HESI LPN
Pediatric HESI 2023
1. A 2-week-old infant is admitted with a tentative diagnosis of a ventricular septal defect. The parents report that their baby has had difficulty feeding since coming home after birth. What should the nurse consider before responding?
- A. Feeding problems are common in neonates.
- B. Inadequate sucking is not significant in the absence of cyanosis.
- C. Ineffective sucking and swallowing may be early indications of a heart defect.
- D. Many neonates retain mucus, which may interfere with feeding for several weeks.
Correct answer: C
Rationale: In this scenario, the nurse should consider that ineffective sucking and swallowing in a 2-week-old infant could be early signs of a heart defect such as a ventricular septal defect. This is crucial information as it can guide further assessment and management. Choice A is incorrect because while feeding problems can be common in neonates, in this case, the specific context of a suspected heart defect should be prioritized. Choice B is incorrect as inadequate sucking can indeed be significant, especially when considering potential underlying heart issues, regardless of the presence of cyanosis. Choice D is incorrect as while mucus retention can affect feeding, in this case, the focus should be on the possibility of a heart defect rather than a temporary issue like mucus interference.
2. A client with severe rheumatoid arthritis is prescribed adalimumab. The nurse should monitor for which potential adverse effect?
- A. Increased risk of infection
- B. Bone marrow suppression
- C. Hair loss
- D. Hyperglycemia
Correct answer: A
Rationale: The correct answer is A: Increased risk of infection. Adalimumab is known to increase the risk of infection due to its immunosuppressive effects. Patients on adalimumab should be closely monitored for signs and symptoms of infection, such as fever, chills, and malaise, and should promptly report any such symptoms to their healthcare provider for further evaluation and management. Monitoring for infection is crucial to prevent serious complications in patients receiving adalimumab therapy.
3. A male client who fell into the lake while fishing and was submerged for about 3 min was successfully resuscitated by his friends. He was brought to the Emergency Department for evaluation and was admitted for a 24-hour uneventful hospital stay. What follow-up instruction should the nurse give?
- A. Avoid smoke-filled environments
- B. Seek medical care promptly if a fever develops
- C. Increase oral fluids if a cough becomes productive
- D. Schedule frequent rest periods
Correct answer: B
Rationale: After being submerged in water, the client should be instructed to seek medical care promptly if a fever develops since complications may arise later. Choices A, C, and D are not directly related to the potential complications from submersion in water and are therefore incorrect. Avoiding smoke-filled environments, increasing oral fluids for a productive cough, and scheduling frequent rest periods are not the priority concerns in this scenario.
4. Which of the following is true regarding the Affordable Care Act?
- A. The Affordable Care Act addressed issues of interest to nursing without controversy.
- B. The Affordable Care Act addressed issues of mandatory overtime, incivility, and high workloads for nurses.
- C. The Affordable Care Act provided a new patient-centered model for health care.
- D. The Affordable Care Act attempted to address many of the issues of interest to nursing, but came with much controversy.
Correct answer: D
Rationale: The correct answer is D. The Affordable Care Act attempted to address many issues relevant to nursing, such as mandatory overtime, incivility, and high workloads, but it faced significant controversy. Choice A is incorrect as the act did not address nursing issues without controversy. Choice B is incorrect as it inaccurately lists the issues the act addressed. Choice C is incorrect as it does not fully capture the controversy surrounding the Affordable Care Act.
5. A client is recovering from gallbladder surgery performed under general anesthesia. How many times per hour should the nurse encourage the client to use the incentive spirometer?
- A. 4-5 times per hour
- B. 2-3 times per hour
- C. 6-7 times per hour
- D. 8-10 times per hour
Correct answer: A
Rationale: Encouraging the client to use the incentive spirometer 4-5 times per hour is the correct approach post-gallbladder surgery under general anesthesia. This frequency helps prevent respiratory complications, such as atelectasis, by promoting lung expansion. Choices B, C, and D suggest either too few or too many sessions per hour, which may not be optimal for the client's respiratory recovery needs. It is important to strike a balance between ensuring adequate lung expansion and not overexerting the client, which is why 4-5 times per hour is the recommended frequency.