HESI LPN
Pediatric HESI 2024
1. What should be included in the nursing plan of care for a 6-month-old infant admitted to the pediatric unit with a diagnosis of respiratory syncytial virus (RSV)?
- A. Place the infant in a warm, dry environment.
- B. Allow parents and siblings to visit.
- C. Maintain standard and contact precautions.
- D. Administer prescribed antibiotics immediately.
Correct answer: C
Rationale: The correct answer is C: Maintain standard and contact precautions. RSV is highly contagious, primarily spread through respiratory secretions. Therefore, it is crucial to implement infection control measures such as standard and contact precautions to prevent the spread of the virus to other patients, staff, and visitors. Choice A is incorrect because warmth and dryness are not specific interventions for RSV; the focus should be on infection control. Choice B may increase the risk of exposing others to RSV, so limiting visitors is recommended. Choice D is unnecessary because RSV is a viral infection, and antibiotics are not effective against viruses.
2. A parent and 4-year-old child who recently emigrated from Colombia arrive at the pediatric clinic. The child has a temperature of 102°F, is irritable, and has a runny nose. Inspection reveals a rash and several small, red, irregularly shaped spots with blue-white centers in the mouth. What illness does the nurse suspect the child has?
- A. Measles
- B. Chickenpox
- C. Fifth disease
- D. Scarlet fever
Correct answer: A
Rationale: The nurse should suspect measles based on the symptoms described, including the presence of Koplik spots (small, red spots with blue-white centers in the mouth). Measles typically presents with fever, irritability, runny nose, and a rash that begins on the face and spreads downward. Chickenpox (choice B) presents with vesicular lesions in different stages of healing and usually starts on the trunk. Fifth disease (choice C) presents with a 'slapped cheek' rash on the face and can cause joint pain. Scarlet fever (choice D) is characterized by a sandpaper-like rash, fever, and strawberry tongue.
3. The healthcare professional is developing a teaching plan for a child who is to have their cast removed. What instruction would the professional most likely include?
- A. Applying petroleum jelly to the dry skin.
- B. Rubbing the skin vigorously to remove the dead skin.
- C. Soaking the area in warm water every day.
- D. Washing the skin with diluted peroxide and water.
Correct answer: C
Rationale: Soaking the area in warm water is the most appropriate instruction for a child who is having their cast removed. This method helps to gently remove dead skin without causing irritation. Applying petroleum jelly to dry skin (Choice A) is not recommended as it may not effectively aid in the removal of dead skin. Rubbing the skin vigorously (Choice B) can lead to skin irritation and should be avoided. Washing the skin with diluted peroxide and water (Choice D) may be too harsh, causing unnecessary irritation to the skin post-cast removal.
4. A 1-year-old child has a congenital cardiac malformation that causes right-to-left shunting of blood through the heart. What clinical finding should the healthcare provider expect?
- A. Proteinuria
- B. Peripheral edema
- C. Elevated hematocrit
- D. Absence of pedal pulses
Correct answer: C
Rationale: In a congenital cardiac malformation causing right-to-left shunting, the nurse should expect an elevated hematocrit. This occurs because the body compensates for decreased oxygenation by producing more red blood cells. Proteinuria (Choice A) is not typically associated with congenital cardiac malformations causing right-to-left shunting. Peripheral edema (Choice B) is more commonly seen in conditions causing left-sided heart failure. Absence of pedal pulses (Choice D) is not a typical finding in congenital cardiac malformations causing right-to-left shunting.
5. The nurse volunteering at a homeless shelter to assist families with children identifies homelessness as a risk preventing families from achieving positive outcomes in life. What family theory encompasses this approach to assessing family dynamics?
- A. Duvall's developmental theory
- B. Friedman's structural functional theory
- C. Von Bertalanffy's general system theory applied to families
- D. Resiliency model of family stress, adjustment, and adaptation
Correct answer: D
Rationale: The Resiliency model of family stress, adjustment, and adaptation is the appropriate theory in this scenario. This model focuses on identifying risks and protective factors that help families achieve positive outcomes despite challenges. Duvall's developmental theory primarily focuses on family life cycle stages, Friedman's structural functional theory emphasizes the interdependence of family members, and Von Bertalanffy's general system theory applied to families looks at the family as a dynamic system. These theories do not specifically address the concept of resilience and adaptation in the face of stressors like homelessness.
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