HESI LPN
Pediatrics HESI 2023
1. What should the nurse recommend to reduce the risk of sudden infant death syndrome (SIDS) in a 6-month-old infant?
- A. Place the infant on their back to sleep
- B. Use a pacifier during sleep
- C. Have the infant sleep on their side
- D. Keep the infant's room cool
Correct answer: A
Rationale: Placing the infant on their back to sleep is the correct recommendation to reduce the risk of sudden infant death syndrome (SIDS). This sleep position has been shown to significantly decrease the incidence of SIDS. Using a pacifier during sleep (Choice B) can also help reduce the risk, but it is secondary to the back sleeping position. Having the infant sleep on their side (Choice C) is not recommended, as it increases the risk of SIDS. Keeping the infant's room cool (Choice D) may provide a comfortable sleeping environment but does not directly reduce the risk of SIDS.
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. An infant with a congenital heart defect is being given gavage feedings. The parents ask the nurse why this is necessary. How should the nurse respond?
- A. It limits the chance of vomiting.
- B. It allows the feeding to be administered rapidly.
- C. The energy that would have been expended on sucking is conserved.
- D. The quantity of nutritional liquid can be regulated better than with a bottle.
Correct answer: C
Rationale: The correct answer is C: 'The energy that would have been expended on sucking is conserved.' Gavage feedings are necessary for infants with congenital heart defects as they help conserve the infant’s energy by eliminating the need for sucking, which can be taxing for infants with cardiac issues. Choice A is incorrect because gavage feedings are not primarily used to limit vomiting. Choice B is incorrect as the speed of administration is not the main reason for gavage feedings in this case. Choice D is incorrect because the regulation of the quantity of nutritional liquid is not the primary rationale for gavage feedings in infants with congenital heart defects.
4. The parent of a child who has received all of the primary immunizations asks the nurse which ones the child should receive before starting kindergarten. The nurse tells the parent that her child should receive boosters of:
- A. IPV, HepB, Td.
- B. DTaP, HepB, Td.
- C. MMR, DTaP, Hib.
- D. DTaP, IPV, MMR.
Correct answer: D
Rationale: The correct answer is D: DTaP, IPV, MMR. Before starting kindergarten, the child should receive boosters of DTaP, IPV, and MMR to ensure ongoing protection against diphtheria, tetanus, pertussis, polio, measles, mumps, and rubella. Choice A is incorrect because it includes HepB instead of MMR. Choice B is incorrect as it includes HepB instead of MMR and DTaP instead of IPV. Choice C is incorrect as it includes Hib instead of IPV.
5. A nurse is planning an initial home care visit to a mother who gave birth to a high-risk infant. For what time of day should the nurse schedule the visit for it to be most productive?
- A. When the husband is out of the home.
- B. At a time when the mother is feeding the infant.
- C. At a time that is convenient for the family.
- D. When the nurse can spend time with the family.
Correct answer: C
Rationale: Scheduling the visit at a time that is convenient for the family is the most appropriate choice. This ensures that the family is receptive and available, making the visit more productive. Choice A is incorrect because the presence of the husband may be important for support and decision-making. Choice B focuses solely on the mother and the infant's feeding time, which may not align with the family's overall availability. Choice D is incorrect as it emphasizes the nurse's convenience rather than the family's, which may not lead to an effective visit.
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