HESI LPN
Pediatrics HESI 2023
1. .A nurse is caring for an infant whose vomiting is intractable. For what complication is it most important for the nurse to assess?
- A. Acidosis
- B. Alkalosis
- C. Hyperkalemia
- D. Hypernatremia
Correct answer: B
Rationale: Intractable vomiting can lead to alkalosis due to loss of stomach acids.
2. The nurse volunteering at a homeless shelter to assist families with children identifies homelessness as a risk preventing families from achieving positive outcomes in life. What family theory encompasses this approach to assessing family dynamics?
- A. Duvall's developmental theory
- B. Friedman's structural functional theory
- C. Von Bertalanffy's general system theory applied to families
- D. Resiliency model of family stress, adjustment, and adaptation
Correct answer: D
Rationale: The Resiliency model of family stress, adjustment, and adaptation focuses on identifying the elements of risks and protective factors that help families achieve positive outcomes. In this scenario, the nurse recognizing homelessness as a risk aligns with the resiliency model, which emphasizes how families cope and adapt in the face of stressors. Duvall's theory primarily focuses on family life cycle stages, Friedman's theory emphasizes the roles and functions within a family structure, and Von Bertalanffy's theory looks at families as complex systems rather than specifically addressing resilience in the face of stressors.
3. What is an important nursing responsibility when a dysrhythmia is suspected?
- A. Order an immediate electrocardiogram
- B. Count the radial pulse every minute for five times
- C. Count the apical pulse for 1 full minute and compare the rate with the radial pulse rate
- D. Have someone else take the radial pulse simultaneously with the apical pulse
Correct answer: C
Rationale: When a dysrhythmia is suspected, it is important for nurses to count the apical pulse for a full minute and compare it with the radial pulse rate. This method helps in identifying dysrhythmias because discrepancies between the apical and radial pulse rates can indicate irregular heart rhythms. Option A is incorrect because ordering an immediate electrocardiogram may not always be feasible or necessary as a first step. Option B, counting the radial pulse multiple times, is less accurate than comparing the apical and radial pulse rates. Option D involves an unnecessary step of having another person take simultaneous pulses when the nurse can do it effectively alone.
4. While assessing an 18-month-old child, a nurse observes that the toddler can crawl upstairs but needs assistance when climbing the stairs upright. What does this action indicate to the nurse?
- A. Presence of talipes equinovarus
- B. Reflective of neurologic damage
- C. Expected behavior in a toddler of this age
- D. Existence of developmental dysplasia of the hip
Correct answer: C
Rationale: The correct answer is C. Needing assistance to climb stairs is considered expected behavior for an 18-month-old toddler. At this age, children are still developing their gross motor skills, coordination, and balance, which can vary in proficiency. It is common for toddlers to be able to crawl upstairs before mastering the skill of climbing stairs upright. Options A, B, and D are incorrect because at 18 months, it is normal for children to require help and practice with climbing stairs and does not necessarily point to any specific medical conditions or developmental issues.
5. A nurse is inspecting the skin of a child with atopic dermatitis. What would the nurse expect to observe?
- A. Erythematous papulovesicular rash
- B. Dry, red, scaly rash with lichenification
- C. Pustular vesicles with honey-colored exudates
- D. Hypopigmented oval scaly lesions
Correct answer: B
Rationale: In atopic dermatitis, the nurse would expect to observe a dry, red, scaly rash with lichenification. Lichenification is thickened skin due to chronic scratching. Choices A, C, and D are incorrect. Erythematous papulovesicular rash is more characteristic of contact dermatitis, pustular vesicles with honey-colored exudates are seen in impetigo, and hypopigmented oval scaly lesions are typical of pityriasis alba.
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