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 parent asks the nurse what to do when their toddler has temper tantrums. What play materials should the nurse suggest to offer the child as another way of expressing anger?
- A. Ball and bat
- B. Wad of clay
- C. Punching bag
- D. Pegs and pounding board
Correct answer: D
Rationale: Pegs and pounding boards are recommended as play materials for toddlers to express their anger in a constructive manner. These tools provide a safe and effective outlet for the child's emotions through physical activity. Options A, B, and C do not offer the same interactive and expressive qualities that pegs and pounding boards provide. A ball and bat may encourage aggressive behavior, a wad of clay is more suitable for creative expression rather than anger management, and a punching bag may promote violent behavior which is not appropriate for toddlers.
3. A 2-year-old child with a diagnosis of hemophilia is admitted to the hospital. What should the nurse include in the care plan?
- A. Encourage participation in contact sports
- B. Use a soft toothbrush for oral care
- C. Administer nonsteroidal anti-inflammatory drugs
- D. Administer aspirin for pain
Correct answer: B
Rationale: Using a soft toothbrush helps to prevent bleeding in a child with hemophilia.
4. What is the most important intervention for a nurse to implement for a child with sickle cell anemia admitted to the hospital during a vaso-occlusive crisis?
- A. Administering oxygen
- B. Ensuring adequate hydration
- C. Monitoring vital signs
- D. Administering pain medication
Correct answer: B
Rationale: Ensuring adequate hydration is crucial during a vaso-occlusive crisis in sickle cell anemia as it helps to reduce the viscosity of the blood and prevent further sickling of the cells. While administering oxygen may be necessary in some cases, ensuring hydration takes precedence as it directly impacts the underlying pathophysiology of the crisis. Monitoring vital signs is important for ongoing assessment but does not directly address the crisis as hydration does. Administering pain medication is important for pain relief but does not address the primary issue of vaso-occlusion and is not the most crucial intervention in this scenario.
5. A child is being assessed by a nurse for suspected nephrotic syndrome. What clinical manifestation is the nurse likely to observe?
- A. Jaundice
- B. Edema
- C. Hypertension
- D. Polyuria
Correct answer: B
Rationale: Edema is a hallmark clinical manifestation of nephrotic syndrome. In nephrotic syndrome, there is increased permeability of the glomerular filtration barrier, leading to protein loss in the urine (proteinuria). The decrease in serum protein levels results in a reduced oncotic pressure, leading to fluid shifting from the intravascular space into the interstitial spaces, causing edema. Jaundice (choice A) is not typically associated with nephrotic syndrome. Hypertension (choice C) is more commonly seen in conditions like nephritic syndrome. Polyuria (choice D) is excessive urination and is not a prominent feature of nephrotic syndrome.
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