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. Why does a cleft lip predispose an infant to infection?
- A. Waste products accumulate along the defect.
- B. There is evidence of inadequate circulation in the defective area.
- C. Nutrition is inadequate due to ineffective feeding.
- D. Mouth breathing dries the oropharyngeal mucous membranes.
Correct answer: D
Rationale: The correct answer is D. Mouth breathing due to a cleft lip can dry the mucous membranes, making them more susceptible to infection. Choice A is incorrect because waste products do not accumulate along the defect to predispose the infant to infection. Choice B is incorrect as there is no evidence of inadequate circulation being a primary factor in infection predisposition in cleft lip cases. Choice C is incorrect because although ineffective feeding may lead to other issues, it is not the main reason for infection predisposition in infants with a cleft lip.
3. The healthcare provider is assessing a family to determine if they have access to adequate health care. Which statement accurately describes how certain families are affected by common barriers to health care?
- A. After a decade of escalation, the percentage of children living in low-income families has been declining since 2000.
- B. White, non-Hispanic children overall are more likely than African American and Hispanic children to be in very good or excellent health.
- C. The proportion of children between the ages of 6 and 18 who are overweight is decreasing, but there is a significant increase in African American females.
- D. The overall health care plan of working families may improve access to specialty care but limit access to preventive services.
Correct answer: B
Rationale: Choice B is the correct answer as white, non-Hispanic children are more likely to be in very good or excellent health compared to African American and Hispanic children. This is an important disparity in health outcomes that may be influenced by various social determinants. Choices A, C, and D are incorrect because they do not accurately describe how certain families are affected by common barriers to health care. Choice A discusses the declining percentage of children in low-income families, which is not directly related to barriers to health care. Choice C talks about overweight children and the increase in African American females but does not address access to health care. Choice D discusses the impact of health care plans on working families but does not specifically address barriers to health care access for families.
4. The nurse is caring for a boy with probable intussusception. He had diarrhea before admission, but while waiting for the administration of air pressure to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate?
- A. notify the practitioner
- B. measure abdominal girth
- C. auscultate for bowel sounds
- D. take vital signs, including blood pressure
Correct answer: A
Rationale: The passage of a normal brown stool in a child with intussusception could indicate spontaneous reduction of the intussusception. This change in the patient's condition is significant, requiring prompt notification of the practitioner for further evaluation and management. While measuring abdominal girth (Choice B) is important for assessing abdominal distention, it is not the priority when a potential spontaneous reduction may have occurred. Auscultating for bowel sounds (Choice C) and taking vital signs, including blood pressure (Choice D), are routine nursing assessments but do not address the immediate need to inform the practitioner of a possible change in the patient's condition that necessitates urgent attention.
5. During a check-up for a 5-year-old child with eczema before school starts, what will the nurse do?
- A. Change the bandage on a cut on the child’s hand.
- B. Assess the compliance with treatment regimens.
- C. Discuss systemic corticosteroid therapy.
- D. Assess the child’s fluid volume.
Correct answer: B
Rationale: Assessing compliance with treatment regimens is crucial in managing eczema effectively and preventing flare-ups. This involves ensuring that the child is following the prescribed treatment plan, which may include medication application, skincare routines, and lifestyle modifications. Changing a bandage on a cut would not be a routine part of an eczema check-up unless there was a specific wound related to eczema. Discussing systemic corticosteroid therapy may be part of the management plan for severe eczema cases but would not be the primary focus during a routine check-up. Assessing the child’s fluid volume, while important in general health assessments, is not directly related to managing eczema specifically.
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