HESI LPN
Pediatric HESI 2023
1. The nurse is reviewing the laboratory test results of a child with Addison's disease. What would the nurse expect to find?
- A. Hypernatremia
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hypercalcemia
Correct answer: B
Rationale: In Addison's disease, adrenal insufficiency leads to decreased aldosterone production. The decreased aldosterone results in impaired sodium reabsorption and potassium excretion, leading to hyperkalemia. Hypernatremia (Choice A) is unlikely because sodium reabsorption is impaired. Hyperglycemia (Choice C) is not a typical lab finding in Addison's disease. Hypercalcemia (Choice D) is not associated with Addison's disease; rather, it can be seen in conditions like hyperparathyroidism.
2. During a nap, a 3-year-old hospitalized child wets the bed. How should the nurse respond?
- A. Ask the child to help with remaking the bed.
- B. Put clean sheets on the bed over a rubber sheet.
- C. Change the child’s clothes without discussing the incident.
- D. Explain that children should call the nurse when they need to go to the bathroom.
Correct answer: C
Rationale: When a 3-year-old hospitalized child wets the bed during a nap, the nurse should respond by changing the child's clothes without discussing the incident. This approach helps to maintain the child's dignity, avoid embarrassment, and reduce anxiety about bedwetting. Asking the child to help remake the bed (Choice A) may not be developmentally appropriate for a 3-year-old and could potentially lead to further distress. Putting clean sheets on the bed over a rubber sheet (Choice B) addresses the aftermath but does not directly address the child's needs and feelings. Explaining that children should call the nurse when they need to go to the bathroom (Choice D) may not be effective in this situation as the child may not have control over bedwetting during sleep.
3. A 3-year-old child with a history of frequent respiratory infections is being evaluated for cystic fibrosis. What diagnostic test should the nurse anticipate will be ordered?
- A. Chest X-ray
- B. Sweat chloride test
- C. Pulmonary function test
- D. Sputum culture
Correct answer: B
Rationale: The sweat chloride test is the gold standard diagnostic test for cystic fibrosis as it measures the concentration of chloride in sweat. In cystic fibrosis, there is an abnormal transport of chloride across epithelial membranes, leading to elevated sweat chloride levels. A chest X-ray may show characteristic changes in the lungs associated with cystic fibrosis, but it is not a definitive diagnostic test. Pulmonary function tests assess lung function but do not specifically diagnose cystic fibrosis. Sputum culture may identify respiratory infections but does not confirm the diagnosis of cystic fibrosis.
4. A nurse is caring for an infant with phenylketonuria (PKU). What diet should the nurse anticipate will be ordered by the health care provider?
- A. Fat-free
- B. Protein-enriched
- C. Phenylalanine-free
- D. Low-phenylalanine
Correct answer: D
Rationale: A low-phenylalanine diet is required for infants with PKU to prevent the buildup of phenylalanine, which can lead to brain damage.
5. A parent and 3-month-old infant are visiting the well-baby clinic for a routine examination. What should the nurse include in the accident prevention teaching plan?
- A. Remove small objects from the floor.
- B. Cover electric outlets with safety plugs.
- C. Remove toxic substances from low areas.
- D. Test the temperature of water before bathing.
Correct answer: D
Rationale: Testing the temperature of water before bathing is crucial to prevent burns, which is a significant risk for infants due to their sensitive skin. Infants have delicate skin that can easily be burned by water that is too hot. Testing the water temperature before bathing ensures that the water is at a safe and comfortable level for the infant. While choices A, B, and C are also important in accident prevention, such as reducing choking hazards, preventing electric shocks, and avoiding poisoning, testing the water temperature before bathing is the most immediate and direct action to prevent harm to the infant during bathing.
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