HESI LPN
Pediatric Practice Exam HESI
1. Which of the following signs or symptoms is more common in children than adults following head trauma?
- A. nausea and vomiting
- B. altered mental status
- C. tachycardia and diaphoresis
- D. changes in pupillary reaction
Correct answer: A
Rationale: Nausea and vomiting are more common in children following head trauma due to their higher risk of increased intracranial pressure. Children have less skull compliance and higher brain water content, making them more susceptible to developing symptoms like nausea and vomiting. Altered mental status (choice B) can occur in both children and adults but is not more common in children. Tachycardia and diaphoresis (choice C) are nonspecific and can occur in both age groups. Changes in pupillary reaction (choice D) are not typically more common in children following head trauma compared to adults.
2. A parent receives a note from the school that a student in class has head lice. The parent calls the school nurse to ask how to check for head lice. What instructions should the nurse provide?
- A. Ask the child where it itches.
- B. Check to see if your dog has ear mites.
- C. Look along the scalp line for white dots.
- D. Observe between the fingers for red lines.
Correct answer: C
Rationale: The correct answer is to look along the scalp line for white dots (nits) when checking for head lice. White dots/nits are the eggs of head lice and are commonly found attached to the hair shaft near the scalp. This method helps identify if head lice are present. Choice A is incorrect as itching alone may not be a definitive sign of head lice; it could be due to other reasons. Choice B is irrelevant as ear mites in dogs are not related to head lice infestation in humans. Choice D is also incorrect as observing between the fingers for red lines is not a method for checking head lice.
3. When caring for a neonate with a suspected tracheoesophageal fistula, what nursing care should be included?
- A. Elevating the head and not giving anything by mouth
- B. Elevating the head at all times
- C. Administering glucose water only during feedings
- D. Avoiding suctioning unless the infant is cyanotic
Correct answer: A
Rationale: When caring for a neonate with a suspected tracheoesophageal fistula, it is essential to elevate the head and avoid giving anything by mouth. Elevating the head helps prevent aspiration, and withholding oral intake reduces the risk of complications like aspiration pneumonia. Elevating the head at all times (choice B) is overly restrictive and unnecessary. Administering glucose water only during feedings (choice C) is not recommended as it can still lead to aspiration. Avoiding suctioning unless the infant is cyanotic (choice D) is incorrect because maintaining airway patency may require suctioning, irrespective of cyanosis, in a neonate with a suspected tracheoesophageal fistula.
4. A parent and 3-month-old infant are visiting the well-baby clinic for a routine examination. What should the nurse include in the accident prevention teaching plan?
- A. Remove small objects from the floor.
- B. Cover electric outlets with safety plugs.
- C. Remove toxic substances from low areas.
- D. Test the temperature of water before bathing.
Correct answer: D
Rationale: The correct answer is to test the temperature of water before bathing. This is crucial in preventing burns, which is a significant risk for infants due to their sensitive skin. Infants have delicate skin that can be easily burned by water that is too hot. Removing small objects from the floor (Choice A) is important to prevent choking hazards but not directly related to burns. Covering electric outlets with safety plugs (Choice B) is essential to prevent electrocution but does not address the risk of burns specifically. Removing toxic substances from low areas (Choice C) is necessary to prevent poisoning but is not directly related to burns. Therefore, the priority in this scenario is to prevent burns by ensuring the water temperature is safe for the infant.
5. A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base imbalance should the nurse expect the child to develop?
- A. metabolic alkalosis caused by decreased acid metabolites production
- B. respiratory alkalosis caused by decreased respiratory rate and carbon dioxide retention
- C. respiratory acidosis caused by impaired respirations and increased carbonic acid formation
- D. metabolic acidosis caused by the kidneys' inability to compensate for increased carbonic acid production
Correct answer: C
Rationale: In a severe asthma attack, the child is likely to develop respiratory acidosis due to impaired respirations leading to the retention of carbon dioxide, which combines with water to form carbonic acid. This results in the pH imbalance characterized by an excess of carbonic acid. Choices A, B, and D are incorrect. Metabolic alkalosis (Choice A) is not typically associated with severe asthma attacks; respiratory alkalosis (Choice B) would involve a decrease, not an increase, in carbon dioxide levels; and metabolic acidosis (Choice D) is not the primary acid-base imbalance seen in severe asthma attacks.
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