HESI LPN
Pediatric HESI 2023
1. When developing the plan of care for a child with burns requiring fluid replacement therapy, what information would the nurse expect to include?
- A. Administration of colloid initially followed by a crystalloid
- B. Determination of fluid replacement based on the type of burn
- C. Administration of most of the volume during the first 8 hours
- D. Monitoring of hourly urine output to achieve less than 1 mL/kg/hr
Correct answer: C
Rationale: The correct answer is C. In fluid replacement therapy for burns, it is crucial to administer most of the volume during the first 8 hours to prevent shock and maintain perfusion. This rapid administration is essential to stabilize the child's condition. Choices A and B are incorrect because the initial fluid replacement in burns typically involves administering crystalloids, not colloids, and the fluid replacement is generally calculated based on the extent of the burn injury, not the type of burn. Choice D is incorrect as monitoring hourly urine output to achieve less than 1 mL/kg/hr is not recommended in burn patients; instead, urine output should be monitored to achieve 1-2 mL/kg/hr in children to ensure adequate renal perfusion.
2. The nurse is planning care for a 32-year-old male client diagnosed with HIV infection who has a history of chronic depression. Recently, the client's viral load has begun to increase rather than decrease despite his adherence to the HIV drug regimen. What should the nurse do first while taking the client's history upon admission to the hospital?
- A. Determine if the client attends a support group weekly.
- B. Hold all antidepressant medications until further notice.
- C. Ask the client if he takes St. John's Wort routinely.
- D. Have the client describe any recent changes in mood.
Correct answer: C
Rationale: The nurse's top priority upon admission is to determine if the client has been taking St. John's Wort, an herbal preparation often used for depression. St. John's Wort can interact adversely with medications used to treat HIV infection, potentially explaining the rise in the viral load (C). Asking about attending support groups (A) or recent changes in mood (D) may provide valuable information about the client's depression but is not as critical as determining St. John's Wort use. Holding antidepressant medications (B) without assessing for potential interactions can be harmful to the client.
3. A client with a history of atrial fibrillation is prescribed verapamil. The nurse should monitor for which potential side effect?
- A. Constipation
- B. Diarrhea
- C. Headache
- D. Hypotension
Correct answer: A
Rationale: Verapamil, a calcium channel blocker, can commonly cause constipation due to its effects on smooth muscle relaxation in the gastrointestinal tract. Therefore, monitoring for constipation is important when a client is prescribed verapamil.
4. A client who had a stroke requires assistance with morning ADLs. Which of the following interprofessional team members should the nurse consult?
- A. Registered dietitian.
- B. Occupational therapist.
- C. Speech-language pathologist.
- D. Physical therapist.
Correct answer: B
Rationale: The correct answer is B, Occupational therapist. An occupational therapist specializes in assisting clients with daily living activities, making them crucial for a stroke patient requiring help with morning activities of daily living (ADLs). While a registered dietitian (A) may provide nutritional guidance, a speech-language pathologist (C) focuses on communication and swallowing disorders, and a physical therapist (D) primarily deals with mobility and physical rehabilitation. However, none of these professionals directly address the specific needs related to ADLs following a stroke as effectively as an occupational therapist.
5. The instructor is educating a group of students about myelination in a child. Which statement by the students indicates that the teaching was successful?
- A. Myelination continues into adolescence.
- B. The process occurs in a head-to-toe fashion.
- C. Myelination speeds up nerve impulses.
- D. Myelination increases the specificity and efficiency of nerve impulses.
Correct answer: B
Rationale: The correct answer is B. Myelination occurs in a cephalocaudal (head-to-toe) pattern, improving nerve function progressively. Choice A is incorrect because myelination continues beyond 4 years of age and into adolescence. Choice C is incorrect as myelination speeds up nerve impulses rather than slowing them down. Choice D is incorrect because myelination increases the specificity and efficiency of nerve impulses, making them more focused and precise.