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. 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.
3. A parent of a 2-year-old child tells a nurse at the clinic, 'Whenever I go to the store, my child has a screaming tantrum, demanding a toy or candy on the shelves. How can I deal with this situation?' What is the nurse’s best response?
- A. “Attempt to distract the child by offering a toy.”
- B. “Say nothing and allow the tantrum to continue until it ends.”
- C. “Have a babysitter stay with the child at home until the child outgrows this behavior.”
- D. “Give the child the item while in the store, and when the child loses interest, return the item to the shelf.”
Correct answer: B
Rationale: The best approach in dealing with a child's tantrum is to not give in to their demands. By allowing the tantrum to continue until it ends, the child learns that this behavior is not effective in getting what they want. Offering a distraction (Choice A) might temporarily calm the child but does not address the underlying issue of the tantrum. Leaving the child with a babysitter (Choice C) does not teach the child how to handle such situations. Giving in to the child's demands (Choice D) reinforces the tantrum behavior.
4. A child with a diagnosis of leukemia is receiving chemotherapy. What is the priority nursing intervention?
- A. Monitoring for signs of infection
- B. Providing nutritional support
- C. Monitoring for signs of bleeding
- D. Monitoring for signs of pain
Correct answer: A
Rationale: The priority nursing intervention for a child with leukemia receiving chemotherapy is monitoring for signs of infection. Chemotherapy can suppress the immune system, putting the child at a higher risk of developing infections. Early detection of signs of infection is crucial to prevent serious complications and initiate timely treatment. Providing nutritional support is important for overall health but is not the priority when the child is at risk of infection. Monitoring for signs of bleeding is essential, but infection surveillance takes precedence due to the immediate threat it poses to the child's health. Monitoring for signs of pain is important for comfort but is not the priority over infection prevention and management.
5. When assessing a child with a possible fracture, what would be the most reliable indicator for the nurse to identify?
- A. Lack of spontaneous movement
- B. Point tenderness
- C. Bruising
- D. Inability to bear weight
Correct answer: B
Rationale: Point tenderness is the most reliable indicator of a possible fracture in a child. It refers to localized pain at a specific point, indicating a potential bone injury. Lack of spontaneous movement (Choice A) is non-specific and can be due to various reasons. Bruising (Choice C) may be present in fractures but is not as specific as point tenderness. Inability to bear weight (Choice D) can also be seen in fractures but may not always be present, making it less reliable compared to point tenderness.
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