HESI LPN
Pediatric HESI 2023
1. A healthcare provider is assessing a 3-month-old infant with suspected pyloric stenosis. What clinical manifestation is the healthcare provider likely to observe?
- A. Projectile vomiting
- B. Diarrhea
- C. Constipation
- D. Abdominal distension
Correct answer: A
Rationale: Projectile vomiting is a classic clinical manifestation of pyloric stenosis in infants. This occurs due to the narrowing of the pyloric sphincter, leading to the forceful expulsion of gastric contents in a projectile manner. Diarrhea (choice B) is not typically associated with pyloric stenosis. Constipation (choice C) is also not a common symptom of this condition. Abdominal distension (choice D) may occur in pyloric stenosis but is not as specific or characteristic as projectile vomiting in diagnosing this condition.
2. When picked up by a parent or the nurse, an 8-month-old infant screams and seems to be in pain. After observing this behavior, what should the nurse discuss with the parent?
- A. Accidents and the importance of accident prevention
- B. Limiting playtime with other children in the family
- C. Any other behaviors that the parent may have noticed
- D. Food and appropriate vitamins for infants
Correct answer: C
Rationale: Discussing any other observed behaviors can help identify patterns or potential issues, which is crucial for assessing the infant's overall well-being. Option A about accidents and prevention is not pertinent to the situation described. Option B regarding playtime with other children does not address the infant's behavior and potential causes. Option D about food and vitamins is not relevant to the presented scenario and the observed behavior of the infant.
3. What is the nurse’s priority intervention when preparing for admission of a child with acute laryngotracheobronchitis?
- A. Pad the side rails of the crib.
- B. Arrange for a quiet, cool room.
- C. Place a tracheotomy set at the bedside.
- D. Obtain a recliner so that a parent can stay.
Correct answer: C
Rationale: The correct answer is to place a tracheotomy set at the bedside. Acute laryngotracheobronchitis can cause airway obstruction, which may require an emergency tracheotomy. Having the tracheotomy set readily available ensures quick access in case of respiratory distress. Padding the side rails of the crib, arranging for a quiet, cool room, and obtaining a recliner for a parent are important aspects of care but are not the priority when managing a potentially life-threatening airway emergency.
4. The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the mother indicates a need for further teaching?
- A. I need to avoid pushing or pulling on an arm or leg.
- B. I must avoid lifting the baby from under the armpits.
- C. I should not bend an arm or leg into an awkward position.
- D. We must avoid lifting the legs by the ankles to change diapers.
Correct answer: B
Rationale: Lifting the baby from under the armpits can cause fractures in infants with osteogenesis imperfecta. The correct approach is to support the baby's body and head carefully, avoiding pressure on vulnerable areas prone to fractures. Choices A, C, and D demonstrate proper awareness of caring for an infant with osteogenesis imperfecta by emphasizing caution to prevent fractures.
5. A child with a diagnosis of nephrotic syndrome is being treated with corticosteroids. What is an important nursing consideration?
- A. Monitor for signs of infection
- B. Monitor blood pressure
- C. Monitor for hyperglycemia
- D. Monitor for hypertension
Correct answer: A
Rationale: When a child with nephrotic syndrome is undergoing treatment with corticosteroids, it is crucial to monitor for signs of infection. Corticosteroids can suppress the immune system, increasing the child's susceptibility to infections. Monitoring for signs of infection allows for early detection and prompt intervention, reducing the risk of complications. While monitoring blood pressure (choice B) is important in nephrotic syndrome, it is not the most immediate concern when the child is on corticosteroids. Monitoring for hyperglycemia (choice C) is relevant in corticosteroid therapy, but the priority in this scenario is to watch for signs of infection. Monitoring for hypertension (choice D) is important in nephrotic syndrome but is not the most critical consideration when the child is on corticosteroids.
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