HESI LPN
Pediatric HESI 2023
1. A child with a diagnosis of nephrotic syndrome is being discharged. What dietary instructions should the nurse provide?
- A. Encourage a high-protein diet
- B. Avoid foods high in salt
- C. Encourage a low-sodium diet
- D. Encourage a low-protein diet
Correct answer: B
Rationale: For a child with nephrotic syndrome, it is important to avoid foods high in salt. This instruction helps manage symptoms and prevent complications associated with the condition. High salt intake can lead to fluid retention and worsen edema, which are common issues in nephrotic syndrome. Encouraging a low-sodium diet is crucial to maintaining fluid balance and reducing strain on the kidneys. Choices A, C, and D are incorrect because a high-protein diet can further stress the kidneys, while a low-protein diet may not be necessary unless specifically advised by the healthcare provider. Encouraging a low-sodium diet is more appropriate for managing nephrotic syndrome.
2. A child with a diagnosis of leukemia is admitted to the hospital with a fever. What is the priority nursing intervention?
- A. Administering antibiotics
- B. Administering antipyretics
- C. Providing nutritional support
- D. Monitoring for signs of infection
Correct answer: D
Rationale: The correct answer is D: Monitoring for signs of infection. When a child with leukemia presents with a fever, the priority nursing intervention is to monitor for signs of infection due to the immunocompromised state of the child. Administering antibiotics (choice A) may be necessary based on the assessment of signs of infection, but monitoring comes first. Administering antipyretics (choice B) helps to reduce fever but does not address the underlying cause. Providing nutritional support (choice C) is essential but not the priority when the child is at risk of infection.
3. The nurse is teaching a father how to stimulate his 7-year-old son, who has a 'slow-to-warm-up' temperament. Which guidance will be most successful?
- A. Telling him to read stories to the child about famous athletes
- B. Suggesting he take the child to watch him play softball
- C. Urging him to sign the child up for little league football
- D. Proposing wrestling with the child and letting him win
Correct answer: A
Rationale: The correct answer is A. Reading stories to the child about famous athletes would be the most successful guidance for a child with a 'slow-to-warm-up' temperament. This approach allows for a less active and more acceptable way of engaging with the child, aligning better with the child's temperament. Choices B, C, and D involve more active and potentially overwhelming activities for a child with such a temperament, which may not be as effective in stimulating and engaging the child.
4. The nurse is caring for a 3-day-old girl with Down syndrome whose mother had no prenatal care. What is the priority nursing diagnosis?
- A. Imbalanced nutrition, less than body requirements related to the effects of hypotonia
- B. Deficient knowledge related to the presence of a genetic disorder
- C. Delayed growth and development related to a cognitive impairment
- D. Impaired physical mobility related to poor muscle tone
Correct answer: A
Rationale: The priority nursing diagnosis for a 3-day-old girl with Down syndrome, whose mother had no prenatal care, is imbalanced nutrition, less than body requirements related to the effects of hypotonia. Newborns with Down syndrome often experience feeding difficulties due to hypotonia, which can lead to inadequate nutrition intake. Option B is incorrect because at this age, the infant is not capable of having knowledge deficits related to a genetic disorder. Option C is incorrect as delayed growth and development are not the immediate priority in this scenario. Option D is incorrect as impaired physical mobility is not typically a priority concern for a newborn with Down syndrome.
5. A child with a diagnosis of leukemia is receiving chemotherapy. What is the priority nursing intervention?
- A. Monitoring for signs of infection
- B. Providing nutritional support
- C. Monitoring for signs of bleeding
- D. Monitoring for signs of pain
Correct answer: A
Rationale: The priority nursing intervention for a child with leukemia receiving chemotherapy is monitoring for signs of infection. Chemotherapy can suppress the immune system, increasing the risk of infections. Detecting and managing infections promptly is crucial to prevent complications and improve outcomes. Providing nutritional support is important, but infection prevention takes precedence due to the immediate threat it poses to the child's health. Monitoring for signs of bleeding is relevant in leukemia due to decreased platelet count, but infection surveillance is more critical. Monitoring for signs of pain is essential, but addressing infections promptly is the priority to prevent further deterioration in the child's condition.
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