HESI LPN
Pediatric Practice Exam HESI
1. During a clinical conference with a group of nursing students, the instructor is describing burn classifications. The instructor determines that the teaching has been successful when the group identifies what as characteristic of full-thickness burns?
- A. Skin that is reddened, dry, and slightly swollen
- B. Skin appearing wet with significant pain
- C. Skin with blistering and swelling
- D. Skin that is leathery and dry with some numbness
Correct answer: D
Rationale: Full-thickness burns, also known as third-degree burns, are characterized by a leathery, dry appearance with numbness due to nerve damage. This type of burn extends through all layers of the skin, affecting nerve endings. Choice A describes characteristics of superficial partial-thickness burns, which involve the epidermis and part of the dermis. Choice B describes characteristics of superficial burns, or first-degree burns, which only affect the epidermis. Choice C describes characteristics of superficial to mid-dermal burns, also known as second-degree burns, which involve the epidermis and part of the dermis but do not extend through all skin layers. Therefore, the correct answer is D.
2. A nurse is preparing a presentation for a parent group about musculoskeletal injuries. When describing a child's risk for this type of injury, the nurse integrates knowledge that bone growth occurs primarily in which area?
- A. Growth plate.
- B. Epiphysis.
- C. Physis.
- D. Metaphysis.
Correct answer: B
Rationale: The correct answer is B: Epiphysis. Bone growth primarily occurs in the epiphysis, which is the area where growth plates are located. The epiphysis is responsible for longitudinal bone growth. Choice A, 'Growth plate,' is incorrect as it does not specify the exact area where bone growth primarily occurs. Choice C, 'Physis,' refers to the same structure as a growth plate, but the term 'epiphysis' is more specific to bone growth. Choice D, 'Metaphysis,' is incorrect as it is the area of the bone where the epiphysis meets the diaphysis, not the primary site of bone growth.
3. What behavior is essential for preventing in a child postoperatively after undergoing heart surgery to repair defects associated with tetralogy of Fallot?
- A. Crying
- B. Coughing
- C. Straining at stool
- D. Unnecessary movement
Correct answer: C
Rationale: Preventing straining at stool is crucial postoperatively after heart surgery for tetralogy of Fallot to avoid increasing intrathoracic pressure and placing stress on the surgical site. This can help prevent complications and promote faster healing. While crying, coughing, and unnecessary movement are common postoperative behaviors, they are not specifically linked to worsening outcomes in this context. Straining at stool is particularly emphasized due to its potential to impact the surgical site and overall recovery process.
4. A child with a diagnosis of celiac disease is admitted to the hospital. What dietary restriction should the nurse teach the parents?
- A. Avoid dairy products
- B. Avoid gluten
- C. Avoid high-fat foods
- D. Avoid foods high in sugar
Correct answer: B
Rationale: The correct answer is B: 'Avoid gluten.' Children with celiac disease must follow a gluten-free diet to prevent symptoms and intestinal damage. Gluten is a protein found in wheat, barley, and rye, which triggers an immune response in individuals with celiac disease. Choices A, C, and D are incorrect because while some individuals with celiac disease may also have lactose intolerance or may need to manage fat or sugar intake for overall health, the primary dietary restriction for celiac disease is avoiding gluten to maintain gastrointestinal health.
5. In a case where a limb is protruding from a mother's vagina during active labor, how should this condition be managed?
- A. Positioning the mother in a semi-Fowler's position, administering oxygen, and providing transport
- B. Positioning the mother in a head-down position with her hips elevated, administering oxygen, and providing transport
- C. Applying gentle traction to the protruding limb to remove pressure of the fetus from the umbilical cord
- D. Giving the mother 100% oxygen and attempting to manipulate the protruding limb so that delivery can occur
Correct answer: B
Rationale: When a limb is protruding from the vagina during active labor, the appropriate management includes positioning the mother in a head-down position with her hips elevated. This position helps relieve pressure on the umbilical cord, reducing the risk of compromising fetal blood flow and oxygenation. Administering oxygen is essential to maintain oxygenation levels for both the mother and the fetus. Providing transport to a healthcare facility equipped to manage this obstetric emergency is crucial for ensuring a safe delivery. Choice A is incorrect because a semi-Fowler's position does not effectively relieve pressure on the umbilical cord. Choice C is incorrect as applying traction to the protruding limb can lead to injury or complications for both the mother and the fetus. Choice D is incorrect because attempting to manipulate the limb without proper positioning and preparation can worsen the situation and increase risks during delivery.
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