HESI LPN
Pediatric Practice Exam HESI
1. A child with a diagnosis of acute glomerulonephritis is admitted to the hospital. What is the priority nursing intervention?
- A. Monitoring for hypertension
- B. Providing pain relief
- C. Restricting fluid intake
- D. Encouraging fluid intake
Correct answer: A
Rationale: The correct answer is monitoring for hypertension. Acute glomerulonephritis involves inflammation of the kidney's glomeruli, potentially leading to impaired kidney function and elevated blood pressure. Monitoring for hypertension is crucial as it is a common complication of this condition. Providing pain relief (choice B) may be necessary for comfort but is not the priority. While fluid restriction (choice C) is important in some kidney conditions, in acute glomerulonephritis, maintaining adequate hydration to support kidney function is typically recommended. Encouraging fluid intake (choice D) may exacerbate fluid overload, making it an inappropriate intervention in this scenario.
2. A 2-year-old child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?
- A. Avoid spicy foods
- B. Avoid gluten
- C. Avoid high-fat foods
- D. Avoid dairy products
Correct answer: B
Rationale: The correct dietary instruction for a 2-year-old child with GERD is to avoid gluten. Gluten is a protein found in wheat, barley, and rye that can worsen GERD symptoms. Avoiding gluten can help reduce inflammation and discomfort in the esophagus. Choices A, C, and D are incorrect because spicy foods, high-fat foods, and dairy products can exacerbate GERD symptoms. Spicy foods can irritate the esophagus, high-fat foods delay stomach emptying leading to increased acid reflux, and dairy products can stimulate acid production, all of which can worsen GERD symptoms.
3. A health care provider orders a tap water enema for a 6-month-old infant with suspected Hirschsprung disease. What rationale causes the nurse to question the order?
- A. The result could lead to loss of necessary nutrients.
- B. It could cause a fluid and electrolyte imbalance.
- C. It could increase the fear of intrusive procedures.
- D. The result could cause shock from a sudden drop in temperature.
Correct answer: B
Rationale: The correct answer is B. Tap water enemas can cause significant fluid and electrolyte imbalances, particularly in infants, making them unsafe for this age group. Choice A is incorrect because tap water enemas do not directly lead to loss of necessary nutrients. Choice C is incorrect as it focuses on emotional impact rather than physiological risks. Choice D is incorrect as shock from a sudden drop in temperature is not a common consequence of a tap water enema in this scenario.
4. During a clinical conference with a group of nursing students, the instructor is describing burn classification. The instructor determines that the teaching has been successful when the group identifies what as characteristic of full-thickness burns?
- A. Skin that is reddened, dry, and slightly swollen
- B. Skin appearing wet with significant pain
- C. Skin with blistering and swelling
- D. Skin that is leathery and dry with some numbness
Correct answer: D
Rationale: Full-thickness burns are characterized by a leathery, dry appearance with numbness due to nerve damage. Choice A describes characteristics of superficial burns, which are not full-thickness. Choice B describes characteristics of partial-thickness burns with intact blisters, not full-thickness burns. Choice C describes characteristics of partial-thickness burns with blistering and swelling, not full-thickness burns.
5. During a routine monthly examination, a 5-month-old infant is brought to the pediatric clinic. What assessment finding should alert the nurse to notify the health care provider?
- A. Temperature of 99.5°F
- B. Blood pressure of 75/48 mm Hg
- C. Heart rate of 100 beats per minute
- D. Respiratory rate of 50 breaths per minute
Correct answer: D
Rationale: A respiratory rate of 50 breaths per minute in a 5-month-old infant is considered high and may indicate respiratory distress. Infants normally have a higher respiratory rate than older children and adults, but a rate of 50 breaths per minute is above the expected range. This finding warrants immediate attention as it may be indicative of an underlying respiratory issue or distress. Choice A (Temperature of 99.5°F) is within the normal range for body temperature and does not necessarily indicate a critical issue. Choice B (Blood pressure of 75/48 mm Hg) is not typically assessed in isolation for a 5-month-old infant during a routine examination, and the values provided are not indicative of a critical condition. Choice C (Heart rate of 100 beats per minute) is within the normal range for heart rate in infants and may not be a cause for immediate concern during a routine examination.
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