HESI LPN
Pediatric HESI 2023
1. During a physical examination of an infant with Down syndrome, what anomaly should the healthcare provider assess the child for?
- A. Bulging fontanels
- B. Stiff lower extremities
- C. Abnormal heart sounds
- D. Unusual pupillary reactions
Correct answer: C
Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.
2. A person with no known illness whose daily routine consists of walking and following a healthy diet would be best characterized as engaging in which kind of activities?
- A. health balance
- B. disease prevention
- C. health promotion
- D. self-fulfillment
Correct answer: C
Rationale: The correct answer is C: health promotion. Health promotion activities involve maintaining a healthy lifestyle to prevent illness. In this scenario, the person is actively engaging in behaviors that promote their overall health and well-being, such as walking and following a healthy diet. Choice A, 'health balance,' is vague and does not specifically address the proactive nature of the person's actions. Choice B, 'disease prevention,' while related, focuses more on specific actions taken to prevent diseases rather than the broader concept of promoting overall health. Choice D, 'self-fulfillment,' does not directly relate to the activities described in the question.
3. What is the priority nursing intervention for a child with a diagnosis of acute lymphoblastic leukemia (ALL) receiving chemotherapy?
- A. Preventing infection
- B. Administering chemotherapy
- C. Providing nutritional support
- D. Monitoring fluid intake
Correct answer: A
Rationale: The correct answer is A: Preventing infection. When caring for a child with acute lymphoblastic leukemia (ALL) undergoing chemotherapy, the top priority is to prevent infection. Chemotherapy suppresses the immune system, making the child more susceptible to infections. By implementing infection control measures such as hand hygiene, aseptic techniques, and environmental cleanliness, the nurse can help protect the child from potentially life-threatening infections. Administering chemotherapy (choice B) is important but not the priority over preventing infection. Providing nutritional support (choice C) and monitoring fluid intake (choice D) are essential aspects of care but take a back seat to preventing infection in this scenario.
4. A nurse is caring for an adolescent client who has full-thickness burns on his leg. The client expresses concern about his future. Which of the following is a therapeutic response by the nurse?
- A. “You’re concerned about what will happen when you leave the hospital?”
- B. “If you work hard on your physical therapy, you won’t need to worry.”
- C. “You shouldn’t worry about the future so you can concentrate on getting well.”
- D. “Why are you concerned even though everyone is here to help you?”
Correct answer: A
Rationale: The correct response is A, “You’re concerned about what will happen when you leave the hospital?” This response acknowledges the client's concerns about the future, validating their feelings and encouraging open communication. It shows empathy and allows the client to express their worries. Choice B minimizes the client's concerns by suggesting that they won't need to worry if they work hard on physical therapy, which may invalidate their emotions. Choice C dismisses the client's worry, implying that they should ignore their concerns to focus on getting well. Choice D uses a confrontational approach by questioning the client's concerns, which may discourage open communication and make the client feel defensive.
5. A dying client is coping with feelings regarding impending death. The nurse bases care on the theory of death and dying by Kübler-Ross. During which stage of grieving should the LPN/LVN primarily use nonverbal interventions?
- A. Anger
- B. Denial
- C. Bargaining
- D. Acceptance
Correct answer: D
Rationale: Nonverbal interventions are primarily used during the acceptance stage according to Kübler-Ross's theory of death and dying. During the acceptance stage, the individual is more likely to be reflective and less communicative, making nonverbal interventions more effective. Choices A, B, and C are incorrect because anger, denial, and bargaining are stages that precede the acceptance stage in Kübler-Ross's model, where verbal communication and processing emotions play a more significant role.