HESI LPN
Pediatric HESI 2024
1. What is a common finding that the nurse can identify in most children with symptomatic cardiac malformations?
- A. Mental retardation
- B. Inherited genetic factors
- C. Delayed physical growth
- D. Clubbing of the fingertips
Correct answer: C
Rationale: Delayed physical growth is a common finding in children with symptomatic cardiac malformations. This occurs due to insufficient oxygenation and nutrient supply, which can affect overall growth and development. Mental retardation (Choice A) is not typically associated with symptomatic cardiac malformations. Inherited genetic factors (Choice B) may contribute to the development of cardiac malformations but are not a common finding in affected children. Clubbing of the fingertips (Choice D) is more commonly associated with chronic respiratory or cardiovascular conditions, rather than symptomatic cardiac malformations.
2. A client morning assessment includes bounding peripheral pulses, weight gain of 2 pounds, pitting ankle edema, and moist crackles bilaterally. Which intervention is most important for the nurse to include in this client’s plan of care?
- A. Restrict daily fluid intake to 1500 ml
- B. Weight the client every morning
- C. Maintain accurate intake and output
- D. Administer prescribed diuretic
Correct answer: D
Rationale: Administering a prescribed diuretic is the most important intervention in this scenario as the client is presenting signs of fluid overload and heart failure. Diuretics help reduce fluid retention in the body, alleviating symptoms like edema and crackles. Restricting fluid intake may be necessary in some cases, but in this acute situation, addressing the immediate fluid overload with a diuretic takes precedence. Weighing the client daily and maintaining accurate intake and output are important aspects of monitoring, but they do not directly address the urgent need to manage fluid overload.
3. A 3-year-old child is admitted to the hospital with a diagnosis of Kawasaki disease. What is the priority nursing intervention?
- A. Administering IV immunoglobulin
- B. Monitoring for coronary artery aneurysms
- C. Encouraging fluid intake
- D. Providing nutritional support
Correct answer: B
Rationale: The priority nursing intervention for a 3-year-old child with Kawasaki disease is monitoring for coronary artery aneurysms. Kawasaki disease can lead to coronary artery complications, making early detection crucial in preventing serious outcomes. Administering IV immunoglobulin is a standard treatment for Kawasaki disease but does not take precedence over monitoring for potential complications. Encouraging fluid intake and providing nutritional support are important aspects of care but are not the priority when compared to monitoring for coronary artery aneurysms to prevent long-term cardiac issues.
4. Which of the following is a common complication of an untreated inguinal hernia in children?
- A. Gastroenteritis
- B. Strangulation of the hernia
- C. Chronic cough
- D. Epistaxis
Correct answer: B
Rationale: The correct answer is B: Strangulation of the hernia. Untreated inguinal hernias in children can lead to strangulation, which can result in bowel obstruction and ischemia. This is a serious complication that requires prompt medical attention. Choices A, C, and D are incorrect. Gastroenteritis is a gastrointestinal infection that is not directly related to untreated inguinal hernias. Chronic cough is not typically associated with this condition. Epistaxis refers to nosebleeds, which are not a common complication of untreated inguinal hernias in children.
5. A client with peripheral neuropathy due to cirrhosis is at risk for injury. What should the nurse do?
- A. Protect the client's feet from injury
- B. Apply a heating pad to the affected area
- C. Keep the client's feet elevated
- D. Assess the feet and legs for jaundice
Correct answer: A
Rationale: Protecting the client's feet from injury is critical as peripheral neuropathy can lead to decreased sensation and increased risk of trauma. This measure helps prevent wounds, ulcers, and other complications. Applying a heating pad (Choice B) can worsen symptoms and cause burns due to decreased sensation. Keeping the client's feet elevated (Choice C) may help reduce swelling but does not directly address the risk of injury. Assessing for jaundice (Choice D) is important in cirrhosis but is not directly related to the client's risk of injury due to peripheral neuropathy.