HESI LPN
Pediatric Practice Exam HESI
1. What behavior is essential for preventing in a child postoperatively after undergoing heart surgery to repair defects associated with tetralogy of Fallot?
- A. Crying
- B. Coughing
- C. Straining at stool
- D. Unnecessary movement
Correct answer: C
Rationale: Preventing straining at stool is crucial postoperatively after heart surgery for tetralogy of Fallot to avoid increasing intrathoracic pressure and placing stress on the surgical site. This can help prevent complications and promote faster healing. While crying, coughing, and unnecessary movement are common postoperative behaviors, they are not specifically linked to worsening outcomes in this context. Straining at stool is particularly emphasized due to its potential to impact the surgical site and overall recovery process.
2. When preparing a 2-year-old child for surgery, what preoperative teaching should be provided to help them understand the procedure?
- A. Explaining the procedure in simple terms
- B. Using a doll to demonstrate the procedure
- C. Showing pictures of the hospital environment
- D. Allowing the child to play with medical equipment
Correct answer: B
Rationale: The correct preoperative teaching for a 2-year-old child undergoing surgery involves using a doll to demonstrate the procedure. This method helps the child understand what to expect in a non-threatening and visual way, making the experience less intimidating. Explaining the procedure in simple terms (Choice A) may not effectively convey the details to a young child. Showing pictures of the hospital environment (Choice C) may not directly address the surgical procedure itself. Allowing the child to play with medical equipment (Choice D) can be unsafe and may not effectively prepare the child for the surgery.
3. Where should the child admitted with injuries that may be related to abuse be placed?
- A. In a private room
- B. With an older, friendly child
- C. With a child of the same age
- D. In a room near the nurses’ desk
Correct answer: D
Rationale: The correct answer is to place the child in a room near the nurses’ desk. This placement allows for close monitoring and immediate intervention if needed, ensuring the safety and well-being of the child. Placing the child in a private room (Choice A) may limit visibility and monitoring. Putting the child with an older, friendly child (Choice B) or a child of the same age (Choice C) does not prioritize the necessary close monitoring and intervention that a child potentially experiencing abuse requires. Hence, placing the child in a room near the nurses’ desk is the most appropriate choice in this scenario.
4. A parent asks a nurse how to tell the difference between measles (rubeola) and German measles (rubella). What should the nurse tell the parent about rubeola that is different from rubella?
- A. High fever and Koplik spots
- B. Rash on the trunk with pruritus
- C. Nausea, vomiting, and abdominal cramps
- D. Characteristics of a cold, followed by a rash
Correct answer: A
Rationale: Rubeola (measles) is characterized by a high fever and the presence of Koplik spots, which are not seen in rubella (German measles). Therefore, the correct answer is A. Choice B, rash on the trunk with pruritus, is more indicative of rubella rather than rubeola. Choice C, nausea, vomiting, and abdominal cramps, are not specific differentiating symptoms between rubeola and rubella. Choice D, characteristics of a cold followed by a rash, does not specifically distinguish between rubeola and rubella.
5. A 1-month-old girl with low-set ears and severe hypotonia has been diagnosed with trisomy 18. Which nursing diagnosis would the nurse identify as most likely?
- A. Interrupted family process related to the child's diagnosis
- B. Deficient knowledge related to the genetic disorder
- C. Grieving related to the child's poor prognosis
- D. Ineffective coping related to the stress of providing care
Correct answer: C
Rationale: The most likely nursing diagnosis for a 1-month-old girl with trisomy 18, characterized by low-set ears and severe hypotonia, is 'Grieving related to the child's poor prognosis.' Trisomy 18 is associated with a poor prognosis, and families often experience grief as they come to terms with the challenges and uncertainties associated with the condition. 'Interrupted family process' may not be as relevant since the primary focus is on the child's condition. 'Deficient knowledge related to the genetic disorder' could be important but may not be the most likely initial concern, as emotional support for the family is crucial at this point. 'Ineffective coping related to the stress of providing care' is a broad diagnosis that does not specifically address the emotional response to the child's prognosis, which is the primary concern in this case.
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