what should be assessed first in a child with suspected head trauma
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Nursing Elites

HESI LPN

HESI PN Nutrition Practice Exam

1. What should be assessed first in a child with suspected head trauma?

Correct answer: A

Rationale: The correct answer is to assess the response to verbal stimuli first in a child with suspected head trauma. This assessment helps in determining the child's level of consciousness and neurological status. Assessing the response to verbal stimuli allows healthcare providers to quickly evaluate if the child is alert, oriented, and able to communicate effectively. This initial assessment is crucial in identifying any immediate concerns related to the child's neurological function. Choices B, C, and D are not the primary assessments in cases of suspected head trauma. While pupillary reaction, skin color, and heart rate are important assessments in trauma situations, assessing the response to verbal stimuli takes precedence in evaluating the neurological status of a child with head trauma.

2. The parents of a child with sickle cell anemia ask why their child experiences pain. What is the most likely cause?

Correct answer: B

Rationale: In sickle cell anemia, pain is primarily caused by the obstruction of blood flow by sickle-shaped cells. This obstruction leads to inadequate oxygen supply to tissues, resulting in tissue damage and pain. Choice A, inflammation of the vessels, is incorrect as it is not the primary cause of pain in sickle cell anemia. Choice C, overhydration, is unrelated to the pathophysiology of sickle cell anemia and would not lead to the characteristic pain experienced. Choice D, stress-related headaches, is also unrelated to the underlying mechanisms of pain in sickle cell anemia.

3. What will the treatment for a newly admitted child with cystic fibrosis center on?

Correct answer: A

Rationale: The correct answer is A: Chest physiotherapy. Treatment for cystic fibrosis focuses on chest physiotherapy and aerosol medications to manage and clear thick pulmonary secretions. Chest physiotherapy helps loosen and clear mucus from the lungs, aiding in breathing and reducing the risk of infections. Mucus-drying agents (choice B) are not typically used in the treatment of cystic fibrosis as the goal is to help clear mucus, not dry it. Prevention of diarrhea (choice C) is not a primary focus in the treatment of cystic fibrosis. Insulin therapy (choice D) is not relevant to cystic fibrosis, which primarily affects the respiratory and digestive systems.

4. What should the nurse anticipate as challenging in caring for a child with acute glomerulonephritis?

Correct answer: C

Rationale: The correct answer is C: Bed rest. Implementing bed rest can be challenging, especially in active children, but it's necessary to manage the symptoms of acute glomerulonephritis. Forced fluids (choice A) may be required to maintain hydration but are not typically challenging. Increased feedings (choice B) and frequent position changes (choice D) are not primary interventions in the care of a child with acute glomerulonephritis.

5. Why would a person who eats a bowl of oatmeal for breakfast every day most likely be making a food choice based on ___?

Correct answer: A

Rationale: The correct answer is A: habit. Eating the same food regularly often stems from habit, which is a behavior that is repeated regularly and tends to occur subconsciously. Choice B, availability, is incorrect as it refers to the accessibility of a particular food rather than the frequency of consumption. Choice C, body image, is also incorrect as this term relates to how one perceives their own body rather than their food choices. Choice D, environmental concerns, is unrelated to the scenario provided, which is about the frequency of choosing oatmeal for breakfast.

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