HESI LPN
Pediatrics HESI 2023
1. A healthcare professional is reviewing the laboratory report of a child with tetralogy of Fallot that indicates an elevated RBC count. What does the professional identify as the cause of the polycythemia?
- A. Low tissue oxygen needs
- B. Tissue oxygen needs
- C. Diminished iron level
- D. Hypertrophic cardiac muscle
Correct answer: B
Rationale: The correct answer is B: Tissue oxygen needs. Polycythemia occurs as the body's response to chronic hypoxia by increasing RBC production to enhance oxygen delivery. In tetralogy of Fallot, a congenital heart defect, the heart's structure causes reduced oxygen levels in the blood. This chronic hypoxia stimulates the bone marrow to produce more red blood cells, leading to an elevated RBC count. Choice A is incorrect as low blood pressure is not directly related to polycythemia in this context. Choice C, diminished iron level, is not the cause of polycythemia in tetralogy of Fallot. Choice D, hypertrophic cardiac muscle, is not the primary cause of the elevated RBC count in this case.
2. A client with diabetes mellitus type 2 is prescribed sitagliptin. The nurse should include which instruction in the client's teaching plan?
- A. Take this medication with meals.
- B. Avoid alcohol while taking this medication.
- C. Take this medication on an empty stomach.
- D. Report any signs of pancreatitis to the healthcare provider.
Correct answer: D
Rationale: The correct instruction to include in the teaching plan for a client prescribed sitagliptin is to report any signs of pancreatitis to the healthcare provider. Sitagliptin is generally taken with meals to reduce gastrointestinal side effects. Therefore, choice A, 'Take this medication with meals,' is incorrect. Sitagliptin does not have specific interactions with alcohol, so there is no need to advise the client to avoid alcohol, making choice B incorrect. Taking sitagliptin on an empty stomach is not recommended, so choice C is also incorrect. Pancreatitis is a rare but serious side effect of sitagliptin, so it is crucial for the client to report any signs or symptoms to their healthcare provider promptly.
3. A group of students is reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system?
- A. Regulation of water balance
- B. Hormonal secretion
- C. Cellular metabolism
- D. Growth stimulation
Correct answer: B
Rationale: The primary function of the endocrine system is hormonal secretion. This system is responsible for producing and releasing hormones that regulate various bodily functions such as growth, metabolism, and mood. Choice A, regulation of water balance, is more related to the functions of the renal system rather than the endocrine system. Choice C, cellular metabolism, is a general cellular process that involves various systems, not specific to the endocrine system. Choice D, growth stimulation, though hormones can influence growth, it is not the primary function of the endocrine system. Therefore, the correct answer is B.
4. A client with a diagnosis of tuberculosis (TB) is being discharged home. Which instruction is most important for the nurse to provide?
- A. Avoid close contact with others until treatment is complete.
- B. Take all prescribed medications as directed.
- C. Schedule a follow-up appointment with the healthcare provider.
- D. Wear a mask when in public places.
Correct answer: B
Rationale: The most important instruction for a client with tuberculosis (TB) is to take all prescribed medications as directed. This is crucial to prevent the development of drug-resistant TB. While avoiding close contact with others until treatment is complete (Choice A) is important to prevent the spread of TB, ensuring the client completes the prescribed medication regimen is the priority. Scheduling a follow-up appointment (Choice C) is important for monitoring but not as critical as medication adherence. Wearing a mask in public places (Choice D) can help reduce the spread of TB but is not as essential as taking medications as prescribed.
5. Which nursing diagnosis would be a priority for a client admitted with a CVA (cerebral vascular accident)?
- A. Risk for aspiration
- B. Impaired physical mobility
- C. Disturbed sensory perception
- D. Interrupted family processes
Correct answer: A
Rationale: The correct answer is 'Risk for aspiration' as it is a priority concern in clients with a CVA due to potential swallowing difficulties. Aspiration poses immediate risks such as pneumonia, which can be life-threatening. Impaired physical mobility, while important, may not be as urgent as the risk for aspiration in this scenario. Disturbed sensory perception and interrupted family processes are not typically the most critical concerns in the acute phase of a CVA.