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 child with a diagnosis of leukemia is receiving chemotherapy. What is the most important nursing intervention?
- A. Monitor for signs of infection
- B. Monitor for signs of bleeding
- C. Monitor for signs of dehydration
- D. Monitor for signs of pain
Correct answer: A
Rationale: The correct answer is to monitor for signs of infection. When a child is undergoing chemotherapy, their immune system is compromised, making them more susceptible to infections. Monitoring for signs of infection is crucial to promptly identify and treat any potential infections. Choices B, C, and D are incorrect because although monitoring for bleeding, dehydration, and pain are important aspects of care, the priority for a child receiving chemotherapy is to prevent and detect infections due to their increased vulnerability.
3. The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC). What would the nurse interpret as indicative of this disorder?
- A. Shortened prothrombin time
- B. Increased fibrinogen level
- C. Positive fibrin split products
- D. Increased platelets
Correct answer: C
Rationale: Positive fibrin split products indicate disseminated intravascular coagulation (DIC), a condition characterized by the widespread formation of blood clots throughout the body. In DIC, clotting factors are consumed, leading to increased fibrin split products. A shortened prothrombin time (Choice A) is not typically seen in DIC as it indicates faster blood clotting, which is not consistent with the pathophysiology of DIC. An increased fibrinogen level (Choice B) is also not a characteristic finding in DIC, as fibrinogen levels may be decreased due to consumption in the formation of clots. Increased platelets (Choice D) are not typically observed in DIC; instead, thrombocytopenia (decreased platelet count) is more common due to their consumption in clot formation.
4. A school nurse is educating parents of school-age children on the significance of immunizations for childhood communicable diseases. What preventable disease may lead to the complication of encephalitis?
- A. Varicella (Chickenpox)
- B. Scarlet fever
- C. Poliomyelitis
- D. Whooping cough
Correct answer: A
Rationale: The correct answer is A: Varicella (Chickenpox). Varicella can lead to the complication of encephalitis, characterized by brain inflammation. Encephalitis is a known complication of chickenpox in rare cases. Scarlet fever (choice B) is caused by Streptococcus bacteria and does not typically result in encephalitis. Poliomyelitis (choice C) primarily affects the spinal cord and does not lead to encephalitis. Whooping cough (choice D) can cause severe coughing spells but does not directly result in encephalitis.
5. A nurse is caring for an infant with intractable vomiting. For what complication is it most important for the nurse to assess?
- A. Acidosis
- B. Alkalosis
- C. Hyperkalemia
- D. Hypernatremia
Correct answer: B
Rationale: When an infant experiences intractable vomiting, it can lead to the loss of stomach acids, resulting in metabolic alkalosis. Alkalosis is characterized by elevated blood pH and can lead to serious complications. Assessing for alkalosis is essential in this scenario to monitor and manage the infant's condition. Choices A, C, and D are incorrect because in this context, the primary concern is the metabolic imbalance caused by excessive vomiting, leading to alkalosis rather than acidosis, hyperkalemia, or hypernatremia.
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