a nurse is assessing a child with suspected pneumonia what clinical manifestation is the nurse likely to observe
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Nursing Elites

HESI LPN

Pediatric HESI 2024

1. A healthcare provider is assessing a child with suspected pneumonia. What clinical manifestation is the provider likely to observe?

Correct answer: A

Rationale: A cough is a common clinical manifestation of pneumonia. Pneumonia often presents with symptoms such as cough, fever, chest pain, and difficulty breathing. The inflammation and infection in the lungs lead to the characteristic cough observed in patients with pneumonia. Diarrhea, rash, and vomiting are not typically associated with pneumonia and are less likely to be observed in a child with this condition.

2. What are the most common signs and symptoms of leukemia related to bone marrow involvement?

Correct answer: A

Rationale: The correct answer is A: petechiae, infection, fatigue. In leukemia, bone marrow involvement leads to a decrease in normal blood cell production, resulting in petechiae (small red or purple spots on the skin), increased susceptibility to infections due to decreased white blood cells, and fatigue from anemia. Choices B, C, and D are incorrect because they do not directly relate to the typical signs and symptoms of leukemia with bone marrow involvement. Headache, papilledema, irritability, muscle wasting, weight loss, decreased intracranial pressure, psychosis, and confusion are not typically associated with leukemia and bone marrow involvement.

3. A 4-year-old child is admitted with a diagnosis of bacterial pneumonia. What is the priority nursing intervention?

Correct answer: B

Rationale: The priority nursing intervention for a 4-year-old child admitted with bacterial pneumonia is administering antibiotics. Antibiotics are essential to treat the infection, prevent its spread, and avoid potential complications. Administering antipyretics (Choice A) may help reduce fever but does not address the underlying cause of pneumonia, which is bacterial in this case. Monitoring fluid intake (Choice C) is important to maintain hydration but does not directly treat the infection. Providing nutritional support (Choice D) is crucial for overall health, but the immediate priority is to address the bacterial infection with antibiotics to prevent further complications and promote recovery.

4. What is the priority nursing intervention for a child admitted to the hospital with a diagnosis of acute glomerulonephritis?

Correct answer: A

Rationale: The priority nursing intervention for a child with acute glomerulonephritis is monitoring for hypertension. Acute glomerulonephritis involves inflammation of the kidney's glomeruli, leading to impaired kidney function. Hypertension is a common complication due to fluid retention and increased renin-angiotensin system activity. Monitoring for hypertension is crucial for early detection and management to prevent further kidney damage and complications. Providing pain relief (Choice B) may be required for discomfort but is not the priority. Restricting fluid intake (Choice C) may be necessary in some kidney diseases, but in acute glomerulonephritis, the focus is on monitoring and managing hypertension. Encouraging fluid intake (Choice D) is inappropriate as it can exacerbate fluid overload and hypertension in acute glomerulonephritis.

5. What type of play do nurses expect when observing a toddler in a playroom with other children?

Correct answer: A

Rationale: The correct answer is A: Parallel. Toddlers typically engage in parallel play, where they play alongside but not directly with other children. This type of play is common during early childhood as children are still developing social skills and may prefer to play independently while observing others. Choice B, Solitary play, refers to a child playing alone without interacting with others. Choice C, Cooperative play, involves children playing together towards a common goal or activity. Choice D, Competitive play, emphasizes winning and outperforming others, which is less common in toddlers as they are in the stage of exploring and learning through play rather than competing.

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