HESI LPN
Pediatric Practice Exam HESI
1. 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.
2. A newborn with an anorectal anomaly had an anoplasty performed. At the 2-week follow-up visit, a series of anal dilations are begun. What should the nurse recommend to the parents to help prevent the infant from becoming constipated?
- A. Use a soy formula.
- B. Breastfeed if possible.
- C. Administer a suppository nightly.
- D. Offer glucose water between feedings.
Correct answer: B
Rationale: Breastfeeding is the best recommendation to help prevent constipation in infants. Breast milk is easily digestible and contains the right balance of nutrients, which can lead to softer stools, thus reducing the likelihood of constipation. Offering a soy formula (Choice A) may not necessarily prevent constipation as effectively as breast milk due to differences in nutrient composition. Administering a suppository nightly (Choice C) is not a routine measure for preventing constipation in infants and may not be suitable for regular use in this scenario. Offering glucose water (Choice D) between feedings is not recommended as it does not provide the necessary nutrients found in breast milk, which are essential for preventing constipation and promoting overall health in newborns.
3. When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?
- A. Skeletal traction
- B. Physical therapy
- C. Orthotics
- D. Occupational therapy
Correct answer: A
Rationale: When caring for a child with cerebral palsy, skeletal traction is the least likely treatment intervention. Cerebral palsy primarily involves motor function impairments, and skeletal traction is not a typical intervention for this condition. Physical therapy is commonly used to improve movement and function, orthotics help with posture and mobility, and occupational therapy addresses activities of daily living. These interventions are more aligned with the needs of a child with cerebral palsy compared to skeletal traction, making it the least likely treatment option.
4. The nurse is assessing a child with a possible fracture. What would the nurse identify as the most reliable indicator?
- 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 is a localized tenderness experienced when pressure is applied to a specific area, suggesting a potential fracture. This tenderness is considered more specific to a fracture than other symptoms such as lack of spontaneous movement, bruising, or inability to bear weight. Lack of spontaneous movement and inability to bear weight can be present in various musculoskeletal injuries, while bruising may not always be immediate or specific to a fracture.
5. A nurse on the pediatric unit is observing the developmental skills of several 2-year-old children in the playroom. Which child should the nurse continue to evaluate?
- A. Cannot stand on one foot
- B. Builds a tower of 7 blocks
- C. Uses echolalia when speaking
- D. Colors outside the lines of a picture
Correct answer: C
Rationale: The correct answer is C because using echolalia (repeating words or phrases) is not typical for a 2-year-old and may indicate the need for further evaluation. Choices A, B, and D are within the expected developmental skills for a 2-year-old. While a 2-year-old may not be able to stand on one foot for an extended period, it is not a concerning developmental milestone at this age. Building a tower of 7 blocks and coloring outside the lines of a picture are both age-appropriate activities that demonstrate fine motor skills and creativity, respectively. However, echolalia at this age could be a sign of an underlying communication or developmental issue that warrants further assessment and monitoring.
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