HESI LPN
Pediatrics HESI 2023
1. The healthcare professional is developing a teaching plan for a child who is to have their cast removed. What instruction would the professional most likely include?
- A. Applying petroleum jelly to the dry skin.
- B. Rubbing the skin vigorously to remove the dead skin.
- C. Soaking the area in warm water every day.
- D. Washing the skin with diluted peroxide and water.
Correct answer: C
Rationale: Soaking the area in warm water is the most appropriate instruction for a child who is having their cast removed. This method helps to gently remove dead skin without causing irritation. Applying petroleum jelly to dry skin (Choice A) is not recommended as it may not effectively aid in the removal of dead skin. Rubbing the skin vigorously (Choice B) can lead to skin irritation and should be avoided. Washing the skin with diluted peroxide and water (Choice D) may be too harsh, causing unnecessary irritation to the skin post-cast removal.
2. Following corrective surgery for hypertrophic pyloric stenosis (HPS), an infant is returned to the pediatric unit with an IV infusion in place. What is the priority nursing action?
- A. Apply adequate restraints.
- B. Administer a mild sedative.
- C. Assess the IV site for infiltration.
- D. Attach the nasogastric tube to wall suction.
Correct answer: C
Rationale: The priority nursing action after a corrective surgery for hypertrophic pyloric stenosis (HPS) is to assess the IV site for infiltration. This is crucial to ensure proper fluid administration and prevent complications such as extravasation or infiltration. Applying restraints (Choice A) is not indicated in this scenario and can compromise the infant's comfort and safety. Administering a mild sedative (Choice B) is not necessary and should only be done based on specific clinical indications. Attaching the nasogastric tube to wall suction (Choice D) may be important for certain conditions but is not the priority immediately post-surgery; assessing the IV site is more urgent to prevent potential complications related to IV therapy.
3. A newborn is admitted to the neonatal intensive care unit (NICU) with choanal atresia. Which part of the infant’s body should the nurse assess?
- A. Rectum
- B. Nasopharynx
- C. Intestinal tract
- D. Laryngopharynx
Correct answer: B
Rationale: Choanal atresia is a congenital condition that presents with a blockage in the nasal passages at the junction of the nasal cavity and the nasopharynx. To assess and confirm the diagnosis of choanal atresia, the nurse should focus on assessing the nasopharynx. Choices A, C, and D are incorrect as choanal atresia specifically involves a blockage in the nasal passages, not the rectum, intestinal tract, or laryngopharynx. By assessing the nasopharynx, the severity of the obstruction can be determined, aiding in planning appropriate interventions for the newborn.
4. A child with sickle cell anemia is admitted to the hospital during a vaso-occlusive crisis. What is the most important intervention for the nurse to implement?
- A. Administering oxygen
- B. Ensuring adequate hydration
- C. Monitoring vital signs
- D. Administering pain medication
Correct answer: B
Rationale: During a vaso-occlusive crisis in sickle cell anemia, ensuring adequate hydration is crucial because it helps to reduce the viscosity of the blood and prevent further sickling of the cells. Administering oxygen may be necessary in some cases to improve tissue oxygenation, but hydration is the priority to prevent complications. Monitoring vital signs is important, but hydration takes precedence during a vaso-occlusive crisis. Administering pain medication is important for pain management but does not address the underlying issue of vaso-occlusion.
5. When explaining exercise in type 1 diabetes to the parents of a newly diagnosed child, what should the nurse emphasize?
- A. Exercise will increase blood glucose levels
- B. Exercise should be restricted
- C. Extra snacks are needed before exercise
- D. Extra insulin is required during exercise
Correct answer: C
Rationale: In children with type 1 diabetes, it is essential to emphasize the need for extra snacks before exercise to prevent hypoglycemia. Choice A is incorrect because exercise typically lowers blood glucose levels, not increases them. Choice B is inappropriate as exercise is beneficial but needs to be managed carefully. Choice D is inaccurate as extra insulin during exercise can lead to hypoglycemia.
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