HESI LPN
Pediatric Practice Exam HESI
1. 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 skull compliance and higher brain water content, making them more susceptible to developing symptoms like nausea and vomiting. Altered mental status (choice B) can occur in both children and adults but is not more common in children. Tachycardia and diaphoresis (choice C) are nonspecific and can occur in both age groups. Changes in pupillary reaction (choice D) are not typically more common in children following head trauma compared to adults.
2. After a motor vehicle collision, a client is admitted to the medical unit with acute adrenal insufficiency (Addisonian crisis). Which prescription should the nurse implement?
- A. Determine serum glucose levels
- B. Withhold potassium additives to IV fluids
- C. Give IV corticosteroid replacement
- D. Prepare to initiate IV vasopressors
Correct answer: C
Rationale: In a client with acute adrenal insufficiency (Addisonian crisis) following a motor vehicle collision, the priority intervention is to administer IV corticosteroid replacement. This is crucial to manage the crisis by replacing the deficient cortisol. Determining serum glucose levels (Choice A) may be important but is not the immediate priority in this situation. Withholding potassium additives to IV fluids (Choice B) is not indicated and may exacerbate electrolyte imbalances. Initiating IV vasopressors (Choice D) is not the primary treatment for acute adrenal insufficiency and should be reserved for managing hypotension that is unresponsive to corticosteroid therapy.
3. What is a common finding that the nurse can identify in most children with symptomatic cardiac malformations?
- A. Mental retardation
- B. Inherited genetic factors
- C. Delayed physical growth
- D. Clubbing of the fingertips
Correct answer: C
Rationale: Delayed physical growth is a common finding in most children with symptomatic cardiac malformations. This occurs due to inadequate oxygenation and nutrient supply to tissues as a result of the cardiac defect. Mental retardation (Choice A) is not typically associated with cardiac malformations unless there are complications affecting brain function. Inherited genetic factors (Choice B) may contribute to the development of cardiac malformations but are not a direct common finding in affected children. Clubbing of the fingertips (Choice D) is more commonly associated with chronic respiratory or cardiac conditions, not specifically cardiac malformations in children.
4. What is important to include in discharge instructions for parents of a child who has had a tonsillectomy?
- A. Encourage the child to gargle with salt water
- B. Encourage fluid intake
- C. Provide the child with hard candy
- D. Apply heat to the neck
Correct answer: B
Rationale: Encouraging fluid intake is essential in the discharge instructions for a child who has had a tonsillectomy. It helps keep the throat moist, aids in preventing dehydration, and promotes healing. Gargling with salt water is not typically recommended after a tonsillectomy as it may irritate the surgical site. Providing the child with hard candy is not advisable as it can irritate the throat and potentially cause harm. Applying heat to the neck is also not recommended post-tonsillectomy as it can increase swelling and discomfort in the surgical area.
5. A nurse is inspecting the skin of a child with atopic dermatitis. What would the nurse expect to observe?
- A. Erythematous papulovesicular rash
- B. Dry, red, scaly rash with lichenification
- C. Pustular vesicles with honey-colored exudates
- D. Hypopigmented oval scaly lesions
Correct answer: B
Rationale: In atopic dermatitis, the characteristic presentation includes a dry, red, scaly rash with lichenification. This appearance is due to chronic inflammation and scratching. Choice A is incorrect as erythematous papulovesicular rash is more indicative of conditions like contact dermatitis. Choice C is incorrect as pustular vesicles with honey-colored exudates are seen in impetigo. Choice D is incorrect as hypopigmented oval scaly lesions are more characteristic of tinea versicolor.