HESI LPN
Pediatrics HESI 2023
1. During a health assessment of a school-age child, where should the nurse focus more attention based on the child's developmental level?
- A. Infections
- B. Poisonings
- C. Risk-taking behaviors
- D. Accidents and injuries
Correct answer: D
Rationale: During the school-age period, children are active, curious, and engaged in various physical activities, making them more susceptible to accidents and injuries. This developmental stage is characterized by increased motor skills and exploration, leading to a higher risk of unintentional harm. While infections, poisonings, and risk-taking behaviors are also concerns for school-age children, focusing on preventing and addressing accidents and injuries is essential due to their heightened physical activity and curiosity.
2. A 5-year-old child is diagnosed with acute glomerulonephritis. What is a key assessment the nurse should perform?
- A. Monitor blood glucose levels
- B. Monitor respiratory rate
- C. Monitor urine output
- D. Monitor for signs of infection
Correct answer: C
Rationale: In a child diagnosed with acute glomerulonephritis, monitoring urine output is a crucial assessment. Acute glomerulonephritis affects the kidneys, leading to decreased urine output due to impaired kidney function. Monitoring urine output helps assess renal perfusion, fluid status, and kidney function. This assessment is essential in determining the effectiveness of treatment and identifying complications. Monitoring blood glucose levels (Choice A) is not directly related to acute glomerulonephritis. Respiratory rate (Choice B) may be important in other conditions but is not a key assessment for acute glomerulonephritis. Monitoring for signs of infection (Choice D) is important in general, but it is not specific to the primary issue of impaired kidney function in acute glomerulonephritis.
3. Based on the interpretation of this strip, what action should be implemented first?
- A. Call a code.
- B. Start CPR.
- C. Administer IV fluids.
- D. Apply oxygen.
Correct answer: A
Rationale: The correct answer is A: 'Call a code.' In the context of ventricular fibrillation (V-Fib), immediate defibrillation is crucial. Calling a code is the first step to activating the emergency response team, including individuals trained to provide defibrillation. Starting CPR (Choice B) may be necessary but should follow defibrillation. Administering IV fluids (Choice C) and applying oxygen (Choice D) are important interventions in cardiac arrest cases, but in V-Fib, the priority is defibrillation to restore normal heart rhythm.
4. A 25-year-old gravida 3, para 2 client gave birth to a 9-pound, 7-ounce boy 4 hours ago after augmentation of labor with oxytocin (Pitocin). She presses her call light and asks for her nurse right away, stating 'I’m bleeding a lot.' What is the most likely cause of postpartum hemorrhage in this client?
- A. Retained placental fragments.
- B. Unrepaired vaginal lacerations.
- C. Uterine atony.
- D. Puerperal infection.
Correct answer: C
Rationale: Uterine atony is the most likely cause of bleeding 4 hours after delivery, especially after delivering a macrosomic infant and augmenting labor with oxytocin. Uterine atony is characterized by the inability of the uterine muscles to contract effectively after childbirth, leading to excessive bleeding. The other options, such as retained placental fragments (A), unrepaired vaginal lacerations (B), and puerperal infection (D), are less likely causes of postpartum hemorrhage in this scenario. Retained placental fragments can cause bleeding, but this typically presents earlier than 4 hours postpartum. Unrepaired vaginal lacerations would likely be evident sooner and not typically result in significant bleeding. Puerperal infection is not a common cause of immediate postpartum hemorrhage unless there are other signs of infection present.
5. The healthcare provider prescribes morphine sulfate 4mg IM STAT. Morphine comes in 8 mg per ml. How many ml should the LPN/LVN administer?
- A. 0.5 ml
- B. 1 ml
- C. 1.5 ml
- D. 2 ml
Correct answer: A
Rationale: To administer 4 mg of morphine, as prescribed, the LPN/LVN needs to calculate the correct volume based on the concentration provided (8 mg per ml). Since the desired dose is 4 mg, half of 8 mg (0.5 ml) is required to administer the correct amount. Therefore, the correct answer is 0.5 ml. Choices B, C, and D are incorrect as they would either underdose or overdose the patient.