the child that no one loves him more than his parents.
- C. Engage in special activities with the child to compensate for the divorce.
- D. Discuss your feelings with the child.
Correct answer: A
Rationale: The correct answer is A. It is essential for both parents to inform the child about the divorce together, using age-appropriate language. This approach can help minimize the negative impact on the child by providing a sense of unity and understanding. Choice B is incorrect because offering false reassurance about love may not address the child's concerns effectively, as the situation is complex. Choice C is not suitable as engaging in special activities cannot substitute for the emotional stability that the child may lose due to the divorce. Choice D is incorrect because sharing the parent's feelings may burden the child with adult emotions, which could be overwhelming and confusing for their developmental stage.
5. 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.
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