HESI LPN
HESI Pediatrics Quizlet
1. A 13-year-old girl tells the nurse at the pediatric clinic that she took a pregnancy test and it was positive. She adds that her grandfather, with whom she, her younger sisters, and her mother live, has repeatedly molested her for the past 3 years. When the nurse asks the girl if she has told this to anyone, she replies, 'Yes, but my mother doesn’t believe me.' Legally, who should the nurse notify?
- A. Police regarding a possible sex crime
- B. Healthcare provider to confirm the pregnancy
- C. Child Protective Services for immediate intervention
- D. Girl’s mother about the positive pregnancy test result
Correct answer: C
Rationale: In this scenario, the nurse should notify Child Protective Services for immediate intervention. The girl disclosed ongoing sexual abuse by her grandfather, which is a serious concern requiring immediate protection and intervention by the appropriate authorities. Child Protective Services are trained to handle cases of child abuse and neglect, ensuring the safety and well-being of the child. While notifying the police about a possible sex crime is crucial, Child Protective Services should be the first point of contact in cases of suspected child abuse due to their specialized role. Confirming the pregnancy through a healthcare provider is not the priority at this moment, as ensuring the safety of the child is paramount. Informing the girl's mother about the positive test result is not appropriate given the lack of belief in the abuse disclosure and the potential risk to the child's safety.
2. When teaching a group of parents in the daycare center about accident prevention, the nurse explains that young toddlers are prone to injuries from falls. When receiving feedback, the nurse identifies that more teaching is needed when one parent states, 'I will:'
- A. keep medications in a medicine cabinet.
- B. have secured gates at entrances to staircases.
- C. move our child to a regular bed by the appropriate age.
- D. buy shoes that close with Velcro rather than laces.
Correct answer: C
Rationale: Moving a child to a regular bed by the appropriate age is not recommended as it can increase the risk of falls. Toddlers should transition to a regular bed only when developmentally ready to prevent accidents. Keeping medications in a medicine cabinet (Choice A) promotes safety by preventing accidental ingestion. Securing gates at entrances to staircases (Choice B) helps prevent falls down stairs. Buying shoes that close with Velcro rather than laces (Choice D) is a good practice to prevent tripping and falling.
3. What is an important dietary consideration for a child with celiac disease?
- A. Increased iron intake
- B. Gluten-free diet
- C. High-protein diet
- D. Low-sodium diet
Correct answer: B
Rationale: A gluten-free diet is crucial for managing celiac disease in children because it helps prevent intestinal damage and alleviate symptoms. Gluten is a protein found in wheat, barley, and rye, and it triggers an immune response in individuals with celiac disease, damaging the lining of the small intestine. Therefore, choices A, C, and D are incorrect. While iron intake is important for overall health, a child with celiac disease can still meet their iron needs through sources that are naturally gluten-free or fortified. A high-protein diet or a low-sodium diet are not specifically required for managing celiac disease.
4. The charge nurse has a health care team that consists of 1 PN, 1 unlicensed assistive personnel (UAP), and 1 PN nursing student. Which assignment should be questioned by the nurse manager?
- A. An admission at the change of shifts with atrial fibrillation and heart failure - PN
- B. Client who had a major stroke 6 days ago - PN nursing student
- C. A child with burns who has packed cells and albumin IV running - charge nurse
- D. An elderly client who had a myocardial infarction a week ago - UAP
Correct answer: A
Rationale: Assigning an admission with atrial fibrillation and heart failure to a PN is not appropriate. This complex case requires more advanced skills and should not be managed by a PN without adequate support. The PN may not have the necessary training or expertise to handle such a critical situation effectively. Choice B is a suitable assignment for a PN nursing student as they can handle a client who had a major stroke 6 days ago. Choice C is also appropriate as a child with burns receiving packed cells and albumin IV running can be managed by the charge nurse. Choice D is within the scope of practice for a UAP since an elderly client post-myocardial infarction a week ago may require basic care and assistance.
5. A client has been admitted to the hospital with severe diarrhea. The nurse should monitor the client for which complication?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Hyperkalemia
- D. Hypercalcemia
Correct answer: A
Rationale: Severe diarrhea can lead to metabolic acidosis due to the loss of bicarbonate. When there is excessive loss of bicarbonate through diarrhea, the pH of the blood decreases, leading to metabolic acidosis. Metabolic alkalosis (Choice B) is not typically associated with severe diarrhea as it involves elevated pH and bicarbonate levels. Hyperkalemia (Choice C) is less likely with severe diarrhea as potassium is often lost along with fluids. Hypercalcemia (Choice D) is not a common complication of severe diarrhea; instead, hypocalcemia may occur due to malabsorption of calcium.