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. The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. What is the priority nursing diagnosis?
- A. Deficient fluid volume related to dehydration
- B. Excess fluid volume related to edema
- C. Deficient knowledge related to fluid intake regimen
- D. Imbalanced nutrition related to excess weight
Correct answer: A
Rationale: The priority nursing diagnosis for a 7-year-old boy with diabetes insipidus is deficient fluid volume related to dehydration. Diabetes insipidus causes excessive thirst and urination, leading to fluid imbalance and potential dehydration. Choice B, excess fluid volume related to edema, is not a priority as diabetes insipidus is characterized by fluid loss, not retention. Choice C, deficient knowledge related to fluid intake regimen, may be important but is not the priority when the child is at risk of dehydration. Choice D, imbalanced nutrition related to excess weight, is not directly associated with the primary concern of fluid volume imbalance in diabetes insipidus.
3. .A nurse is performing a physical examination on an infant with Down syndrome. For what anomaly should the nurse assess the child?
- A. Bulging fontanels
- B. Stiff lower extremities
- C. Abnormal heart sounds
- D. Unusual pupillary reactions
Correct answer: C
Rationale: Abnormal heart sounds could indicate a congenital heart defect, which is common in infants with Down syndrome.
4. A 2-year-old child who was admitted to the hospital for further surgical repair of a clubfoot is standing in the crib, crying. The child refuses to be comforted and calls for the mother. As the nurse approaches the crib to provide morning care, the child screams louder. Knowing that this behavior is typical of the stage of protest, what is the most appropriate nursing intervention?
- A. Use comforting measures while holding the child.
- B. Fill the basin with water and bathe the child.
- C. Sit by the crib and bathe the child later when the anxiety decreases.
- D. Postpone the bath for a day because a child this upset should not be traumatized further.
Correct answer: C
Rationale: During the stage of protest, children may display distress when separated from their primary caregiver. Sitting by the crib and providing comfort when the child is less anxious is an appropriate intervention. Choice A is incorrect because attempting to hold the child while they are in distress may escalate the situation. Choice B is inappropriate as it ignores the child's emotional distress and proceeds with a task that can wait. Choice D is not the best option as postponing the bath for a day is not necessary; instead, addressing the child's emotional needs promptly is crucial in this situation.
5. Which best describes a full-thickness (third-degree) burn?
- A. Erythema and pain
- B. Skin showing erythema followed by blister formation
- C. Destruction of all layers of skin evident with extension into subcutaneous tissue
- D. Destruction injury involving underlying structures such as muscle, fascia, and bone
Correct answer: C
Rationale: The correct answer is C: Full-thickness burns involve the destruction of all layers of skin, extending into the subcutaneous tissue. This type of burn causes severe damage and loss of sensation due to nerve destruction. Choice A, erythema and pain, describes superficial burns (first-degree). Choice B, skin showing erythema followed by blister formation, describes partial-thickness burns (second-degree). Choice D, destruction injury involving underlying structures such as muscle, fascia, and bone, goes beyond the description of full-thickness burns.
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