HESI LPN
Pediatric Practice Exam HESI
1. What is the priority nursing intervention for a child admitted to the hospital with a diagnosis of acute glomerulonephritis?
- A. Monitoring for hypertension
- B. Providing pain relief
- C. Restricting fluid intake
- D. Encouraging fluid intake
Correct answer: A
Rationale: The priority nursing intervention for a child with acute glomerulonephritis is monitoring for hypertension. Acute glomerulonephritis involves inflammation of the kidney's glomeruli, leading to impaired kidney function. Hypertension is a common complication due to fluid retention and increased renin-angiotensin system activity. Monitoring for hypertension is crucial for early detection and management to prevent further kidney damage and complications. Providing pain relief (Choice B) may be required for discomfort but is not the priority. Restricting fluid intake (Choice C) may be necessary in some kidney diseases, but in acute glomerulonephritis, the focus is on monitoring and managing hypertension. Encouraging fluid intake (Choice D) is inappropriate as it can exacerbate fluid overload and hypertension in acute glomerulonephritis.
2. A healthcare professional is teaching parents about why most children should be immunized against varicella (chickenpox) and why some receiving specific medications should not. Which medication should be included in the discussion?
- A. Insulin
- B. Steroids
- C. Antibiotics
- D. Anticonvulsants
Correct answer: B
Rationale: The correct answer is B: Steroids. Children receiving steroids should not receive the varicella vaccine as it can increase the risk of severe infection due to the immunosuppressive effects of steroids. Insulin (Choice A) is not a medication that contraindicates varicella vaccination. Antibiotics (Choice C) and anticonvulsants (Choice D) are also not medications that would impact the decision to immunize against varicella.
3. When caring for a neonate with a suspected tracheoesophageal fistula, what nursing care should be included?
- A. Elevating the head but giving nothing by mouth
- B. Elevating the head for feedings
- C. Feeding glucose water only
- D. Avoiding suctioning unless the infant is cyanotic
Correct answer: A
Rationale: In a neonate with a suspected tracheoesophageal fistula, elevating the head but giving nothing by mouth is crucial to prevent aspiration. Placing the neonate in a semi-upright position helps reduce the risk of reflux and aspiration of gastric contents into the lungs. Elevating the head for feedings (Choice B) would still pose a risk of aspiration as the neonate may aspirate during feeding. Feeding glucose water only (Choice C) is not appropriate and does not address the risk of aspiration associated with a tracheoesophageal fistula. Avoiding suctioning unless the infant is cyanotic (Choice D) is incorrect because suctioning may be necessary for maintaining airway patency, regardless of cyanosis, in a neonate with a suspected tracheoesophageal fistula.
4. One principle to be followed for children with type 1 diabetes is to provide for the variability of the child’s activity. What should the nurse teach the child about how to compensate for increased physical activity?
- A. Eat more food when planning to exercise more than usual.
- B. Take oral, not injectable insulin, on days of heavy exercise.
- C. Take insulin in the morning when extra exercise is anticipated.
- D. Eat foods that contain sugar to compensate for the extra exercise.
Correct answer: A
Rationale: The correct answer is to eat more food when planning to exercise more than usual. Increased physical activity requires more energy, so additional food intake is necessary to compensate for the increased energy expenditure. This helps maintain blood sugar levels within the target range. Choice B is incorrect because the mode of insulin administration does not change based on physical activity; the type and dose of insulin remain the same unless adjusted by a healthcare provider. Choice C is incorrect because insulin timing should not be adjusted solely based on anticipated exercise; consistent timing of insulin doses is crucial for stable blood sugar control. Choice D is incorrect because consuming foods with sugar may lead to unstable blood sugar levels and is not the recommended way to compensate for extra exercise, as it can result in sudden spikes and drops in blood glucose levels, affecting overall diabetes management.
5. The parents of a child with asthma ask the nurse how they can help their child prevent asthma attacks. What should the nurse advise?
- A. Avoid exposure to allergens
- B. Encourage regular exercise
- C. Provide a high-protein diet
- D. Increase fluid intake
Correct answer: A
Rationale: The correct answer is to advise the parents to avoid exposure to allergens. Asthma attacks are often triggered by allergens such as dust mites, pollen, pet dander, and mold. By minimizing the child's exposure to these triggers, the likelihood of asthma attacks can be reduced. Encouraging regular exercise is beneficial for overall health but may not directly prevent asthma attacks. Providing a high-protein diet and increasing fluid intake are important for general well-being but do not specifically address asthma prevention.
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