HESI LPN
Pediatric Practice Exam HESI
1. A 2-year-old child with a diagnosis of gastroesophageal reflux disease (GERD) is being discharged. What dietary instructions should the nurse provide?
- A. Avoid spicy foods
- B. Avoid gluten
- C. Avoid high-fat foods
- D. Avoid dairy products
Correct answer: C
Rationale: Avoiding gluten is not typically necessary for managing gastroesophageal reflux disease (GERD) in children. The correct dietary instruction for a 2-year-old with GERD would be to avoid high-fat foods. High-fat foods can relax the lower esophageal sphincter, leading to increased reflux symptoms. While spicy foods and dairy products may also trigger reflux in some individuals, the primary focus should be on avoiding high-fat foods due to their direct impact on the lower esophageal sphincter, which exacerbates GERD symptoms.
2. What is an important aspect of care for a child with congenital adrenal hyperplasia?
- A. Monitoring electrolyte levels
- B. Restricting physical activity
- C. Administering high doses of vitamin A
- D. Providing a high-protein diet
Correct answer: A
Rationale: The correct answer is A: Monitoring electrolyte levels. In the management of congenital adrenal hyperplasia, it is crucial to monitor electrolyte levels to prevent imbalances and related complications. Restricting physical activity (choice B) is not a typical aspect of care for this condition. Administering high doses of vitamin A (choice C) is not a standard treatment for congenital adrenal hyperplasia and can be harmful in excess. Providing a high-protein diet (choice D) may be beneficial for some conditions but is not a specific requirement for managing congenital adrenal hyperplasia.
3. The mother of an 8-year-old boy tells the nurse that he fell out of a tree and hurt his arm and shoulder. Which assessment finding is the most significant indicator of possible child abuse?
- A. The child looks at the floor when answering the nurse's questions
- B. The mother's version of the injury is different from the child's version
- C. The child has several abrasions on the chest and legs
- D. The mother refuses to answer questions about family history
Correct answer: B
Rationale: In cases of possible child abuse, discrepancies between the accounts given by the child and the parent are critical indicators. This inconsistency could suggest that the injury was not accidental and may be a result of abuse. Looking at the floor while answering questions or having abrasions on the body can be concerning but are not as direct indicators of abuse as conflicting stories between the child and the parent.
4. A client with diabetes mellitus is being taught by a nurse about mixing regular and NPH insulin. Which of the following statements by the client indicates an understanding of the teaching?
- A. I should roll the NPH vial between my hands before drawing it up.
- B. I should draw up the NPH insulin before the regular insulin.
- C. I should inject air into the vial of regular insulin first.
- D. I should wait 10 minutes after mixing the insulin to inject it.
Correct answer: A
Rationale: The correct answer is A. Rolling the NPH vial between the hands before drawing it up ensures proper mixing of the insulin. Choice B is incorrect because regular insulin should be drawn up first to avoid contamination. Choice C is incorrect as injecting air into the vial of regular insulin is not necessary. Choice D is incorrect as there is no need to wait 10 minutes after mixing the insulin before injecting it.
5. A client at 30 weeks gestation reports that she has not felt the baby move in the last 24 hours. Concerned, she arrives in a panic at the obstetric clinic where she is immediately sent to the hospital. Which assessment warrants immediate intervention by the nurse?
- A. Fetal Heart rate 60 beats per minute
- B. Ruptured amniotic membrane
- C. Onset of uterine contractions
- D. Leaking amniotic fluid
Correct answer: A
Rationale: A fetal heart rate of 60 beats per minute is significantly below the normal range (110-160 bpm) and indicates fetal distress, requiring immediate intervention. This low heart rate can be a sign of fetal compromise or distress, necessitating urgent evaluation and intervention to ensure the well-being of the fetus. Choices B, C, and D do not indicate immediate fetal distress requiring urgent intervention. Ruptured amniotic membrane, onset of uterine contractions, and leaking amniotic fluid are important assessments but do not present an immediate threat to the fetus's life like a severely low fetal heart rate.