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 child with a diagnosis of asthma is being evaluated for medication management. What is an important assessment for the nurse to perform?
- A. Assess the child's sleep patterns
- B. Assess the child's dietary intake
- C. Assess the child's academic performance
- D. Assess the child's behavior at home
Correct answer: B
Rationale: Assessing the child's dietary intake is crucial in managing asthma as certain foods can trigger or worsen symptoms. Monitoring dietary habits helps identify any potential triggers and ensures proper nutrition, which can impact asthma control. Assessing sleep patterns, academic performance, or behavior at home may provide valuable information in a general health assessment, but when specifically managing asthma, dietary intake assessment is the most relevant.
3. After a discussion with the healthcare provider, the parents of an infant with patent ductus arteriosus (PDA) ask the nurse to explain once again what PDA is. How should the nurse respond?
- A. The diameter of the aorta is enlarged.
- B. The wall between the right and left ventricles is open.
- C. It is a narrowing of the entrance to the pulmonary artery.
- D. It is a connection between the pulmonary artery and the aorta.
Correct answer: D
Rationale: Patent ductus arteriosus (PDA) is an abnormal connection between the pulmonary artery and the aorta. In a fetus, the ductus arteriosus is a normal connection between these two vessels, allowing blood to bypass the lungs. However, it should close shortly after birth. When it remains open (patent), it leads to PDA. Choices A, B, and C do not accurately describe PDA. Choice A describes an enlarged aorta, choice B describes a ventricular septal defect, and choice C describes pulmonary stenosis, which are different cardiac conditions.
4. The healthcare professional is assessing a 4-year-old client. Which finding suggests to the healthcare professional this child may have a genetic disorder?
- A. Inquiry reveals the child had feeding problems.
- B. The child weighs 40 lb (18.2 kg) and is 40 in (101.6 cm) in height.
- C. The child has low-set ears with lobe creases.
- D. The child can hop on one foot but cannot skip.
Correct answer: C
Rationale: Low-set ears with lobe creases are often associated with genetic disorders and can indicate underlying chromosomal abnormalities. This physical characteristic is known to be a common sign in various syndromes like Down syndrome. Choices A, B, and D are not directly linked to genetic disorders. Feeding problems and specific weight/height measurements are more general indicators of growth and development, while the ability to hop on one foot but not skip is a developmental milestone assessment that does not specifically point towards a genetic disorder.
5. When the working mother of a toddler is preparing to take her child home after a prolonged hospitalization, she asks the nurse what type of behavior she should expect to be displayed. What is the nurse’s most appropriate description of her child’s probable behavior?
- A. Excessively demanding behavior
- B. Hostile attitude toward the mother
- C. Cheerful, with shallow attachment behaviors
- D. Withdrawn, without emotional ties to the mother
Correct answer: A
Rationale: After a prolonged hospitalization, a toddler may exhibit excessively demanding behavior as they readjust to being home. This behavior can be a result of the child seeking extra attention and reassurance after a stressful experience. Choices B, C, and D are incorrect because hostility, cheerfulness with shallow attachment, and withdrawal without emotional ties are less likely outcomes in this situation and do not align with common reactions of toddlers after hospitalization.
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