HESI LPN
Pediatric Practice Exam HESI
1. A mother confides to the nurse that she is thinking of 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. Keep your feelings to yourself and maintain a positive facade with the child.
Correct answer: A
Rationale: In situations of divorce, it is crucial for both parents to inform the child together using age-appropriate language. This approach helps maintain consistency and clarity for the child, reducing confusion and anxiety. Choice B is incorrect because reassurance should not be solely focused on love but on explaining the situation appropriately. Choice C may inadvertently send the message that the divorce is the child's fault or requires compensation. Choice D is incorrect as children benefit from understanding and processing emotions in a healthy manner, rather than having them kept hidden.
2. What is the priority nursing responsibility when a 3-year-old child in a crib has a clamped jaw and is having a tonic-clonic seizure?
- A. Apply restraints.
- B. Administer oxygen.
- C. Protect the child from self-injury.
- D. Insert a plastic airway in the child’s mouth.
Correct answer: C
Rationale: During a tonic-clonic seizure, the priority nursing responsibility is to protect the child from self-injury. Applying restraints is not recommended during a seizure as it can lead to further harm. Administering oxygen may be necessary after the seizure to support oxygenation, but it is not the priority during the seizure itself. Inserting a plastic airway is also not indicated as the jaw is clamped, and the child should not have anything placed in the mouth during a seizure. Therefore, the correct action is to ensure the child's safety by protecting them from self-injury, preventing harm from uncontrolled movements and potential falls.
3. When preparing a 2-year-old child for surgery, what preoperative teaching should be provided to help them understand the procedure?
- A. Explaining the procedure in simple terms
- B. Using a doll to demonstrate the procedure
- C. Showing pictures of the hospital environment
- D. Allowing the child to play with medical equipment
Correct answer: B
Rationale: The correct preoperative teaching for a 2-year-old child undergoing surgery involves using a doll to demonstrate the procedure. This method helps the child understand what to expect in a non-threatening and visual way, making the experience less intimidating. Explaining the procedure in simple terms (Choice A) may not effectively convey the details to a young child. Showing pictures of the hospital environment (Choice C) may not directly address the surgical procedure itself. Allowing the child to play with medical equipment (Choice D) can be unsafe and may not effectively prepare the child for the surgery.
4. A child undergoes heart surgery to repair the defects associated with tetralogy of Fallot. What behavior is essential for the nurse to prevent postoperatively?
- A. Crying
- B. Coughing
- C. Straining at stool
- D. Unnecessary movement
Correct answer: C
Rationale: The correct behavior that the nurse needs to prevent postoperatively is straining at stool. Straining at stool should be avoided as it can increase intrathoracic pressure, leading to stress on the surgical site. This stress can potentially compromise the surgical repair and increase the risk of complications. Crying, coughing, and unnecessary movement, although important to monitor postoperatively, do not directly impact the surgical site as significantly as straining at stool does. Therefore, the focus should be on preventing straining at stool to ensure the best postoperative outcome for the child.
5. A family has decided to withhold “extraordinary care” for a newborn with severe abnormalities. How should the nurse interpret this decision?
- A. The newborn has no rights.
- B. It is the same as euthanasia.
- C. It is illegal professional practice.
- D. The newborn is being allowed to die.
Correct answer: D
Rationale: Withholding extraordinary care in cases of severe abnormalities is a legal and ethical decision. It allows the newborn to die naturally without aggressive interventions. Choice A is incorrect because all individuals, including newborns, have rights. Choice B is incorrect because withholding extraordinary care is not equivalent to euthanasia, which involves actively ending a life. Choice C is incorrect because such decisions are legally and ethically permissible when made in consideration of the best interests of the newborn.
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