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. When caring for a neonate with a suspected tracheoesophageal fistula, what nursing care should be included?
- A. Elevating the head but giving nothing by mouth
- B. Elevating the head for feedings
- C. Feeding glucose water only
- D. Avoiding suctioning unless the infant is cyanotic
Correct answer: A
Rationale: In a neonate with a suspected tracheoesophageal fistula, elevating the head but giving nothing by mouth is crucial to prevent aspiration. Placing the neonate in a semi-upright position helps reduce the risk of reflux and aspiration of gastric contents into the lungs. Elevating the head for feedings (Choice B) would still pose a risk of aspiration as the neonate may aspirate during feeding. Feeding glucose water only (Choice C) is not appropriate and does not address the risk of aspiration associated with a tracheoesophageal fistula. Avoiding suctioning unless the infant is cyanotic (Choice D) is incorrect because suctioning may be necessary for maintaining airway patency, regardless of cyanosis, in a neonate with a suspected tracheoesophageal fistula.
3. A child with a diagnosis of cystic fibrosis is under the care of a nurse. What is the priority nursing intervention?
- A. Administering pancreatic enzymes
- B. Providing respiratory therapy
- C. Encouraging physical activity
- D. Encouraging frequent handwashing
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.
4. What is the priority nursing intervention for a child admitted to the hospital with a diagnosis of acute glomerulonephritis?
- A. Monitoring for hypertension
- B. Providing pain relief
- C. Restricting fluid intake
- D. Encouraging fluid intake
Correct answer: A
Rationale: The priority nursing intervention for a child with acute glomerulonephritis is monitoring for hypertension. Acute glomerulonephritis involves inflammation of the kidney's glomeruli, leading to impaired kidney function. Hypertension is a common complication due to fluid retention and increased renin-angiotensin system activity. Monitoring for hypertension is crucial for early detection and management to prevent further kidney damage and complications. Providing pain relief (Choice B) may be required for discomfort but is not the priority. Restricting fluid intake (Choice C) may be necessary in some kidney diseases, but in acute glomerulonephritis, the focus is on monitoring and managing hypertension. Encouraging fluid intake (Choice D) is inappropriate as it can exacerbate fluid overload and hypertension in acute glomerulonephritis.
5. Which of the following signs or symptoms is more common in children than adults following head trauma?
- A. nausea and vomiting
- B. altered mental status
- C. tachycardia and diaphoresis
- D. changes in pupillary reaction
Correct answer: A
Rationale: Nausea and vomiting are more common in children following head trauma due to their higher risk of increased intracranial pressure. Children have less space for swelling within the skull compared to adults, making them more prone to experiencing symptoms like nausea and vomiting. Altered mental status and changes in pupillary reaction can also occur in both children and adults following head trauma, but they are not specifically more common in children. Tachycardia and diaphoresis are generally signs of autonomic nervous system activation and may occur in both children and adults, but they are not typically more common in children compared to adults following head trauma.
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