HESI LPN
Pediatric HESI 2023
1. A 6-year-old child comes to the school nurse reporting a sore throat, and the nurse verifies that the child has a fever and a red, inflamed throat. When a parent of the child arrives at school to take the child home, the nurse urges the parent to seek treatment. The nurse is aware that the causative agent may be beta-hemolytic streptococcus, and the illness may progress to inflamed joints and an infection in the heart. What illness is of most concern to the nurse?
- A. Tetanus
- B. Influenza
- C. Scarlet fever
- D. Rheumatic fever
Correct answer: D
Rationale: The correct answer is D, Rheumatic fever. Rheumatic fever can develop as a complication of untreated strep throat caused by beta-hemolytic streptococcus. It is characterized by inflamed joints and can lead to serious complications such as heart infections. Tetanus (choice A) is caused by a bacterial toxin affecting the nervous system, Influenza (choice B) is a viral respiratory illness, and Scarlet fever (choice C) is also caused by streptococcus but is characterized by a sandpaper-like rash and strawberry tongue. However, in the scenario described, the nurse is most concerned about the child developing rheumatic fever due to the potential serious consequences associated with it.
2. A child is admitted with extensive burns. The nurse notes burns on the child’s lips and singed nasal hairs. The nurse should suspect that the child has a(n)
- A. chemical burn
- B. inhalation injury
- C. electrical burn
- D. hot-water scald
Correct answer: B
Rationale: Burns on the lips and singed nasal hairs are indicative of an inhalation injury. This suggests that the child has likely inhaled hot gases or smoke, leading to damage in the respiratory tract. Choice A, chemical burn, is incorrect because the symptoms described are more aligned with inhalation rather than direct contact with chemicals. Choice C, electrical burn, is incorrect as there are no mentions of contact with an electrical source. Choice D, hot-water scald, is also incorrect as the presentation of burns on the lips and singed nasal hairs is not characteristic of scald injuries.
3. The nurse is teaching a client with gastroesophageal reflux disease (GERD) about dietary modifications. Which food should the client avoid?
- A. Applesauce
- B. White rice
- C. Coffee
- D. Bananas
Correct answer: C
Rationale: The correct answer is C: Coffee. Coffee should be avoided by clients with GERD as it can relax the lower esophageal sphincter, leading to an increase in GERD symptoms. Choices A, B, and D are not directly associated with worsening GERD symptoms and can be included in moderation in the diet of a client with GERD.
4. Which of the following is a priority for the nurse to include in the teaching of a client who was recently prescribed alprazolam (Xanax) as an oral medication?
- A. Monitor heart rate before taking the medication
- B. Monitor temperature daily
- C. Avoid unprotected exposure to sunlight
- D. Avoid alcohol
Correct answer: D
Rationale: The correct answer is D: 'Avoid alcohol.' Alprazolam (Xanax) can have central nervous system depressant effects, which are exacerbated by alcohol. It is crucial to avoid alcohol while taking this medication to prevent severe sedation and respiratory depression. Monitoring heart rate (choice A) is not directly related to alprazolam administration. Monitoring temperature daily (choice B) is not a priority teaching point for a client prescribed alprazolam. Avoiding unprotected exposure to sunlight (choice C) is not specifically linked to the use of alprazolam.
5. A client is admitted with acute pyelonephritis. Which symptom should the nurse expect the client to report?
- A. Flank pain
- B. Pedal edema
- C. Hypotension
- D. Weight gain
Correct answer: A
Rationale: Flank pain is a classic symptom of acute pyelonephritis, which is a bacterial infection of the kidney. It occurs due to inflammation and irritation of the renal capsule, leading to pain in the flank region. Pedal edema (swelling in the feet and ankles) is more commonly associated with conditions like heart failure or kidney disease, not typically seen in acute pyelonephritis. Hypotension (low blood pressure) is a systemic symptom that may occur with severe infections but is not a specific hallmark of pyelonephritis. Weight gain is also not a typical symptom of acute pyelonephritis; instead, patients may experience weight loss due to decreased appetite and systemic effects of infection.