HESI LPN
Pediatrics HESI 2023
1. After completing an oral examination of a healthy 2-year-old child, the parent asks when the child should first be taken to the dentist. When is the most appropriate time in the child’s life for the nurse to suggest?
- A. Before starting school
- B. Within the next few months
- C. When the first deciduous teeth are lost
- D. At the next dental visit of a family member
Correct answer: B
Rationale: It is recommended that a child should visit the dentist within the next few months after turning two years old. This allows for early dental check-ups to monitor oral health, detect any issues early on, and establish a good oral hygiene routine. Choice A ('Before starting school') is not as specific and may delay the child's first dental visit. Choice C ('When the first deciduous teeth are lost') is too late for the first dental visit, as preventive care should start earlier. Choice D ('At the next dental visit of a family member') is not ideal as the child's dental needs should be addressed independently of family members' visits.
2. What finding would the nurse expect to assess in a child with hypothyroidism?
- A. Nervousness
- B. Heat intolerance
- C. Smooth velvety skin
- D. Weight gain
Correct answer: D
Rationale: In a child with hypothyroidism, weight gain is a typical finding due to the slowed metabolism associated with the condition. This occurs because thyroid hormone levels are insufficient to regulate metabolism effectively. Choices A, B, and C are not typically associated with hypothyroidism. Nervousness is more commonly seen in conditions like hyperthyroidism, where there is an excess of thyroid hormones. Heat intolerance may be seen in hyperthyroidism as well, where the body's metabolism is increased. Smooth velvety skin is a characteristic finding in conditions like Cushing's syndrome, where there is excess cortisol production.
3. After receiving a report on an inpatient acute care unit, which client should the nurse assess first?
- A. The client with bowel obstruction due to a volvulus who is experiencing abdominal rigidity
- B. The client who had surgery yesterday and is experiencing a paralytic ileus with absent bowel sounds
- C. The client with an obstruction of the large intestine who is experiencing abdominal distention
- D. The client with a small bowel obstruction who has a nasogastric tube that is draining greenish fluid
Correct answer: A
Rationale: The correct answer is A. Abdominal rigidity in a client with bowel obstruction due to a volvulus indicates possible complications and requires immediate assessment. Choice B is incorrect because although a paralytic ileus with absent bowel sounds is concerning, abdominal rigidity in a client with a volvulus takes priority. Choice C is incorrect as abdominal distention, though indicative of an obstruction, is not as urgent as the sign of abdominal rigidity. Choice D is incorrect as the drainage of greenish fluid from a nasogastric tube in a client with a small bowel obstruction, while concerning, does not present as immediate a threat as the abdominal rigidity in a client with a volvulus.
4. The nurse is caring for a 3-day-old girl with Down syndrome whose mother had no prenatal care. What is the priority nursing diagnosis?
- A. Imbalanced nutrition, less than body requirements related to the effects of hypotonia
- B. Deficient knowledge related to the presence of a genetic disorder
- C. Delayed growth and development related to a cognitive impairment
- D. Impaired physical mobility related to poor muscle tone
Correct answer: A
Rationale: The priority nursing diagnosis for a 3-day-old girl with Down syndrome, whose mother had no prenatal care, is imbalanced nutrition, less than body requirements related to the effects of hypotonia. Newborns with Down syndrome often experience feeding difficulties due to hypotonia, which can lead to inadequate nutrition intake. Option B is incorrect because at this age, the infant is not capable of having knowledge deficits related to a genetic disorder. Option C is incorrect as delayed growth and development are not the immediate priority in this scenario. Option D is incorrect as impaired physical mobility is not typically a priority concern for a newborn with Down syndrome.
5. A nurse is caring for a client who has herpes zoster. The client asks about complementary and alternative therapies for pain control. The nurse should inform the client that this condition is a contraindication for which of the following therapies?
- A. Acupuncture
- B. Massage therapy
- C. Aromatherapy
- D. Herbal supplements
Correct answer: A
Rationale: The correct answer is A, Acupuncture. Acupuncture is contraindicated for clients with herpes zoster due to the risk of infection at the needle sites. In individuals with herpes zoster, the skin's integrity is compromised, increasing susceptibility to infections. Therefore, acupuncture, which involves inserting needles into the skin, can introduce pathogens and lead to local infections. Massage therapy (B), aromatherapy (C), and herbal supplements (D) do not involve skin penetration like acupuncture and are generally considered safe complementary therapies for pain control in clients with herpes zoster.