HESI LPN
Pediatric Practice Exam HESI
1. A 3-year-old child ingests a substance that may be a poison. The parent calls a neighbor who is a nurse and asks what to do. What should the nurse recommend the parent do?
- A. Administer syrup of ipecac.
- B. Call the poison control center.
- C. Take the child to the emergency department.
- D. Give the child bread dipped in milk to absorb the poison.
Correct answer: B
Rationale: In cases of potential poisoning, the best immediate action to take is to call the poison control center. Administering syrup of ipecac is no longer recommended as it can lead to complications such as aspiration and may interfere with subsequent treatments. Taking the child to the emergency department should only be done if advised by the poison control center or if the child is showing severe symptoms. Giving bread dipped in milk to absorb the poison is not an appropriate or effective treatment for poisoning, as it does not address the toxicity of the ingested substance and may delay appropriate medical interventions.
2. After completing an oral examination of a healthy 2-year-old child, the parent asks when the child should first be taken to the dentist. When is the most appropriate time in the child’s life for the nurse to suggest?
- A. Before starting school
- B. Within the next few months
- C. When the first deciduous teeth are lost
- D. At the next dental visit of a family member
Correct answer: B
Rationale: It is recommended that a child should visit the dentist within the next few months after turning two years old. This allows for early dental check-ups to monitor oral health, detect any issues early on, and establish a good oral hygiene routine. Choice A ('Before starting school') is not as specific and may delay the child's first dental visit. Choice C ('When the first deciduous teeth are lost') is too late for the first dental visit, as preventive care should start earlier. Choice D ('At the next dental visit of a family member') is not ideal as the child's dental needs should be addressed independently of family members' visits.
3. How is the diagnosis of Hirschsprung disease confirmed in a 1-month-old infant admitted to the pediatric unit?
- A. Colonoscopy
- B. Rectal biopsy
- C. Multiple saline enemas
- D. Fiberoptic nasoenteric tube
Correct answer: B
Rationale: Rectal biopsy is the definitive diagnostic procedure for Hirschsprung disease in infants. It confirms the absence of ganglion cells in the affected bowel segment, which is characteristic of Hirschsprung disease. Colonoscopy (Choice A) is not typically used for confirmation as it may not provide a definitive result. Multiple saline enemas (Choice C) are utilized in the treatment of meconium ileus, a complication of cystic fibrosis, and not in the diagnosis of Hirschsprung disease. Fiberoptic nasoenteric tube (Choice D) is not a diagnostic tool for Hirschsprung disease; it is commonly used for gastrointestinal decompression or feeding purposes but does not confirm the diagnosis.
4. A 6-year-old child with a diagnosis of juvenile idiopathic arthritis (JIA) is being discharged. What should the nurse include in the discharge teaching?
- A. Encourage participation in physical activity
- B. Provide a high-calorie diet
- C. Provide a low-sodium diet
- D. Administer intravenous fluids
Correct answer: A
Rationale: Encouraging regular physical activity is essential in managing symptoms and improving joint function in juvenile idiopathic arthritis. Physical activity helps maintain joint mobility, muscle strength, and overall function. Providing a high-calorie diet may not be necessary unless there are specific concerns about the child's nutritional status. A low-sodium diet is not typically a priority in the management of JIA unless the child has comorbid conditions requiring sodium restriction. Administering intravenous fluids is not a standard discharge teaching for JIA unless there are specific medical indications necessitating it.
5. A child is diagnosed with atopic dermatitis. Which laboratory test would the nurse expect the child to undergo to provide additional evidence for this condition?
- A. Erythrocyte sedimentation rate
- B. Potassium hydroxide prep
- C. Wound culture
- D. Serum immunoglobulin E (IgE) level
Correct answer: D
Rationale: The correct answer is D: Serum immunoglobulin E (IgE) level. An elevated serum IgE level is commonly associated with atopic dermatitis, reflecting an allergic response. Choice A, erythrocyte sedimentation rate, is a nonspecific test for inflammation and not specific to atopic dermatitis. Choice B, potassium hydroxide prep, is used to diagnose fungal infections like tinea versicolor, not atopic dermatitis. Choice C, wound culture, is not typically indicated for the diagnosis of atopic dermatitis as it is a chronic inflammatory skin condition rather than an infectious process.
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