HESI LPN
Pediatric HESI 2024
1. An infant with hypertrophic pyloric stenosis (HPS) is admitted to the pediatric unit. What does the nurse expect to find when palpating the infant’s abdomen?
- A. A distended colon
- B. Marked tenderness around the umbilicus
- C. An olive-sized mass in the right upper quadrant
- D. Rhythmic peristaltic waves in the lower abdomen
Correct answer: C
Rationale: When palpating the abdomen of an infant with hypertrophic pyloric stenosis (HPS), the nurse would expect to feel an olive-sized mass in the right upper quadrant. This finding is characteristic of HPS, where the hypertrophied pyloric muscle forms a palpable mass in the abdomen. Choices A, B, and D are incorrect. A distended colon is not a typical finding in HPS, marked tenderness around the umbilicus is not specific to this condition, and rhythmic peristaltic waves in the lower abdomen are not associated with HPS.
2. What should the nurse suggest to a parent asking for help with a child experiencing night terrors?
- A. Encourage the child to talk about the night terrors.
- B. Establish a bedtime routine.
- C. Allow the child to sleep with the parents.
- D. Wake the child during the night.
Correct answer: B
Rationale: Establishing a bedtime routine is the most appropriate suggestion for a parent seeking help with a child experiencing night terrors. Bedtime routines can create a sense of security and predictability for the child, potentially reducing the frequency of night terrors. Encouraging the child to talk about the night terrors (Choice A) may not be effective during the episode as the child is usually not fully awake. Allowing the child to sleep with the parents (Choice C) may inadvertently reinforce the behavior and hinder the child’s ability to learn to self-soothe. Waking the child during the night (Choice D) may disrupt the sleep cycle and exacerbate the night terrors.
3. During a physical examination of an infant with Down syndrome, what anomaly should the healthcare provider assess the child for?
- A. Bulging fontanels
- B. Stiff lower extremities
- C. Abnormal heart sounds
- D. Unusual pupillary reactions
Correct answer: C
Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.
4. What should be used to feed an infant born with a unilateral cleft lip and palate?
- A. Plastic spoon
- B. Cross-cut nipple
- C. Parenteral infusion
- D. Rubber-tipped syringe
Correct answer: B
Rationale: A cross-cut nipple is the most appropriate choice for feeding an infant with a unilateral cleft lip and palate. Using a cross-cut nipple helps regulate the flow of milk, making feeding easier for the infant and reducing the risk of aspiration. Plastic spoons, parenteral infusion, and rubber-tipped syringes are not recommended for feeding infants with cleft lip and palate as they can pose risks such as choking, aspiration, or inadequate milk intake. It is essential to choose a feeding method that minimizes these risks and ensures proper nutrition for the infant.
5. What type of play do nurses expect when observing a toddler in a playroom with other children?
- A. Parallel
- B. Solitary
- C. Cooperative
- D. Competitive
Correct answer: A
Rationale: The correct answer is A: Parallel. Toddlers typically engage in parallel play, where they play alongside but not directly with other children. This type of play is common during early childhood as children are still developing social skills and may prefer to play independently while observing others. Choice B, Solitary play, refers to a child playing alone without interacting with others. Choice C, Cooperative play, involves children playing together towards a common goal or activity. Choice D, Competitive play, emphasizes winning and outperforming others, which is less common in toddlers as they are in the stage of exploring and learning through play rather than competing.
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