HESI LPN
Pediatric Practice Exam HESI
1. A parent of a 2-year-old child tells a nurse at the clinic, 'Whenever I go to the store, my child has a screaming tantrum, demanding a toy or candy on the shelves. How can I deal with this situation?' What is the nurse’s best response?
- A. “Attempt to distract the child by offering a toy to the child.”
- B. “Say nothing and allow the tantrum to continue until it ends.”
- C. “Have a babysitter stay with the child at home until the child outgrows this behavior.”
- D. “Give the child the item while in the store, and when the child loses interest, return the item to the shelf.”
Correct answer: B
Rationale: The nurse's best response is to allow the tantrum to continue until it ends without giving in to the child's demands. By not rewarding the child with the desired item during a tantrum, the child learns that this behavior is not effective in getting what they want. Offering a toy to distract the child (Choice A) may reinforce the idea that tantrums lead to rewards. Leaving the child with a babysitter (Choice C) does not address the issue at hand, which is teaching the child appropriate behavior in public places. Giving the child the item temporarily (Choice D) may encourage the child to have tantrums in the future to obtain desired items.
2. When administering medications to a group of clients, which client should the nurse closely monitor for the development of acute kidney injury (AKI)?
- A. Lorazepam
- B. Sucralfate
- C. Digoxin
- D. Vancomycin
Correct answer: D
Rationale: Vancomycin is known to be nephrotoxic, which means it can cause damage to the kidneys. Therefore, clients receiving Vancomycin should be closely monitored for signs and symptoms of acute kidney injury (AKI) to ensure early detection and intervention if necessary. Lorazepam, Sucralfate, and Digoxin do not typically cause acute kidney injury, so they are not the priority for monitoring in this scenario.
3. A female client with major depression is prescribed fluoxetine (Prozac). She reports experiencing increased energy but still feels sad and hopeless. What is the nurse's best response?
- A. ''These feelings are normal and will pass with time.''
- B. ''Increased energy can sometimes lead to increased risk for self-harm.''
- C. ''The medication needs more time to be effective.''
- D. ''Let's talk about the things that make you feel this way.''
Correct answer: B
Rationale: The correct answer is B. Increased energy without improvement in mood can increase the risk of self-harm in clients with depression. It is crucial for the nurse to recognize this potential risk and closely monitor the client for any signs of self-harm. Choice A is incorrect because dismissing the client's persistent feelings of sadness and hopelessness as normal may invalidate her experiences. Choice C is incorrect as fluoxetine (Prozac) typically starts showing effectiveness within a few weeks, so further delay is concerning. Choice D is incorrect because while discussing the client's feelings is important, the immediate focus should be on addressing the potential risk of self-harm associated with increased energy.
4. A client who is at full-term gestation is in active labor and complains of a cramp in her leg. Which intervention should the PN implement?
- A. Massage the calf and foot
- B. Elevate the leg above the heart
- C. Check the pedal pulse in the affected leg
- D. Extend the leg and flex the foot
Correct answer: D
Rationale: During labor, muscle cramps are common due to prolonged muscle tension. The correct intervention to alleviate a cramp in the leg is to extend the leg and flex the foot. This action helps relieve the muscle spasm by stretching and contracting the muscles. Massaging the calf and foot (Choice A) may not be as effective in relieving the cramp as extending and flexing the leg. Elevating the leg above the heart (Choice B) is not necessary and may not directly address the cramp. Checking the pedal pulse (Choice C) is important for assessing circulation, but it does not directly address the muscle cramp.
5. The healthcare provider is evaluating a client for potential dehydration. Which assessment finding is most indicative of fluid volume deficit?
- A. Moist mucous membranes
- B. Increased urine output
- C. Decreased skin turgor
- D. Elevated blood pressure
Correct answer: C
Rationale: Corrected Rationale: Decreased skin turgor is a classic sign of dehydration. When someone is dehydrated, the skin loses its elasticity and becomes less turgid. This change is easily assessed by gently pinching and pulling up the skin on the back of the hand or forearm. If the skin remains elevated or tents rather than quickly returning to its normal position, it indicates dehydration. Moist mucous membranes (Choice A) are actually a sign of adequate hydration. Increased urine output (Choice B) can be a sign of dehydration, but decreased skin turgor is a more specific indicator. Elevated blood pressure (Choice D) is not typically associated with fluid volume deficit and may indicate other health issues.