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. During postoperative care for a child who has had a tonsillectomy, what is an important nursing intervention?
- A. Encouraging deep breathing exercises
- B. Encouraging the child to eat
- C. Administering antibiotics
- D. Applying ice to the throat
Correct answer: C
Rationale: Administering antibiotics is crucial post-tonsillectomy to prevent infection, as the surgical site is susceptible to bacterial growth. Encouraging deep breathing exercises can also be beneficial for lung expansion and preventing respiratory complications. However, administering antibiotics takes precedence as it directly addresses the risk of infection. Encouraging the child to eat may not be appropriate immediately post-tonsillectomy due to the risk of throat irritation and potential discomfort. Applying ice to the throat is typically not recommended after a tonsillectomy, as it may constrict blood vessels and hinder the healing process.
3. The parents of a newborn with phenylketonuria (PKU) need help and support in adhering to specific dietary restrictions. They ask the nurse, “How long will our child have to be on this diet?†How should the nurse respond?
- A. “We are still not sure; you should discuss this with your health care provider.â€
- B. “If your baby does well, foods containing protein can gradually be introduced.â€
- C. “Your child needs to be on this diet at least through adolescence and into adulthood.â€
- D. “This is a lifelong problem, and it is recommended that dietary restrictions must be continued.â€
Correct answer: D
Rationale: The correct answer is D: “This is a lifelong problem, and it is recommended that dietary restrictions must be continued.†PKU requires a lifelong adherence to a specific diet low in phenylalanine to prevent cognitive and developmental issues. Phenylalanine buildup can lead to irreversible damage, making it crucial for individuals with PKU to maintain dietary restrictions throughout their lives. Choices A, B, and C are incorrect because they do not address the lifelong nature of dietary restrictions necessary for PKU management.
4. Which of the following findings would indicate altered mental status in a small child?
- A. Recognition of the parents
- B. Fright at the EMT-B's presence
- C. Lack of attention to the EMT-B's presence
- D. Consistent eye contact with the EMT-B
Correct answer: C
Rationale: In small children, altered mental status can manifest as a lack of attention to the presence of unfamiliar individuals, such as the EMT-B. This lack of engagement may indicate confusion, disorientation, or impaired cognitive function. Choices A, B, and D are incorrect as recognizing parents, exhibiting fear, or maintaining consistent eye contact do not necessarily indicate altered mental status. Recognizing parents is a normal response, fear can be a typical reaction to unfamiliar situations, and making eye contact may be a sign of curiosity or comfort rather than a reflection of mental status.
5. An order is written for an isotonic enema for a 2-year-old child. What is the maximum amount of fluid the nurse should administer without a specific order from the health care provider?
- A. 100 to 150 mL
- B. 155 to 250 mL
- C. 255 to 360 mL
- D. 365 to 500 mL
Correct answer: B
Rationale: For a 2-year-old child, the maximum recommended amount of fluid for an isotonic enema is between 155 to 250 mL to prevent overdistension and potential harm. Choice A (100 to 150 mL) is too low and may not be effective in achieving the desired outcome. Choices C (255 to 360 mL) and D (365 to 500 mL) exceed the safe range for a 2-year-old child and can lead to overdistension, electrolyte imbalance, or other complications. Therefore, the correct answer is B.
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