HESI LPN
Pediatrics HESI 2023
1. What should the nurse include in the care plan for a 6-month-old infant admitted with a diagnosis of respiratory syncytial virus (RSV)?
- A. Provide small, frequent feedings
- B. Administer antibiotics
- C. Maintain strict isolation
- D. Elevate the head of the bed
Correct answer: D
Rationale: Elevating the head of the bed is crucial in the care plan for an infant with RSV as it helps improve breathing by facilitating better airflow and drainage of secretions. This position can also enhance comfort and reduce respiratory distress. Providing small, frequent feedings (Choice A) is generally beneficial for infants but is not specific to managing RSV. Administering antibiotics (Choice B) is not indicated for RSV as it is caused by a virus, and antibiotics are ineffective against viral infections. Maintaining strict isolation (Choice C) is important to prevent the spread of contagious infections but is not a direct intervention for improving the infant's respiratory status in RSV.
2. A healthcare professional is assessing a child with suspected pertussis. What clinical manifestation is the healthcare professional likely to observe?
- A. Dry, hacking cough
- B. Inspiratory stridor
- C. Nasal congestion
- D. Severe coughing spells
Correct answer: D
Rationale: Severe coughing spells are a hallmark clinical manifestation of pertussis. Pertussis, also known as whooping cough, is characterized by paroxysms of rapid, consecutive coughs followed by a distinctive 'whoop' sound as the patient gasps for air. This intense coughing can lead to vomiting, exhaustion, and sometimes a characteristic 'whoop' sound. Inspiratory stridor (Choice B) is more commonly associated with croup, not pertussis. Nasal congestion (Choice C) is not a typical feature of pertussis. While a cough is present in pertussis, the specific type of cough described in Choice A (dry, hacking cough) is not the predominant feature observed in pertussis.
3. The nurse is assisting low-income families to access health care. The nurse is aware that, in today's society, this most accurately defines the diversity of a modern family.
- A. A family consists of parents and their offspring living together.
- B. A family is whatever the child and family say it is.
- C. A family is two or more people related or unrelated who are living together.
- D. A family is two or more genetically related persons living together with separate roles.
Correct answer: B
Rationale: Given the diversity of families in today's society, some believe that family should be defined as whatever the child and family say it is.
4. A parent arrives in the emergency clinic with a 3-month-old baby who says, “My baby stopped breathing for a while.” The infant continues to have difficulty breathing, with prolonged periods of apnea. Which assessment data should alert the nurse to suspect shaken baby syndrome (SBS)?
- A. Birth occurred before 32 weeks’ gestation
- B. Lack of stridor and adventitious breath sounds
- C. Previous episodes of apnea lasting 10 to 15 seconds
- D. Retractions and use of accessory respiratory muscles
Correct answer: D
Rationale: Retractions and the use of accessory respiratory muscles can be signs of respiratory distress, which may indicate trauma such as shaken baby syndrome (SBS). Shaken baby syndrome can result in brain injury and respiratory compromise, leading to breathing difficulties. Choices A, B, and C are less likely to be associated with SBS. Birth before 32 weeks’ gestation is more related to prematurity rather than SBS. The lack of stridor and adventitious breath sounds, as well as previous episodes of apnea lasting 10 to 15 seconds, are not specific indicators of SBS.
5. The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?
- A. The child has a maculopapular rash on his palms.
- B. The parents report that their son is vomiting and not eating well.
- C. The parents report that their son is irritable and not gaining weight.
- D. Auscultation reveals wheezing with diminished lung sounds.
Correct answer: B
Rationale: Vomiting and poor appetite can be symptoms of neuroblastoma, a malignancy that affects the adrenal glands and sympathetic nervous system. A maculopapular rash on the palms (Choice A) is not typically associated with neuroblastoma. Irritability and poor weight gain (Choice C) may be non-specific findings and do not specifically point towards neuroblastoma. Auscultation findings of wheezing with diminished lung sounds (Choice D) are more indicative of respiratory conditions rather than neuroblastoma.
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