HESI LPN
Pediatric Practice Exam HESI
1. A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base imbalance should the nurse expect the child to develop?
- A. metabolic alkalosis due to insufficient production of acid metabolites
- B. respiratory alkalosis due to depressed respirations and retention of carbon dioxide
- C. respiratory acidosis due to impaired respirations and increased formation of carbonic acid
- D. metabolic acidosis due to the kidneys' inability to compensate for decreased carbonic acid formation
Correct answer: C
Rationale: In a severe asthma attack, the child is likely to develop respiratory acidosis. This occurs due to impaired respirations, leading to the retention of carbon dioxide and the formation of carbonic acid. Choice A is incorrect as metabolic alkalosis is not expected in this situation. Choice B is incorrect as respiratory alkalosis does not align with the scenario of impaired respirations in severe asthma attacks. Choice D is also incorrect as it describes metabolic acidosis, which is not typically associated with severe asthma attacks.
2. The healthcare professional is preparing to administer potassium chloride intravenously to a client with hypokalemia. Which action is most important?
- A. Monitor the client's respiratory rate
- B. Check the client's urine output
- C. Administer the potassium chloride as a rapid IV push
- D. Dilute the potassium chloride in an appropriate IV solution
Correct answer: D
Rationale: The correct answer is to dilute the potassium chloride in an appropriate IV solution. Potassium chloride should never be administered as a rapid IV push as it can lead to severe complications, including cardiac arrhythmias. Diluting the medication and administering it slowly helps reduce the risk of adverse effects. Monitoring the client's respiratory rate (Choice A) and checking urine output (Choice B) are important aspects of patient assessment but not the most crucial when administering potassium chloride. Administering potassium chloride as a rapid IV push (Choice C) is dangerous and can result in serious harm to the client.
3. A client with chronic pain is prescribed oxycodone. What instruction should the practical nurse (PN) include in the client's teaching plan?
- A. Take the medication with meals to avoid gastrointestinal upset.
- B. Avoid taking the medication with alcohol.
- C. Increase fluid intake to avoid constipation.
- D. Report any signs of respiratory depression to the healthcare provider.
Correct answer: B
Rationale: The correct answer is to instruct the client to avoid taking oxycodone with alcohol. Mixing oxycodone with alcohol can lead to serious side effects, including respiratory depression. Taking the medication with meals may not always be necessary, and instructions about fluid intake to avoid constipation are important but not the priority when considering the immediate risks associated with oxycodone. While reporting signs of respiratory depression is crucial, preventing it by avoiding alcohol is key in the client's safety.
4. Which of the following is an example of a positive outcome for one of the Leading Health Indicators of Healthy People 2020?
- A. A community has adopted a no smoking policy.
- B. A rural community has a public transportation system.
- C. The high school dropout rate has decreased by 15%.
- D. A county has decreased its divorce rate by 10%.
Correct answer: A
Rationale: The correct answer is A. A community adopting a no smoking policy is a positive outcome for the Leading Health Indicators of Healthy People 2020 as it promotes a healthier environment by reducing exposure to secondhand smoke and decreasing smoking-related illnesses. Choices B, C, and D do not directly align with the goals of the Leading Health Indicators. While public transportation and reduced dropout rates are beneficial for community well-being, they are not specific examples of Leading Health Indicators. Decreasing divorce rates, while potentially beneficial for family stability, is not a focus area of the Leading Health Indicators.
5. A child with juvenile idiopathic arthritis (JIA) is under the care of a nurse. What is the priority nursing intervention?
- A. Encouraging a diet high in protein
- B. Administering nonsteroidal anti-inflammatory drugs (NSAIDs)
- C. Applying heat to affected joints
- D. Providing range-of-motion exercises
Correct answer: B
Rationale: The priority nursing intervention for a child with juvenile idiopathic arthritis (JIA) is administering nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation. NSAIDs are commonly used in the treatment of JIA to help alleviate symptoms. While encouraging a diet high in protein, applying heat to affected joints, and providing range-of-motion exercises are essential components of care, addressing pain and inflammation with NSAIDs is the priority intervention. This is because controlling pain and inflammation is crucial in improving the child's comfort and quality of life, which takes precedence over other supportive measures.