HESI LPN
Pediatrics HESI 2023
1. A child with a diagnosis of leukemia is receiving chemotherapy. What is the most important nursing intervention?
- A. Monitor for signs of infection
- B. Monitor for signs of bleeding
- C. Monitor for signs of dehydration
- D. Monitor for signs of pain
Correct answer: A
Rationale: The most important nursing intervention for a child with leukemia receiving chemotherapy is to monitor for signs of infection. Chemotherapy suppresses the immune system, putting the child at a higher risk of developing infections. Early detection and prompt treatment of infections are crucial to prevent complications and improve outcomes. Monitoring for signs of bleeding (choice B), dehydration (choice C), and pain (choice D) are also important aspects of care, but in this scenario, the priority is to prevent and manage infections due to the compromised immune system.
2. A healthcare professional is reviewing the medical record of a client who has hypocalcemia. The healthcare professional should identify which of the following findings as a risk factor for the development of this electrolyte imbalance?
- A. Crohn’s disease
- B. Postoperative status following appendectomy
- C. History of bone cancer
- D. Hyperthyroidism
Correct answer: A
Rationale: Crohn’s disease is known to impair calcium absorption, which can lead to hypocalcemia. This condition affects the intestines and can disrupt the normal absorption of nutrients, including calcium. Postoperative status following appendectomy, history of bone cancer, and hyperthyroidism are typically not directly associated with a higher risk of developing hypocalcemia compared to Crohn’s disease.
3. The healthcare provider is assessing a client who has just undergone a thoracentesis. Which finding should be reported immediately?
- A. Diminished breath sounds on the affected side.
- B. Pain at the procedure site.
- C. Blood-tinged sputum.
- D. Shortness of breath.
Correct answer: D
Rationale: Shortness of breath should be reported immediately as it may indicate a pneumothorax, a potential complication of thoracentesis. Diminished breath sounds on the affected side, pain at the procedure site, and blood-tinged sputum are common findings post-thoracentesis and do not necessarily indicate immediate complications like a pneumothorax.
4. Following delivery of a newborn, the 21-year-old mother is experiencing mild vaginal bleeding. You note that her heart rate has increased from 90 to 120 beats/min and she is diaphoretic. Management should include
- A. oxygen, uterine massage, and transport
- B. oxygen, placement on the left side, and transport
- C. oxygen, treatment for shock, and uterus massage during transport
- D. oxygen, internal vaginal pads, and treatment of shock during transport
Correct answer: C
Rationale: Postpartum hemorrhage can lead to shock due to excessive bleeding. Oxygen should be provided to support oxygenation. Treatment for shock, which includes maintaining vital signs and perfusion, is crucial. Uterine massage helps prevent further bleeding by promoting uterine contraction. This combination of interventions is essential for managing postpartum hemorrhage effectively. Choices A, B, and D lack the comprehensive approach needed for managing postpartum hemorrhage, as they do not address the treatment of shock, which is vital in this scenario.
5. An IV antibiotic is prescribed for a client with a postoperative infection. The medication is to be administered in 4 divided doses. What schedule is best for administering this prescription?
- A. 1000, 1600, 2200, 0400
- B. Give in equally divided doses during waking hours
- C. Administer with meals and a bedtime snack
- D. 0800, 1200, 1600, 2000
Correct answer: D
Rationale: The best schedule for administering the IV antibiotic in 4 divided doses is 0800, 1200, 1600, and 2000. This timing allows for equal spacing between doses, ensuring consistent therapeutic levels of the medication in the client's system. Choice A provides doses too close together, increasing the risk of medication errors and potential toxicity. Choice B's suggestion of giving doses during waking hours is vague and lacks specific timing, which may result in irregular dosing intervals. Choice C, administering with meals and a bedtime snack, is unrelated to the timing of the antibiotic doses and does not optimize the drug's effectiveness.