a child with a diagnosis of celiac disease is being discharged what dietary instructions should the nurse provide
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Nursing Elites

HESI LPN

Pediatric HESI 2024

1. A child with a diagnosis of celiac disease is being discharged. What dietary instructions should the nurse provide?

Correct answer: B

Rationale: The correct answer is to 'Avoid gluten.' Celiac disease is an autoimmune disorder triggered by gluten consumption, a protein found in wheat, barley, and rye. By avoiding gluten-containing foods, individuals with celiac disease can prevent damage to their small intestine and manage their symptoms effectively. Choice A, 'Avoid dairy products,' is incorrect as dairy is not directly related to celiac disease. Choice C, 'Avoid high-fat foods,' and Choice D, 'Avoid foods high in sugar,' are incorrect as they are not primary dietary concerns in managing celiac disease. The main focus should be on eliminating gluten sources from the diet.

2. An infant with hypertrophic pyloric stenosis (HPS) is admitted to the pediatric unit. What does the nurse expect to find when palpating the infant’s abdomen?

Correct answer: C

Rationale: When palpating the abdomen of an infant with hypertrophic pyloric stenosis (HPS), the nurse would expect to feel an olive-sized mass in the right upper quadrant. This finding is characteristic of HPS, where the hypertrophied pyloric muscle forms a palpable mass in the abdomen. Choices A, B, and D are incorrect. A distended colon is not a typical finding in HPS, marked tenderness around the umbilicus is not specific to this condition, and rhythmic peristaltic waves in the lower abdomen are not associated with HPS.

3. What is the typical therapeutic management treatment for children with Hirschsprung disease?

Correct answer: D

Rationale: The most common treatment for Hirschsprung disease is the surgical removal of the affected section of the bowel. This procedure entails excising the part of the colon that lacks nerve cells crucial for normal bowel function. Daily enemas (Choice A) can offer temporary relief for constipation but do not address the root cause of the condition, which is the absence of nerve cells. A low-fiber diet (Choice B) is not a primary therapy for Hirschsprung disease and may not effectively manage the disorder. A permanent colostomy (Choice C) is typically considered in severe cases where other interventions have failed and is not the standard management approach for Hirschsprung disease.

4. The parent of a 2-year-old child is informed by the nurse that the toddler’s negativism is expected at this age. What need is this behavior meeting?

Correct answer: D

Rationale: Negativism in toddlers commonly occurs around the age of 2 as they begin to assert their independence and autonomy. At this stage, children are exploring their own will and preferences, leading to behaviors like defiance or negativism. Independence (choice D) is the primary need being met by this behavior as toddlers strive to establish their individuality and decision-making. While trust (choice A) is crucial for forming secure attachments, it is not the main need driving negativism in this case. Seeking attention (choice B) may be a behavior exhibited by children, but it is not the fundamental need being fulfilled by negativism. Discipline (choice C) is important for setting boundaries and teaching appropriate conduct, but it is not the primary need being addressed by negativism in toddlers.

5. A 3-month-old infant has been hospitalized with respiratory syncytial virus (RSV). What is the priority intervention?

Correct answer: B

Rationale: The priority intervention for a 3-month-old infant hospitalized with respiratory syncytial virus (RSV) is to cluster care to conserve energy. Infants with RSV often have difficulty breathing and need to rest frequently. Clustering care involves grouping nursing interventions to allow for longer periods of rest between activities, which helps prevent exhaustion and conserve the infant's energy. Administering an antiviral agent is not the primary intervention for RSV, as it is a viral infection and antiviral agents are not typically used for RSV. Offering oral fluids is important for hydration but may not be the priority when the infant is struggling to breathe. Providing an antitussive agent should be done judiciously and under medical guidance, as suppressing the cough reflex can be detrimental in RSV cases where coughing helps clear airway secretions.

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