while assessing an 18 month old child a nurse observes that the toddler can crawl upstairs but needs assistance when climbing the stairs upright what
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Nursing Elites

HESI LPN

Pediatrics HESI 2023

1. While assessing an 18-month-old child, a nurse observes that the toddler can crawl upstairs but needs assistance when climbing the stairs upright. What does this action indicate to the nurse?

Correct answer: C

Rationale: At 18 months of age, needing assistance to climb stairs upright is considered normal behavior for a toddler. Crawling upstairs is a different motor skill and does not necessarily correlate with the ability to climb stairs. The child is still developing gross motor skills, and climbing stairs upright typically requires more coordination and strength, which may not be fully developed at this age. Choices A, B, and D are not relevant in this scenario as the observed behavior is within the expected range of development for an 18-month-old child.

2. What foods are appropriate for a 30-month-old toddler on a regular diet?

Correct answer: D

Rationale: Macaroni and cheese and Cheerios are appropriate choices for a 30-month-old toddler on a regular diet as they provide a balance of carbohydrates and protein. Option A, hamburger with bun and grapes, may be difficult for a toddler to chew, and grapes pose a choking hazard. Option B, chicken fingers and french fries, are high in unhealthy fats and sodium. Option C, hot dog with bun and potato chips, are processed foods high in salt and unhealthy fats, not ideal for a toddler's diet.

3. A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which condition?

Correct answer: A

Rationale: When a child with diabetes insipidus is treated with vasopressin, the nurse should closely monitor for signs and symptoms of Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Vasopressin, also known as antidiuretic hormone, helps retain water in the body. Excessive vasopressin administration can lead to water retention, dilutional hyponatremia, and potentially result in SIADH. Choices B, C, and D are incorrect because they are not directly associated with the use of vasopressin in treating diabetes insipidus.

4. The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching?

Correct answer: B

Rationale: Choice B indicates a need for further teaching because participation in contact sports like football should be avoided in children with idiopathic thrombocytopenia due to the increased risk of bleeding. Choices A, C, and D are correct. Avoiding aspirin and medications like ibuprofen helps prevent bleeding complications. Swimming is a safe physical activity that can be recommended. Antihistamines do not pose a significant risk in this case and can be used if needed.

5. A nurse plans to talk to the parents of a toddler about toilet training. What should the nurse explain is the most important factor in the process of toilet training?

Correct answer: D

Rationale: The most crucial factor in the process of toilet training is the parents' willingness to consistently engage and work with their child. While parents' attitude and the child's desire to remain dry can influence the process, the key to successful toilet training lies in the parents' commitment and effort. The child's ability to sit still on the toilet is important but not as critical as the parents' active involvement and support in guiding and encouraging the child through the training process.

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