HESI LPN
Pediatric Practice Exam HESI
1. A child with juvenile idiopathic arthritis (JIA) is under the care of a nurse. What is the priority nursing intervention?
- A. Encouraging a diet high in protein
- B. Administering nonsteroidal anti-inflammatory drugs (NSAIDs)
- C. Applying heat to affected joints
- D. Providing range-of-motion exercises
Correct answer: B
Rationale: The priority nursing intervention for a child with juvenile idiopathic arthritis (JIA) is administering nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation. NSAIDs are commonly used in the treatment of JIA to help alleviate symptoms. While encouraging a diet high in protein, applying heat to affected joints, and providing range-of-motion exercises are essential components of care, addressing pain and inflammation with NSAIDs is the priority intervention. This is because controlling pain and inflammation is crucial in improving the child's comfort and quality of life, which takes precedence over other supportive measures.
2. A 4-year-old child is admitted with a diagnosis of bacterial pneumonia. What is the priority nursing intervention?
- A. Administering antipyretics
- B. Administering antibiotics
- C. Monitoring fluid intake
- D. Providing nutritional support
Correct answer: B
Rationale: The priority nursing intervention in a 4-year-old child admitted with bacterial pneumonia is administering antibiotics. Antibiotics are crucial for treating the infection and preventing potential complications. Administering antipyretics (Choice A) may help reduce fever, but addressing the underlying infection with antibiotics is the priority. Monitoring fluid intake (Choice C) is important for hydration but does not take precedence over administering antibiotics. Providing nutritional support (Choice D) is essential for overall care but is not the immediate priority when managing bacterial pneumonia.
3. 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 are indicative of head lice infestation. Itching alone, as mentioned in choice A, is not a reliable indicator of head lice. Choice B is irrelevant as it refers to checking for ear mites in a dog, not head lice in a human. Observing between the fingers for red lines, as in choice D, is not a method to check for head lice.
4. A healthcare provider is assessing a child with suspected rheumatic fever. What clinical manifestation is the provider likely to observe?
- A. Jaundice
- B. Peeling skin on the hands and feet
- C. High fever
- D. Severe joint pain
Correct answer: D
Rationale: Severe joint pain is a classic symptom of rheumatic fever, resulting from inflammation of the joints. Rheumatic fever primarily affects the joints, heart, skin, and the central nervous system. Jaundice (Choice A) is not typically associated with rheumatic fever. Peeling skin on the hands and feet (Choice B) is more characteristic of conditions like Kawasaki disease. While high fever (Choice C) can be present in rheumatic fever, it is not as specific or characteristic as severe joint pain.
5. A newborn with an anorectal anomaly had an anoplasty performed. At the 2-week follow-up visit, a series of anal dilations is begun. What should the nurse recommend to the parents to help prevent the infant from becoming constipated?
- A. Use a soy formula if necessary.
- B. Breastfeed if possible.
- C. Avoid administering a suppository nightly.
- D. Do not offer glucose water between feedings.
Correct answer: B
Rationale: Breastfeeding is recommended to help prevent constipation in infants due to the easily digestible nature of breast milk, which often leads to softer stools. Breastfeeding is preferred over formula feeding as it provides optimal nutrition for the infant's digestive system. Choice A, using a soy formula if necessary, may be considered only if there are specific dietary concerns or allergies; however, breast milk is still the preferred option. Choice C, avoiding administering a suppository nightly, is correct as it is not a routine method for preventing constipation in infants and may not be appropriate without medical advice. Choice D, not offering glucose water between feedings, is recommended as it may not address the root cause of constipation and may introduce unnecessary sugar to the infant's diet.
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