HESI LPN
Pediatrics HESI 2023
1. What should an adolescent with type 1 diabetes do if an insulin reaction is experienced while at a basketball game?
- A. Call your parents immediately.
- B. Buy a soda and hamburger to eat.
- C. Administer insulin as soon as possible.
- D. Leave the arena and rest until the symptoms subside.
Correct answer: B
Rationale: Choosing option B, 'Buy a soda and hamburger to eat,' is the most appropriate action for an adolescent with type 1 diabetes experiencing an insulin reaction during a basketball game. In this situation, the individual is likely experiencing hypoglycemia, and consuming a soda provides a quick source of sugar to raise blood glucose levels rapidly. The hamburger can offer a more sustained release of energy due to its protein and fat content. Option A is incorrect because while contacting parents for help may be necessary in some situations, immediate action to address hypoglycemia is crucial. Option C is incorrect because administering insulin would further lower blood sugar levels, worsening the condition. Option D is incorrect as leaving the arena without addressing the hypoglycemia can lead to a worsening of symptoms and potentially dangerous outcomes.
2. Which best describes a full-thickness (third-degree) burn?
- A. Erythema and pain
- B. Skin showing erythema followed by blister formation
- C. Destruction of all layers of skin evident with extension into subcutaneous tissue
- D. Destruction injury involving underlying structures such as muscle, fascia, and bone
Correct answer: C
Rationale: A full-thickness (third-degree) burn involves the destruction of all layers of skin, including the epidermis, dermis, and extending into the subcutaneous tissue. This type of burn results in significant tissue damage and can appear pale, charred, or leathery. Choice A is incorrect as erythema and pain are more characteristic of superficial burns. Choice B describes a partial-thickness burn where the skin shows erythema followed by blister formation, involving the epidermis and part of the dermis. Choice D is incorrect as it describes a deeper type of injury involving structures beyond the skin layers, such as muscle, fascia, and bone, which is not specific to a full-thickness burn.
3. After a child has just returned from surgery for a tracheostomy, what is the priority nursing action?
- A. Suctioning the tracheostomy tube
- B. Changing the tracheostomy dressing
- C. Monitoring respiratory status
- D. Ensuring the tracheostomy ties are secure
Correct answer: A
Rationale: The priority nursing action after a child has undergone tracheostomy surgery is to suction the tracheostomy tube. Suctioning is crucial to maintain a clear airway, remove secretions, and prevent potential airway obstruction, which is essential for the child's respiratory function. Changing the tracheostomy dressing, while important for wound care, does not take precedence over airway clearance. Monitoring respiratory status is vital but comes after ensuring airway patency. Ensuring tracheostomy ties are secure is significant for stabilizing the tube but is not as urgent as maintaining a patent airway through suctioning.
4. A group of students is reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration?
- A. Lispro
- B. Regular
- C. NPH
- D. Glargine
Correct answer: D
Rationale: The correct answer is Glargine (Lantus) as it has the longest duration of action among the insulins listed, lasting 12 to 24 hours. Lispro (A) and Regular (B) are rapid-acting insulins with shorter durations of action. NPH (C) is an intermediate-acting insulin with a duration of action of about 12-16 hours. Therefore, Glargine is the correct choice for the insulin with the longest duration.
5. A healthcare provider is preparing a 2-year-old child for surgery. What preoperative teaching should be provided to this child?
- A. Explaining the procedure in simple terms
- B. Using a doll to demonstrate the procedure
- C. Showing pictures of the hospital environment
- D. Allowing the child to play with medical equipment
Correct answer: B
Rationale: Using a doll to demonstrate the procedure is the most appropriate preoperative teaching method for a 2-year-old child. It helps them understand what to expect in a non-threatening way by providing a visual representation of the upcoming surgery. Explaining the procedure in simple terms may be too abstract for a child of this age, as they may not fully comprehend verbal explanations. Showing pictures of the hospital environment may not be as effective as using a doll, as it may not provide a concrete understanding of the actual procedure. Allowing the child to play with medical equipment is unsafe and does not adequately prepare them for the surgery, as it may lead to misunderstandings or fear regarding the equipment's actual use during the surgery.
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