HESI LPN
Pediatric HESI 2023
1. A 4-year-old fell from a third-story window and landed on her head. She is semiconscious with slow, irregular breathing and bleeding from her mouth. After performing a jaw-thrust maneuver with simultaneous stabilization of her head, what should you do next?
- A. Suction the oropharynx
- B. Insert a nasopharyngeal airway
- C. Initiate positive pressure ventilations
- D. Administer oxygen via mask
Correct answer: A
Rationale: In this scenario, the patient is experiencing airway compromise due to the fall and potential oropharyngeal obstruction from bleeding. Performing a jaw-thrust maneuver with head stabilization helps maintain the airway patency. The next step should be to suction the oropharynx to clear any blood or secretions, which can obstruct the airway and lead to aspiration. Inserting a nasopharyngeal airway may worsen bleeding or cause further injury to the patient's airway. Initiating positive pressure ventilations can be ineffective if the airway is not cleared first. Administering oxygen via mask is not the immediate priority; ensuring a patent airway by suctioning takes precedence.
2. While being educated by a nurse, an assistive personnel (AP) is learning about proper hand hygiene. Which statement made by the AP indicates a good understanding of the teaching?
- A. There are times I should use soap and water rather than alcohol-based hand rub to clean my hands.
- B. I can use alcohol-based hand rub after using the restroom.
- C. Soap and water are only necessary if my hands are visibly dirty.
- D. Hand rub is always sufficient, regardless of the situation.
Correct answer: C
Rationale: Choice C is the correct answer because it demonstrates an understanding that soap and water should be used when hands are visibly dirty or when dealing with specific pathogens. Choice A is incorrect because it suggests the use of soap and water over alcohol-based hand rub without specifying the circumstances. Choice B is incorrect as it implies that using alcohol-based hand rub after using the restroom is always suitable. Choice D is incorrect because it states that hand rub is always enough, which is not true when hands are visibly soiled or when specific pathogens are present.
3. Which of the following changes was enacted by the Patient Protection and Affordable Care Act?
- A. Creation of national health insurance exchanges for affordable insurance coverage
- B. Expansion of school-based health centers
- C. Free preventative services for all
- D. Medically managed clinics eligible for federal funding
Correct answer: B
Rationale: The correct answer is B. The Patient Protection and Affordable Care Act expanded school-based health centers to provide additional healthcare services to students. Choice A is incorrect because the creation of national health insurance exchanges was a key provision of the Affordable Care Act, but it was not the only change enacted by the legislation. Choice C is incorrect as while the Affordable Care Act did include provisions for free preventative services for certain groups, it was not applicable to all individuals. Choice D is incorrect as the Act did not specifically address medically managed clinics eligible for federal funding.
4. When caring for a client at the end of life, which statement by the client’s partner reflects effective coping?
- A. I am relying on support from our family during this time.
- B. I am feeling overwhelmed but don’t want to talk about it.
- C. I am managing everything on my own without help.
- D. I prefer to stay alone with my partner.
Correct answer: A
Rationale: The correct answer is A: 'I am relying on support from our family during this time.' When a client is at the end of life, relying on support from family can be an effective coping mechanism. It allows the partner to share the emotional burden, seek comfort, and prevent feelings of isolation. Choice B reflects a reluctance to express feelings, which can hinder coping mechanisms by internalizing stress. Choice C suggests handling everything alone, which can lead to burnout and emotional strain due to the overwhelming responsibilities. Choice D, preferring to stay alone with the partner, may limit access to external support that could provide additional emotional and practical assistance during this challenging time, making it a less effective coping strategy.
5. Which condition is commonly screened for in newborns using the Guthrie test?
- A. Phenylketonuria (PKU)
- B. Cystic fibrosis
- C. Down syndrome
- D. Sickle cell anemia
Correct answer: A
Rationale: The Guthrie test is specifically designed to screen newborns for phenylketonuria (PKU), a metabolic disorder that can lead to intellectual disability if left untreated. Phenylketonuria is caused by the deficiency of an enzyme required to metabolize the amino acid phenylalanine. Screening for PKU in newborns is crucial as early diagnosis and intervention can prevent the severe consequences associated with the condition. Choices B, C, and D are incorrect as the Guthrie test is not used to screen for cystic fibrosis, Down syndrome, or sickle cell anemia.