when developing the plan of care for a child with cerebral palsy which treatment would the nurse expect as least likely
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HESI LPN

Pediatric Practice Exam HESI

1. When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely?

Correct answer: A

Rationale: In caring for a child with cerebral palsy, skeletal traction is least likely to be a part of the treatment plan. Cerebral palsy is a neurological disorder affecting movement and muscle coordination, and skeletal traction, which involves applying a pulling force on a bone to correct alignment, is not a common intervention for this condition. Physical therapy, orthotics, and occupational therapy are more commonly used in the management of cerebral palsy. Physical therapy helps improve mobility and strength, orthotics assist in supporting and aligning the body, and occupational therapy focuses on enhancing daily living skills and independence. Therefore, skeletal traction is the least likely treatment option among the choices provided.

2. A nurse is evaluating a 3-year-old child’s developmental progress. The inability to perform which task indicates to the nurse that there is a developmental delay?

Correct answer: A

Rationale: The inability to copy a square at 3 years old indicates a potential developmental delay in fine motor skills. At this age, children should be able to copy basic shapes like circles and crosses. Hopping on one foot is typically expected around the age of 4, catching a ball reliably around 5, and using a spoon effectively by 2-3 years old. Therefore, choices B, C, and D are not as indicative of a developmental delay at 3 years old as the inability to copy a square.

3. After undergoing surgery using steel bar placement to correct pectus excavatum, what position should the nurse instruct the parents to avoid for the child?

Correct answer: D

Rationale: After undergoing surgery for pectus excavatum correction with steel bar placement, the nurse should instruct the parents to avoid placing the child in a side-lying position. This position should be avoided to prevent displacement of the steel bar, which could compromise the surgical outcome. Semi-Fowler, supine, and high Fowler positions do not pose the same risk of displacing the steel bar and are generally safe and comfortable for the child in this postoperative period.

4. A child with a diagnosis of celiac disease is admitted to the hospital. What dietary restriction should the nurse teach the parents?

Correct answer: B

Rationale: The correct answer is B: 'Avoid gluten.' Children with celiac disease must follow a gluten-free diet to prevent symptoms and intestinal damage. Gluten is a protein found in wheat, barley, and rye, which triggers an immune response in individuals with celiac disease. Choices A, C, and D are incorrect because while some individuals with celiac disease may also have lactose intolerance or may need to manage fat or sugar intake for overall health, the primary dietary restriction for celiac disease is avoiding gluten to maintain gastrointestinal health.

5. At 2 years of age, a child is readmitted to the hospital for additional surgery. What is the most important factor in preparing the toddler for this experience?

Correct answer: B

Rationale: The most important factor in preparing a toddler for additional surgery is their previous experience of hospitalization. This familiarity can help reduce anxiety and fear associated with the hospital environment and medical procedures. Choice A, satisfying the child’s wishes, may not always be feasible or in the child's best interest during medical procedures. Choice C, preventing the child from being with strangers, may not address the core issue of preparing the child for surgery. Choice D, ensuring the child still receives parental affection, is important but may not directly address the preparation needed for surgery.

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