HESI LPN
Pediatric HESI 2023
1. A child with Duchenne muscular dystrophy is to receive prednisone as part of their treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching?
- A. We should give this drug after he eats something.
- B. We need to watch carefully for possible infections.
- C. The drug should not be stopped abruptly.
- D. He might experience weight gain with this drug.
Correct answer: A
Rationale: The correct statement should be, 'We should give this drug after he eats something.' Prednisone should be administered with food to help prevent gastrointestinal upset. Choice B is correct as monitoring for infections is important due to prednisone's immunosuppressive effects. Choice C is correct as prednisone should not be stopped suddenly to prevent withdrawal symptoms. Choice D is correct as weight gain is a common side effect of prednisone.
2. A patient with irritable bowel syndrome starts a new prescription for dicyclomine, an anticholinergic medication. The client reports the onset of sensitivity to light and a dry mouth. How should the nurse respond?
- A. Determine if the medication is being taken correctly
- B. Provide instructions on managing these side effects
- C. Schedule an appointment for evaluation by the healthcare provider
- D. Advise stopping the medication until the unpleasant side effects wear off
Correct answer: B
Rationale: The correct response is to provide instructions on managing these side effects. Sensitivity to light and dry mouth are common side effects of anticholinergic medications like dicyclomine. It is essential for the nurse to educate the patient on strategies to cope with these side effects, such as staying hydrated to address dry mouth and wearing sunglasses to reduce sensitivity to light. Option A is not the priority as the side effects are expected with this medication and do not necessarily indicate incorrect use. Option C is not immediately necessary as the side effects are common and can be managed without a healthcare provider evaluation. Option D is not recommended unless advised by the healthcare provider as abruptly stopping the medication can lead to worsening symptoms or withdrawal effects.
3. A public health nurse can say that she is beginning to achieve her goal of more optimal health for her community when:
- A. people learn self-care
- B. people become involved in determining health care policy
- C. all these indicators are present
- D. people assume responsibility for their own health
Correct answer: C
Rationale: Achieving optimal health for a community involves multiple factors and indicators. For a public health nurse to begin achieving this goal, it is essential that all relevant indicators are present, not just one or a few. While choices A, B, and D are important components of promoting community health, optimal health for a community encompasses a comprehensive approach where all indicators are considered and addressed. Therefore, the correct answer is C.
4. A 13-year-old girl tells the nurse at the pediatric clinic that she took a pregnancy test and it was positive. She adds that her grandfather, with whom she, her younger sisters, and her mother live, has repeatedly molested her for the past 3 years. When the nurse asks the girl if she has told this to anyone, she replies, 'Yes, but my mother doesn’t believe me.' Legally, who should the nurse notify?
- A. Police regarding a potential sex crime
- B. Health care provider to confirm the pregnancy
- C. Child Protective Services for immediate intervention
- D. The girl’s mother about the positive pregnancy test result
Correct answer: C
Rationale: In cases of child abuse and ongoing molestation, as described in the scenario, the primary concern is the safety and well-being of the child. Child Protective Services should be notified immediately for intervention to protect the girl and other children in the household from further harm. The police may be involved later to investigate the criminal aspect of the abuse. Notifying the healthcare provider solely to confirm the pregnancy or informing the girl’s mother about the positive test result does not address the urgent need for intervention and protection from abuse. Child Protective Services are trained to handle such cases and provide the necessary support and protection for the child and other vulnerable individuals in the family. Immediate action is crucial to ensure the girl's safety and prevent further harm.
5. The nurse is providing care to a child with a long-leg hip spica cast. What is the priority nursing diagnosis?
- A. Risk for impaired skin integrity due to cast and location.
- B. Deficient knowledge related to cast care.
- C. Risk for delayed development related to immobility.
- D. Self-care deficit related to immobility.
Correct answer: A
Rationale: The correct answer is A: Risk for impaired skin integrity due to cast and location. When caring for a child with a long-leg hip spica cast, the priority nursing diagnosis is the risk for impaired skin integrity. This is because the child's limited mobility and the pressure from the cast can lead to skin breakdown and complications. Choice B is incorrect as while education is essential, it is not the priority when immediate physical risks are present. Choice C is incorrect because while immobility can impact development, the immediate concern is preventing complications from the cast. Choice D is incorrect as it focuses on self-care deficits rather than the physical risk of skin integrity issues.