HESI LPN
Pediatrics HESI 2023
1. A child with a diagnosis of cystic fibrosis is admitted to the hospital. What is the priority nursing intervention?
- A. Administering pancreatic enzymes
- B. Providing respiratory therapy
- C. Providing nutritional support
- D. Encouraging physical activity
Correct answer: A
Rationale: The correct answer is administering pancreatic enzymes. In cystic fibrosis, the pancreas is often affected, leading to insufficient production of digestive enzymes. Administering pancreatic enzymes is crucial to ensure proper digestion and absorption of nutrients. While respiratory therapy, nutritional support, and physical activity are essential components of care for individuals with cystic fibrosis, addressing the digestive aspect by administering pancreatic enzymes takes priority to prevent malnutrition and promote overall health.
2. Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 90 beats/min. What is the most appropriate initial management for this newborn?
- A. begin positive pressure ventilations
- B. provide blow-by oxygen with oxygen tubing
- C. assess the newborn's skin condition and color
- D. start chest compressions and contact medical control
Correct answer: A
Rationale: A heart rate below 100 beats/min in a newborn indicates the need for positive pressure ventilation to improve oxygenation. Providing positive pressure ventilations helps in assisting the newborn's breathing efforts to ensure adequate oxygenation. Choice B, providing blow-by oxygen, may not be sufficient to address the underlying issue of inadequate breathing. Choice C, assessing the newborn's skin condition and color, is important but not the most immediate action needed for a heart rate below 100 beats/min. Choice D, starting chest compressions, is not indicated as the infant is breathing spontaneously and has a heart rate, albeit lower than normal, which does not warrant chest compressions.
3. A 3-year-old child is being discharged after being treated for dehydration. What should the nurse include in the discharge teaching?
- A. Monitor for signs of infection
- B. Monitor for signs of dehydration
- C. Monitor for signs of hypovolemia
- D. Monitor for signs of malnutrition
Correct answer: B
Rationale: Correct! When a child is being discharged after treatment for dehydration, it is important to educate caregivers about monitoring for signs of dehydration to prevent reoccurrence. Dehydration is the primary concern in this scenario, as the child's fluid levels need to be closely monitored. Choices A, C, and D are incorrect because while infection, hypovolemia, and malnutrition are also important considerations in pediatric care, the immediate focus after treating dehydration should be on preventing its recurrence by monitoring for signs of dehydration.
4. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about blood glucose monitoring. What should the nurse emphasize?
- A. Checking blood glucose levels before meals and at bedtime
- B. Using a lancet device to obtain blood samples
- C. Using urine test strips for monitoring
- D. Recognizing signs of hypoglycemia
Correct answer: A
Rationale: Checking blood glucose levels before meals and at bedtime is essential for managing type 1 diabetes mellitus. This timing helps in assessing the effectiveness of insulin therapy, making adjustments to insulin doses, and preventing hyperglycemia and hypoglycemia. Option B is incorrect because it focuses on the method of obtaining blood samples rather than the timing of monitoring. Option C is incorrect as urine test strips are not recommended for accurate blood glucose monitoring in type 1 diabetes. Option D, recognizing signs of hypoglycemia, is important but not the primary emphasis when teaching about blood glucose monitoring.
5. What explanation should the nurse give a parent about the purpose of a tetanus toxoid injection for their child?
- A. Passive immunity is conferred temporarily.
- B. Long-lasting active immunity is conferred.
- C. Lifelong active natural immunity is conferred.
- D. Passive natural immunity is conferred temporarily.
Correct answer: B
Rationale: The correct answer is B: Long-lasting active immunity is conferred. Tetanus toxoid injection works by stimulating the child's body to produce its antibodies, providing long-lasting active immunity. Choice A is incorrect because passive immunity is not conferred for life; it is temporary and involves receiving antibodies rather than producing them internally. Choice C is incorrect as the immunity conferred by the tetanus toxoid injection is not lifelong natural immunity but rather active immunity stimulated by the body's immune response. Choice D is also incorrect since passive natural immunity is not conferred by the tetanus toxoid injection, and it is not temporary.
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