HESI LPN
Pediatrics HESI 2023
1. A nurse is inspecting the skin of a child with atopic dermatitis. What would the nurse expect to observe?
- A. Erythematous papulovesicular rash
- B. Dry, red, scaly rash with lichenification
- C. Pustular vesicles with honey-colored exudates
- D. Hypopigmented oval scaly lesions
Correct answer: B
Rationale: In atopic dermatitis, the nurse would expect to observe a dry, red, scaly rash with lichenification. Lichenification is thickened skin due to chronic scratching. Choices A, C, and D are incorrect. Erythematous papulovesicular rash is more characteristic of contact dermatitis, pustular vesicles with honey-colored exudates are seen in impetigo, and hypopigmented oval scaly lesions are typical of pityriasis alba.
2. The nurse volunteering at a homeless shelter to assist families with children identifies homelessness as a risk preventing families from achieving positive outcomes in life. What family theory encompasses this approach to assessing family dynamics?
- A. Duvall's developmental theory
- B. Friedman's structural functional theory
- C. Von Bertalanffy's general system theory applied to families
- D. Resiliency model of family stress, adjustment, and adaptation
Correct answer: D
Rationale: The Resiliency model of family stress, adjustment, and adaptation focuses on identifying the elements of risks and protective factors that help families achieve positive outcomes. In this scenario, the nurse recognizing homelessness as a risk aligns with the resiliency model, which emphasizes how families cope and adapt in the face of stressors. Duvall's theory primarily focuses on family life cycle stages, Friedman's theory emphasizes the roles and functions within a family structure, and Von Bertalanffy's theory looks at families as complex systems rather than specifically addressing resilience in the face of stressors.
3. A child with a diagnosis of leukemia is admitted to the hospital with a fever. What is the priority nursing intervention?
- A. Administering antibiotics
- B. Administering antipyretics
- C. Providing nutritional support
- D. Monitoring for signs of infection
Correct answer: D
Rationale: The correct answer is D: Monitoring for signs of infection. When a child with leukemia presents with a fever, the priority nursing intervention is to monitor for signs of infection due to the immunocompromised state of the child. Administering antibiotics (choice A) may be necessary based on the assessment of signs of infection, but monitoring comes first. Administering antipyretics (choice B) helps to reduce fever but does not address the underlying cause. Providing nutritional support (choice C) is essential but not the priority when the child is at risk of infection.
4. A child with a diagnosis of congenital heart disease is admitted to the hospital. What should the nurse include in the child’s care plan?
- A. Monitoring fluid status
- B. Encouraging activity
- C. Promoting a high-calorie diet
- D. Maintaining oxygen therapy
Correct answer: A
Rationale: Monitoring fluid status is crucial for a child with congenital heart disease because these children are at risk of fluid overload which can worsen their condition. Monitoring fluid intake and output helps prevent complications like congestive heart failure. Encouraging activity (Choice B) should be individualized based on the child's condition and tolerance, as excessive activity can strain the heart. Promoting a high-calorie diet (Choice C) is not typically recommended for children with congenital heart disease unless specifically indicated, as excessive weight gain can worsen their cardiac function. Maintaining oxygen therapy (Choice D) may be necessary in some cases, but monitoring fluid status is a more fundamental aspect of care for children with congenital heart disease.
5. The caregiver is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the caregiver indicates a need for further teaching?
- A. I need to avoid pushing or pulling on an arm or leg.
- B. I should carefully lift the baby by supporting the head and neck.
- 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 by supporting the head and neck can cause fractures in infants with osteogenesis imperfecta. Caregivers should avoid lifting infants in this manner due to the risk of injury. Choices A, C, and D demonstrate correct understanding of how to prevent injuries in infants with osteogenesis imperfecta by avoiding excessive force on the arms or legs, preventing awkward positions, and lifting the legs in a safer manner to change diapers.
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