HESI LPN
Pediatric HESI 2023
1. During a check-up for a 5-year-old child with eczema before school starts, what will the nurse do?
- A. Change the bandage on a cut on the child’s hand.
- B. Assess the compliance with treatment regimens.
- C. Discuss systemic corticosteroid therapy.
- D. Assess the child’s fluid volume.
Correct answer: B
Rationale: Assessing compliance with treatment regimens is crucial in managing eczema effectively and preventing flare-ups. This involves ensuring that the child is following the prescribed treatment plan, which may include medication application, skincare routines, and lifestyle modifications. Changing a bandage on a cut would not be a routine part of an eczema check-up unless there was a specific wound related to eczema. Discussing systemic corticosteroid therapy may be part of the management plan for severe eczema cases but would not be the primary focus during a routine check-up. Assessing the child’s fluid volume, while important in general health assessments, is not directly related to managing eczema specifically.
2. The healthcare provider is assessing a family to determine if they have access to adequate health care. Which statement accurately describes how certain families are affected by common barriers to health care?
- A. After a decade of escalation, the percentage of children living in low-income families has been declining since 2000.
- B. White, non-Hispanic children overall are more likely than African American and Hispanic children to be in very good or excellent health.
- C. The proportion of children between the ages of 6 and 18 who are overweight is decreasing, but there is a significant increase in African American females.
- D. The overall health care plan of working families may improve access to specialty care but limit access to preventive services.
Correct answer: B
Rationale: Choice B is the correct answer as white, non-Hispanic children are more likely to be in very good or excellent health compared to African American and Hispanic children. This is an important disparity in health outcomes that may be influenced by various social determinants. Choices A, C, and D are incorrect because they do not accurately describe how certain families are affected by common barriers to health care. Choice A discusses the declining percentage of children in low-income families, which is not directly related to barriers to health care. Choice C talks about overweight children and the increase in African American females but does not address access to health care. Choice D discusses the impact of health care plans on working families but does not specifically address barriers to health care access for families.
3. 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: Weight gain is the expected finding in a child with hypothyroidism. Hypothyroidism leads to a slowed metabolism, which can result in weight gain. Choices A, B, and C are not typical findings in hypothyroidism. Nervousness and heat intolerance are more commonly associated with hyperthyroidism, where the body is in a state of overactivity. Smooth velvety skin is not a characteristic sign of hypothyroidism.
4. A 6-year-old child comes to the school nurse reporting a sore throat, and the nurse verifies that the child has a fever and a red, inflamed throat. When a parent of the child arrives at school to take the child home, the nurse urges the parent to seek treatment. The nurse is aware that the causative agent may be beta-hemolytic streptococcus, and the illness may progress to inflamed joints and an infection in the heart. What illness is of most concern to the nurse?
- A. Tetanus
- B. Influenza
- C. Scarlet fever
- D. Rheumatic fever
Correct answer: D
Rationale: The correct answer is D, Rheumatic fever. Rheumatic fever can develop as a complication of untreated strep throat caused by beta-hemolytic streptococcus. It is characterized by inflamed joints and can lead to serious complications such as heart infections. Tetanus (choice A) is caused by a bacterial toxin affecting the nervous system, Influenza (choice B) is a viral respiratory illness, and Scarlet fever (choice C) is also caused by streptococcus but is characterized by a sandpaper-like rash and strawberry tongue. However, in the scenario described, the nurse is most concerned about the child developing rheumatic fever due to the potential serious consequences associated with it.
5. A nurse is assessing a 2-year-old child with suspected Down syndrome. What characteristic physical feature is the nurse likely to observe?
- A. Epicanthal folds
- B. Webbed neck
- C. Enlarged head
- D. Polydactyly
Correct answer: A
Rationale: Epicanthal folds are a distinctive physical feature commonly observed in individuals with Down syndrome. These are horizontal skin folds that cover the inner corners of the eyes. Webbed neck (choice B) is not typically associated with Down syndrome but can be seen in conditions like Turner syndrome. Enlarged head (choice C) is not a characteristic feature of Down syndrome; however, individuals with hydrocephalus may present with this finding. Polydactyly (choice D) is the presence of extra fingers or toes, which is not a typical feature of Down syndrome.
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