HESI LPN
Pediatrics HESI 2023
1. Upon assessing a newborn immediately after delivery, you note that the infant is breathing spontaneously and has a heart rate of 90 beats/min. What is the most appropriate initial management for this newborn?
- A. begin positive pressure ventilations
- B. provide blow-by oxygen with oxygen tubing
- C. assess the newborn's skin condition and color
- D. start chest compressions and contact medical control
Correct answer: A
Rationale: A heart rate below 100 beats/min in a newborn indicates the need for positive pressure ventilation to improve oxygenation. Providing positive pressure ventilations helps in assisting the newborn's breathing efforts to ensure adequate oxygenation. Choice B, providing blow-by oxygen, may not be sufficient to address the underlying issue of inadequate breathing. Choice C, assessing the newborn's skin condition and color, is important but not the most immediate action needed for a heart rate below 100 beats/min. Choice D, starting chest compressions, is not indicated as the infant is breathing spontaneously and has a heart rate, albeit lower than normal, which does not warrant chest compressions.
2. The nurse is teaching a father how to stimulate his 7-year-old son, who has a 'slow-to-warm-up' temperament. Which guidance will be most successful?
- A. Telling him to read stories to the child about famous athletes
- B. Suggesting he take the child to watch him play softball
- C. Urging him to sign the child up for little league football
- D. Proposing wrestling with the child and letting him win
Correct answer: A
Rationale: The correct answer is A. Reading stories to the child about famous athletes would be the most successful guidance for a child with a 'slow-to-warm-up' temperament. This approach allows for a less active and more acceptable way of engaging with the child, aligning better with the child's temperament. Choices B, C, and D involve more active and potentially overwhelming activities for a child with such a temperament, which may not be as effective in stimulating and engaging the child.
3. While assessing a child admitted for an asthma attack, a nurse in the emergency department observes large welts and scars on the child's back. What additional information must be included in the nurse’s assessment?
- A. History of an injury
- B. Signs of child abuse
- C. Presence of food allergies
- D. Recent recovery from chickenpox
Correct answer: B
Rationale: The correct answer is B: Signs of child abuse. When a nurse observes large welts and scars on a child, it raises concern for possible child abuse. It is crucial for the nurse to assess further for signs of abuse, document findings, and report appropriately to protect the child. Choice A, history of an injury, is not specific to potential abuse and may not provide insight into the current situation. Choice C, presence of food allergies, is not directly related to the observed welts and scars. Choice D, recent recovery from chickenpox, is also unrelated to the signs of abuse and does not impact the immediate assessment of the child's safety.
4. What is one of the most important factors that a healthcare professional must consider when parents of a toddler request to be present at a procedure occurring on the hospital unit?
- A. Type of procedure to be performed
- B. Individual assessment of the parents
- C. Whether the toddler wants the parents present
- D. Probable reaction to the toddler’s response to pain
Correct answer: B
Rationale: When parents of a toddler request to be present during a procedure, it is crucial to conduct an individual assessment of the parents. This assessment helps healthcare professionals understand the parents' ability to cope with the procedure, provide support to their child, and ensure a safe and comfortable environment for all involved. Choice A, the type of procedure to be performed, while important, is not the most critical factor in this scenario. Choice C, whether the toddler wants the parents present, is significant but secondary to assessing the parents themselves. Choice D, probable reaction to the toddler’s response to pain, is important but focuses more on the child's reaction rather than the parents' capacity to provide appropriate support.
5. A 5-year-old child is admitted to the hospital with a diagnosis of bacterial meningitis. What is the priority nursing intervention?
- A. Administering antibiotics
- B. Isolating the child
- C. Monitoring vital signs
- D. Administering fluids
Correct answer: B
Rationale: The priority nursing intervention for a child admitted with bacterial meningitis is isolating the child. Isolation is crucial to prevent the spread of the highly contagious infection to other patients and healthcare workers. Administering antibiotics (Choice A) is important but isolating the child takes precedence to contain the spread of the infection. Monitoring vital signs (Choice C) and administering fluids (Choice D) are essential aspects of care but do not address the immediate need to prevent transmission of the infection.
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