HESI LPN
Pediatrics HESI 2023
1. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about blood glucose monitoring. What should the nurse emphasize?
- A. Checking blood glucose levels before meals and at bedtime
- B. Using a lancet device to obtain blood samples
- C. Using urine test strips for monitoring
- D. Recognizing signs of hypoglycemia
Correct answer: A
Rationale: Checking blood glucose levels before meals and at bedtime is essential in managing type 1 diabetes mellitus as it helps in monitoring blood sugar levels at different times of the day and adjusting insulin doses accordingly. Option B about using a lancet device to obtain blood samples is a technique rather than an emphasis on monitoring frequency. Option C suggesting the use of urine test strips is incorrect as urine test strips are not recommended for accurate real-time monitoring of blood glucose levels in type 1 diabetes. Option D, recognizing signs of hypoglycemia, is important but not the primary emphasis when educating about blood glucose monitoring.
2. After an infant has had corrective surgery for hypertrophic pyloric stenosis (HPS), what should the nurse teach a parent to do immediately after a feeding to limit vomiting?
- A. Rock the infant.
- B. Place the infant in an infant seat.
- C. Place the infant flat on the right side.
- D. Keep the infant awake with sensory stimulation.
Correct answer: B
Rationale: Correct Answer: B. Placing the infant in an infant seat is essential after feeding to help keep the head elevated and reduce the risk of vomiting. This position helps prevent regurgitation of formula or milk. Rocking the infant (Choice A) is incorrect because it may exacerbate vomiting due to the movement. Placing the infant flat on the right side (Choice C) is incorrect as it does not promote proper digestion and can increase the risk of vomiting. Keeping the infant awake with sensory stimulation (Choice D) is incorrect as it does not directly address the physiological need to reduce vomiting after feeding.
3. A 3-year-old child ingests a substance that may be a poison. The parent calls a neighbor who is a nurse and asks what to do. What should the nurse recommend the parent to do?
- A. Administer syrup of ipecac.
- B. Call the poison control center.
- C. Take the child to the emergency department.
- D. Give the child bread dipped in milk to absorb the poison.
Correct answer: B
Rationale: In cases of potential poisoning, immediate guidance from professionals is crucial. Administering syrup of ipecac is no longer recommended routinely due to potential risks and lack of benefit. Taking the child to the emergency department is necessary in severe cases but may not always be the immediate action needed. Giving the child bread dipped in milk is not an appropriate method to manage poisoning and could potentially worsen the situation. Therefore, the most appropriate action for the nurse to recommend is to call the poison control center for expert advice on managing the situation.
4. During a physical examination of a 9-month-old baby, the nurse observes a flat, discolored area on the skin. The nurse documents this as a:
- A. Papule.
- B. Macule.
- C. Vesicle.
- D. Scale.
Correct answer: B
Rationale: The correct answer is B: Macule. A macule is a flat, discolored area on the skin that is smaller than 1 cm in diameter. This term is used to describe conditions like freckles or petechiae. Choice A, Papule, refers to a small, solid, raised skin lesion (<0.5 cm) like a pimple. Choice C, Vesicle, describes a small blister filled with clear fluid. Choice D, Scale, refers to flakes or plates of dead skin that may be dry or greasy.
5. The nurse is teaching a group of parents about the side effects of immunization vaccines. Which sign should the nurse include when discussing an infant receiving the Haemophilus influenzae (Hib) vaccine?
- A. Lethargy
- B. Urticaria
- C. Generalized rash
- D. Low-grade fever
Correct answer: D
Rationale: The correct answer is 'D. Low-grade fever.' A low-grade fever is a common and mild side effect of the Hib vaccine, indicating that the immune system is responding to the immunization. Lethargy (choice A) can be a sign of more serious adverse effects and should be monitored closely but is not typically associated with the Hib vaccine. Urticaria (choice B) and generalized rash (choice C) are less common side effects of the Hib vaccine compared to low-grade fever.
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