HESI LPN
Pediatric Practice Exam HESI
1. The school nurse is caring for a boy with hemophilia who fell on his arm during recess. What supportive measures should the nurse use until factor replacement therapy can be instituted?
- A. Apply warm, moist compresses
- B. Apply pressure for at least 1 minute
- C. Elevate the area above the level of the heart
- D. Begin passive range-of-motion unless the pain is severe
Correct answer: C
Rationale: The correct supportive measure for the school nurse to use for a boy with hemophilia who fell on his arm during recess is to elevate the area above the level of the heart. Elevating the affected area helps reduce bleeding and swelling in a child with hemophilia until factor replacement therapy can be provided. Applying warm, moist compresses (Choice A) may worsen bleeding by dilating blood vessels. Applying pressure for at least 1 minute (Choice B) is not recommended for hemophilia as it can lead to increased bleeding. Beginning passive range-of-motion (Choice D) should be avoided as it can exacerbate bleeding and further injury in a child with hemophilia.
2. A client with chronic obstructive pulmonary disease (COPD) is struggling to breathe. What should the nurse do first?
- A. Increase the oxygen flow rate according to the prescription
- B. Encourage the client to perform pursed-lip breathing
- C. Prepare for emergency intubation
- D. Assess the client's oxygen saturation and breath sounds
Correct answer: D
Rationale: The correct first action for a nurse when a client with COPD is struggling to breathe is to assess the client's oxygen saturation and breath sounds. This initial assessment is crucial in determining the severity of the client's condition and the appropriate intervention. Increasing the oxygen flow rate without proper assessment can potentially be harmful, as COPD clients have a risk of retaining carbon dioxide. Encouraging pursed-lip breathing can be beneficial but should come after assessing the client's current status. Emergency intubation is a drastic measure and should only be considered after a comprehensive assessment indicates the need for it.
3. A nurse is caring for a young adult at a college health clinic. Which of the following actions should the nurse take first?
- A. Give the client information about immunization against meningitis.
- B. Tell the client to have a TB skin test every 2 years.
- C. Determine the client’s health risks.
- D. Teach the client about exercise recommendations.
Correct answer: C
Rationale: Assessing the client’s health risks is the priority as it provides essential information to guide subsequent care. By understanding the client’s health risks, the nurse can tailor health education and interventions, such as immunizations and lifestyle modifications, to address specific needs. Providing information about immunization against meningitis (Choice A) is important but should come after assessing health risks. Instructing the client to have a TB skin test every 2 years (Choice B) is relevant but not the initial step in care. Teaching about exercise recommendations (Choice D) is also essential but should follow the assessment of health risks.
4. The nurse assesses a client who has a nasal cannula delivering oxygen at 2 L/min. To assess for skin damage related to the cannula, which areas should the nurse observe?
- A. Tops of the ears
- B. Bridge of the nose
- C. Around the nostrils
- D. Over the cheeks
Correct answer: A
Rationale: When a client is using a nasal cannula for oxygen therapy, the areas prone to skin damage are the tops of the ears and around the nostrils. The pressure exerted by the cannula on these areas can lead to skin breakdown, so it is important for the nurse to observe these sites for any signs of damage. The correct answer is 'Tops of the ears.' Choices 'Bridge of the nose' and 'Over the cheeks' are not typically areas where skin damage related to the cannula would occur, making them incorrect choices.
5. The nurse is assessing a client with Addison's disease who is weak, dizzy, disoriented, and has dry oral mucous membranes, poor skin turgor, and sunken eyes. Vital signs are blood pressure 94/44, heart rate 123 beats/minute, respiration 22 breaths/minute. Which intervention should the nurse implement first?
- A. Assess extremity strength and resistance
- B. Report a sodium level of 132 mEq/L or mmol/L (SI units)
- C. Measure and record the cardiac QRS complex
- D. Check current finger stick glucose
Correct answer: D
Rationale: The client’s symptoms suggest possible adrenal crisis or hypoglycemia. Checking glucose is a priority to rule out hypoglycemia, which requires immediate intervention. The client is presenting with symptoms indicative of hypoglycemia, which can be life-threatening if not promptly addressed. Assessing extremity strength, reporting sodium levels, or measuring the cardiac QRS complex are not the most urgent actions in this scenario.