HESI LPN
Pediatric HESI 2023
1. You are caring for a 6-year-old child with a possible fractured left arm and have reason to believe that the child was abused. How should you manage this situation?
- A. inform the parents of your suspicions
- B. call the police so the parents can be arrested
- C. advise the parents that the child needs to be transported
- D. transport the child to the hospital regardless of the parents' wishes
Correct answer: C
Rationale: In cases where child abuse is suspected, the priority is the safety and well-being of the child. Advising the parents that the child needs to be transported allows for the child to receive necessary medical care without immediate confrontation or escalating the situation. Calling the police to have the parents arrested without concrete evidence may not be appropriate and could further endanger the child. Informing the parents of suspicions may lead to interference or denial of necessary care. Transporting the child to the hospital is crucial, but involving and engaging with the parents in a non-confrontational manner is the initial step to ensure the child's safety and well-being.
2. How do integrative models of human health see health factors?
- A. derived solely from physical phenomena
- B. intertwined and interactive, with multiple components such as physical, psychological, and social
- C. generally being attributable to psychosocial problems in individuals
- D. effective only when combined and integrated with alternative therapies
Correct answer: B
Rationale: Integrative models of human health consider health factors as intertwined and interactive, involving various components like physical, psychological, and social aspects. This holistic approach recognizes that health is influenced by a combination of factors, not just physical phenomena (choice A). While psychosocial problems can impact health, integrative models go beyond attributing health solely to psychosocial issues (choice C). Additionally, integrative models do not imply that health is effective only when combined with alternative therapies (choice D), but rather emphasize the interconnectedness of various health components.
3. A healthcare professional is assessing a child with suspected bacterial meningitis. What is a common clinical manifestation that the healthcare professional is likely to observe?
- A. Rash
- B. Photophobia
- C. Jaundice
- D. Kernig sign
Correct answer: D
Rationale: A common clinical manifestation of bacterial meningitis is a positive Kernig sign, indicating irritation of the meninges. Rash (Choice A) is not typically associated with bacterial meningitis. Photophobia (Choice B) can be present but is more commonly seen in viral meningitis. Jaundice (Choice C) is not a typical clinical manifestation of meningitis and is more indicative of liver dysfunction.
4. At 0345, you receive a call for a woman in labor. Upon arriving at the scene, you are greeted by a very anxious man who tells you that his wife is having her baby 'now.' This man escorts you into the living room where a 25-year-old woman is lying on the couch in obvious pain. After determining that delivery is not imminent, you begin transport. While en route, the mother tells you that she feels the urge to push. You assess her and see the top of the baby's head bulging from the vagina. What is your most appropriate first action?
- A. Allow the head to deliver and check for the location of the cord.
- B. Advise your partner to stop the ambulance and assist with the delivery.
- C. Tell the mother to take short, quick breaths until you arrive at the hospital.
- D. Prepare the mother for an emergency delivery and open the obstetrics kit.
Correct answer: B
Rationale: In this scenario, the most appropriate first action is to advise your partner to stop the ambulance and assist with the delivery. When the baby's head is visible and delivery is imminent, it is crucial to provide immediate assistance to ensure the safety of both the mother and the baby. Allowing the head to deliver and checking for the location of the cord (Choice A) may delay necessary actions during an imminent delivery. Instructing the mother to take short, quick breaths (Choice C) is not suitable as active delivery is already in progress. Preparing the mother for an emergency delivery and opening the obstetrics kit (Choice D) is not the most immediate action needed when the baby's head is already visible and delivery is imminent.
5. What maternal factor should the nurse identify as having the greatest impact on the development of spina bifida occulta in a newborn?
- A. Short interval between pregnancies
- B. Folic acid deficiency
- C. Preeclampsia
- D. Tobacco use
Correct answer: B
Rationale: Folic acid deficiency during pregnancy is a well-known risk factor for neural tube defects, including spina bifida occulta, making supplementation critical in prenatal care. Folic acid plays a crucial role in neural tube formation during early pregnancy. Short intervals between pregnancies do not directly impact the development of spina bifida occulta. Preeclampsia is a hypertensive disorder of pregnancy and is not directly linked to spina bifida occulta. While tobacco use during pregnancy has various adverse effects, it is not the primary factor influencing the development of spina bifida occulta in newborns.