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. A child with a diagnosis of leukemia is receiving chemotherapy. What is the priority nursing intervention?
- A. Monitoring for signs of infection
- B. Providing nutritional support
- C. Monitoring for signs of bleeding
- D. Monitoring for signs of pain
Correct answer: A
Rationale: The priority nursing intervention for a child with leukemia receiving chemotherapy is monitoring for signs of infection. Chemotherapy can suppress the immune system, putting the child at a higher risk of developing infections. Early detection of signs of infection is crucial to prevent serious complications and initiate timely treatment. Providing nutritional support is important for overall health but is not the priority when the child is at risk of infection. Monitoring for signs of bleeding is essential, but infection surveillance takes precedence due to the immediate threat it poses to the child's health. Monitoring for signs of pain is important for comfort but is not the priority over infection prevention and management.
3. What finding would lead healthcare providers to suspect Turner syndrome in a child?
- A. Webbed neck
- B. Microcephaly
- C. Gynecomastia
- D. Cognitive delay
Correct answer: A
Rationale: A webbed neck is a classic physical characteristic seen in individuals with Turner syndrome, a genetic condition that results from a missing or partially missing X chromosome in females. This distinctive feature occurs due to excess skin on the neck and is a key clinical clue for healthcare providers. Microcephaly (choice B) refers to a small head size and is not typically associated with Turner syndrome. Gynecomastia (choice C) is the enlargement of breast tissue in males and is not a common finding in Turner syndrome. Cognitive delay (choice D) involves intellectual or developmental delays and is not a specific feature of Turner syndrome.
4. A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which condition?
- A. Syndrome of inappropriate antidiuretic hormone (SIADH)
- B. Thyroid storm
- C. Cushing syndrome
- D. Vitamin D toxicity
Correct answer: A
Rationale: When a child with diabetes insipidus is treated with vasopressin, the nurse should closely monitor for signs and symptoms of Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Vasopressin, also known as antidiuretic hormone, helps retain water in the body. Excessive vasopressin administration can lead to water retention, dilutional hyponatremia, and potentially result in SIADH. Choices B, C, and D are incorrect because they are not directly associated with the use of vasopressin in treating diabetes insipidus.
5. The school nurse is presenting a class to a group of students about common overuse disorders. Which disorder would the school nurse include?
- A. Dislocated radial head
- B. Transient synovitis of the hip
- C. Osgood-Schlatter disease
- D. Scoliosis
Correct answer: C
Rationale: The correct answer is C: Osgood-Schlatter disease. This condition is a common overuse injury that affects the knee. Osgood-Schlatter disease typically occurs in children and adolescents who are involved in activities that require frequent running, jumping, and kicking. It is characterized by pain, swelling, and tenderness at the tibial tuberosity, where the patellar tendon inserts into the tibia. Choice A, Dislocated radial head, is not an overuse disorder but rather a form of elbow injury where the head of the radius bone is displaced from its normal position. Choice B, Transient synovitis of the hip, is a self-limiting condition that causes hip pain and limping in children. It is not typically considered an overuse disorder. Choice D, Scoliosis, is a condition characterized by an abnormal lateral curvature of the spine. While it may be related to certain activities or postures, it is not primarily classified as an overuse disorder.
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