type 1 diabetes mellitus is suspected in an adolescent which clinical manifestation may be present
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Pediatric HESI Practice Questions

1. In an adolescent suspected of having type 1 diabetes mellitus, which clinical manifestation may be present?

Correct answer: D

Rationale: Poor wound healing is a common clinical manifestation of type 1 diabetes mellitus. Elevated blood glucose levels in diabetes can lead to impaired wound healing by affecting various cellular processes involved in the healing cascade. Moist skin (Choice A) is not typically associated with type 1 diabetes mellitus. Weight gain (Choice B) is more commonly seen in type 2 diabetes due to insulin resistance. Fluid overload (Choice C) is not a typical clinical manifestation of type 1 diabetes mellitus. Therefore, the correct answer is poor wound healing.

2. A healthcare professional is assessing a child with suspected pertussis. What clinical manifestation is the healthcare professional likely to observe?

Correct answer: D

Rationale: Severe coughing spells are a hallmark clinical manifestation of pertussis. Pertussis, also known as whooping cough, is characterized by paroxysms of rapid, consecutive coughs followed by a distinctive 'whoop' sound as the patient gasps for air. This intense coughing can lead to vomiting, exhaustion, and sometimes a characteristic 'whoop' sound. Inspiratory stridor (Choice B) is more commonly associated with croup, not pertussis. Nasal congestion (Choice C) is not a typical feature of pertussis. While a cough is present in pertussis, the specific type of cough described in Choice A (dry, hacking cough) is not the predominant feature observed in pertussis.

3. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about insulin administration. What should the nurse emphasize?

Correct answer: A

Rationale: The correct answer is to rotate injection sites. Rotating injection sites is crucial in insulin administration to prevent lipodystrophy, which is the breakdown of subcutaneous fat at the injection site. It also helps ensure consistent insulin absorption. Administering insulin before meals (choice B) is important to match insulin peak action with the rise in blood glucose after eating. Storing insulin in the refrigerator (choice C) is correct to maintain its potency and stability. Administering insulin at bedtime (choice D) may not be suitable for all patients and is not a universal recommendation for insulin administration.

4. After surgery to correct hypertrophic pyloric stenosis (HPS) in a 3-week-old infant who had been formula-fed, which postoperative feeding order is appropriate?

Correct answer: C

Rationale: Following surgery for hypertrophic pyloric stenosis (HPS) in infants, it is appropriate to resume regular formula feeding within 24 hours postoperatively to support recovery. This helps maintain adequate nutrition and hydration for the infant. Choice A is incorrect because thickened formula may not be necessary and could potentially cause issues postoperatively. Choice B is incorrect as withholding feedings for the first 24 hours can lead to nutritional deficiencies and delay recovery. Choice D is inappropriate as additional glucose feedings are not typically indicated postoperatively for infants with HPS and may not provide the necessary nutrition needed for recovery.

5. A child with a diagnosis of cystic fibrosis is under the care of a nurse. What is the priority nursing intervention?

Correct answer: A

Rationale: The priority nursing intervention for a child with cystic fibrosis is administering pancreatic enzymes. This is crucial for managing the condition as it helps in proper digestion of nutrients. Providing respiratory therapy and encouraging physical activity are important aspects of care for cystic fibrosis, but administering pancreatic enzymes takes precedence due to its direct impact on the child's ability to digest and absorb essential nutrients. Encouraging frequent handwashing is a good practice for infection control but is not the priority intervention in this scenario.

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