HESI LPN
Pediatric HESI 2024
1. 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.
2. A client is post-operative day two from an abdominal surgery and reports feeling weak and lightheaded when attempting to get out of bed. What is the nurse's priority action?
- A. Encourage the client to drink fluids.
- B. Assist the client back to bed and monitor vital signs.
- C. Administer a prescribed antiemetic.
- D. Notify the healthcare provider.
Correct answer: B
Rationale: The nurse's priority action should be to assist the client back to bed and monitor vital signs. The client's symptoms of feeling weak and lightheaded could indicate potential issues like hypotension or dehydration, which need to be assessed promptly. Encouraging fluids (Choice A) could be beneficial but is not the immediate priority. Administering an antiemetic (Choice C) may not address the underlying cause of the client's symptoms. Notifying the healthcare provider (Choice D) can be done after the client has been stabilized and assessed.
3. What is a common side effect of corticosteroid therapy in children?
- A. Increased appetite
- B. Decreased blood glucose levels
- C. Inhibited growth
- D. Mood changes
Correct answer: A
Rationale: The correct answer is A: Increased appetite. Corticosteroid therapy commonly causes increased appetite in children. This side effect can lead to weight gain and other metabolic changes. Option B is incorrect because corticosteroid therapy is more likely to result in increased blood glucose levels. Option C is incorrect because corticosteroid therapy can inhibit growth due to its impact on the endocrine system. Option D is incorrect because corticosteroid therapy can lead to mood changes such as irritability or even mood swings rather than improved mood.
4. A client with a history of seizures is receiving phenytoin (Dilantin). The nurse should monitor the client for which of the following side effects?
- A. Hypertension
- B. Hyperglycemia
- C. Gingival hyperplasia
- D. Hypokalemia
Correct answer: C
Rationale: The correct answer is C: Gingival hyperplasia. Phenytoin can cause gingival hyperplasia, characterized by an overgrowth of gum tissue. It is important for the nurse to monitor the client for this side effect as it can lead to oral health issues. Choices A, B, and D are incorrect. Phenytoin does not typically cause hypertension, hyperglycemia, or hypokalemia as common side effects.
5. The LPN/LVN is caring for a client who has been prescribed lithium carbonate. What is the most important instruction for the nurse to provide?
- A. Take the medication with food to avoid stomach upset.
- B. Do not change your salt intake while on this medication.
- C. Drink plenty of water and maintain a consistent salt intake.
- D. Avoid excessive intake of caffeine while on this medication.
Correct answer: B
Rationale: The most important instruction for a client prescribed lithium carbonate is not to change their salt intake. Alterations in sodium levels can impact lithium levels, leading to an increased risk of toxicity. Choice A is not crucial for lithium carbonate administration. While hydration is essential, maintaining a consistent salt intake is more critical than just increasing water intake (Choice C). Although caffeine can interact with lithium, it is not as important as maintaining a consistent salt intake (Choice D).