HESI LPN
Pediatric Practice Exam HESI
1. When caring for a neonate with a suspected tracheoesophageal fistula, what nursing care should be included?
- A. Elevating the head but giving nothing by mouth
- B. Elevating the head for feedings
- C. Feeding glucose water only
- D. Avoiding suctioning unless the infant is cyanotic
Correct answer: A
Rationale: In a neonate with a suspected tracheoesophageal fistula, elevating the head but giving nothing by mouth is crucial to prevent aspiration. Placing the neonate in a semi-upright position helps reduce the risk of reflux and aspiration of gastric contents into the lungs. Elevating the head for feedings (Choice B) would still pose a risk of aspiration as the neonate may aspirate during feeding. Feeding glucose water only (Choice C) is not appropriate and does not address the risk of aspiration associated with a tracheoesophageal fistula. Avoiding suctioning unless the infant is cyanotic (Choice D) is incorrect because suctioning may be necessary for maintaining airway patency, regardless of cyanosis, in a neonate with a suspected tracheoesophageal fistula.
2. 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.
3. What is the priority nursing responsibility when a 3-year-old child in a crib is experiencing a tonic-clonic seizure with a clamped jaw?
- 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 (Choice A) can cause harm by restricting movement during the seizure. While administering oxygen (Choice B) may be necessary, it is not the immediate priority during an active seizure. Inserting a plastic airway (Choice D) is contraindicated as it can lead to injury and is not recommended during a seizure. Protecting the child from self-injury (Choice C) is crucial to prevent harm from uncontrolled movements and potential falls, ensuring the safety of the child.
4. 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.
5. The school nurse is caring for a boy with hemophilia who fell on his arm during recess. What supportive measures should the nurse use until factor replacement therapy can be instituted?
- A. Apply warm, moist compresses
- B. Apply pressure for at least 1 minute
- C. Elevate the area above the level of the heart
- D. Begin passive range-of-motion unless the pain is severe
Correct answer: C
Rationale: Elevating the affected area above the level of the heart is the correct supportive measure for a child with hemophilia who has experienced trauma. This action helps reduce bleeding and swelling by promoting venous return and preventing further pooling of blood in the affected area. Applying warm, moist compresses (Choice A) may not be recommended as it can potentially increase bleeding by dilating blood vessels. Applying pressure for at least 1 minute (Choice B) can be helpful for minor cuts or wounds but may not be as effective in managing bleeding in a child with hemophilia. Beginning passive range-of-motion (Choice D) should be avoided as it can exacerbate bleeding and cause further damage in a child with hemophilia.
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