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. What information should be included in the preoperative plan of care for an infant with myelomeningocele?
- A. Positioning the infant supine with a pillow under the buttocks
- B. Covering the sac with saline-soaked nonadhesive gauze
- C. Wrapping the infant snugly in a blanket
- D. Applying a diaper to prevent fecal soiling of the sac
Correct answer: B
Rationale: Covering the sac with saline-soaked nonadhesive gauze is essential in the preoperative care of an infant with myelomeningocele. This practice helps prevent infection and maintains moisture around the sac before surgery, promoting optimal healing outcomes. Positioning the infant supine with a pillow under the buttocks may be uncomfortable and unnecessary. Wrapping the infant snugly in a blanket does not address the specific care needs of the myelomeningocele. Applying a diaper over the sac can increase the risk of infection and should be avoided in this case.
3. .A child with type 1 diabetes mellitus is being discharged from the hospital. What is important for the nurse to include in the discharge teaching?
- A. Monitor blood glucose levels once a day
- B. Follow a strict meal plan
- C. Administer insulin only when blood glucose is high
- D. Recognize signs of hypoglycemia
Correct answer: D
Rationale: Recognizing signs of hypoglycemia is crucial for managing type 1 diabetes mellitus and preventing complications.
4. Why should the nurse closely monitor the IV flow rate for a 5-month-old infant with severe diarrhea receiving IV fluids?
- A. Maintaining electrolyte balance
- B. Preventing dehydration
- C. Preventing fluid overload
- D. Avoiding cardiac overload
Correct answer: C
Rationale: In infants, monitoring IV flow rates is essential to prevent fluid overload, not cardiac overload. Excessive fluid administration can lead to complications such as pulmonary edema or congestive heart failure. It is crucial to maintain a balance between providing adequate hydration and avoiding fluid overload to prevent adverse outcomes. Options A, B, and D are incorrect because the primary concern is to prevent complications related to excess fluid rather than focusing on electrolyte balance, dehydration prevention, or avoiding cardiac overload.
5. 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.
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