HESI LPN
Pediatric HESI 2023
1. What should the nurse advise the parents of a child with asthma on preventing asthma attacks?
- A. Avoid exposure to allergens
- B. Encourage regular exercise
- C. Provide a high-protein diet
- D. Increase fluid intake
Correct answer: A
Rationale: The correct answer is to advise the parents to avoid exposure to allergens. Asthma attacks are commonly triggered by allergens such as pollen, dust mites, pet dander, and mold. By minimizing the child's contact with these triggers, the likelihood of asthma attacks can be reduced. Encouraging regular exercise can be beneficial for overall health but may not directly prevent asthma attacks. Providing a high-protein diet and increasing fluid intake are important for general health but are not specific preventive measures for asthma attacks.
2. What is the most appropriate method to feed an infant born with a unilateral cleft lip and palate?
- A. Plastic spoon
- B. Cross-cut nipple
- C. Parenteral infusion
- D. Rubber-tipped syringe
Correct answer: B
Rationale: A cross-cut nipple is the most appropriate method to feed an infant born with a unilateral cleft lip and palate. Using a cross-cut nipple allows for easier feeding by modifying the flow of milk, which helps in reducing the risk of aspiration in infants with this condition. Plastic spoon, parenteral infusion, and rubber-tipped syringe are not suitable for feeding infants with cleft lip and palate. Feeding an infant with a cleft lip and palate requires special considerations to ensure safe and effective nutrition delivery.
3. A child with sickle cell anemia develops severe chest pain, fever, a cough, and dyspnea. What should the nurse do first?
- A. Administer 100% oxygen to relieve hypoxia
- B. Administer pain medication to relieve symptoms
- C. Notify the practitioner because chest syndrome is suspected
- D. Notify the practitioner because the child may be having a stroke
Correct answer: C
Rationale: The correct action to take first when a child with sickle cell anemia presents with severe chest pain, fever, cough, and dyspnea is to notify the practitioner because acute chest syndrome is suspected. This condition is a medical emergency requiring prompt intervention. Administering oxygen or pain medication may be necessary interventions but should not precede notifying the practitioner. Stroke is not typically associated with these symptoms in sickle cell anemia.
4. A parent tells the nurse, “My 9-month-old baby no longer has the same strong grasp that was present at birth and no longer acts startled by loud noises.” How should the nurse explain these changes in behavior?
- A. “I will check these responses before deciding how to proceed.”
- B. “Failure of these responses may be related to a developmental delay.”
- C. “Additional sensory stimulation is needed to aid in the return of these responses.”
- D. “These responses are replaced by voluntary activity at about five months of age.”
Correct answer: D
Rationale: The correct answer is D. The grasp reflex and startle reflex (Moro reflex) are normal in newborns but typically disappear as the infant's nervous system matures and voluntary control develops. At around five months of age, these reflexes are replaced by voluntary movements as part of the normal developmental process. Choices A, B, and C are incorrect. Choice A suggests delaying a decision until further assessment, which is not necessary as the disappearance of these reflexes is a normal part of infant development. Choice B implies a developmental delay, which is not the case as these reflexes naturally disappear with age. Choice C recommending additional sensory stimulation is unnecessary and not the reason for the absence of these reflexes.
5. Parents of a sick infant talk with a nurse about their baby. One parent says, “I am so upset; I didn’t realize our baby was ill.” What major indication of illness in an infant should the nurse explain to the parent?
- A. Grunting respirations
- B. Excessive perspiration
- C. Longer periods of sleep
- D. Crying immediately after feedings
Correct answer: C
Rationale: Longer periods of sleep than usual can be a sign of illness in infants. When an infant sleeps more than usual, it may indicate that the baby is conserving energy due to an underlying condition. Grunting respirations (choice A) can be a sign of respiratory distress, excessive perspiration (choice B) may indicate overheating or fever, and crying immediately after feedings (choice D) can be a sign of gastrointestinal discomfort, such as colic or reflux. However, in this scenario, the emphasis is on changes in sleep patterns as a potential indicator of illness.
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