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2024 EVOLVE HESI PEDS PRACTICE EXAM QUESTIONS WITH CORRECT ANSWERS
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2024 EVOLVE HESI PEDS PRACTICE EXAM QUESTIONS WITH CORRECT ANSWERS
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2024 EVOLVE HESI PEDSPRACTICE EXAM QUESTIONS
WITH CORRECT ANSWERS
A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin
elixir. Which observation by the nurse warrants immediate intervention?
Apical heart rate of 60.
Sweating across the forehead.
Doesn't suck well.
Respiratory rate of 30 breaths per minute. - CORRECT ANSWERS-Apical
heart rate of 60.
A heart rate of 60 (A) is much lower than normal for a 6-month-old and
warrants immediate intervention. The normal heart rate for a 6-month-old is
80 to 150 BPM when awake, and a rate of 70 while sleeping is considered
within normal limits. (B and C) are expected symptoms of heart failure in an
infant. (D) is within normal limits for an infant.
Surgery is being delayed for an infant with undescended testes. In
collaboration with the healthcare provider and the family, which prescription
should the nurse anticipate?
A trial of adrenocorticotrophic hormone injections.
Frequent stimulation of the cremasteric reflex.
A trial of human chorionic gonadotrophic hormone.
Frequent warm baths to gently dilate the scrotal area. - CORRECT ANSWERS-
A trial of human chorionic gonadotrophic hormone.
A trial of HCG (human chorionic gonadotrophic hormone) (C) may aid in
testicular descent, but does not replace surgical repair for true undescended
testes. Undescended testes (cryptorchidism) may be found in the inguinal
canal due to exaggerated cremasteric reflex. (A) is not indicated. Stimulation
of the cremasteric reflex causes the testes to ascend rather than descend in
the scrotum (B). (D) may relax the cremasteric muscle, but may not cause
the testes to descend.
A preschool-age child who is hospitalized for hypospadias repair is most
strongly influenced by which behavior?
Ability to communicate verbally.
Response to separation from family.
Concern for body integrity.
, Socialization with other children. - CORRECT ANSWERS-Concern for body
integrity.
The preschooler's major stressor is concern for his body integrity (C). He
fears that his "insides will leak out." A child undergoing surgery to his
genitalia is even more concerned about body integrity. The preschooler is
quite verbal, so comprehension of the words he uses or hears may be
inaccurate, while his imagination and fears may fantasize the reality (A). (B)
is a concern for all children, but of most concern to the toddler. (D) is not a
prime concern in this situation.
A six-month-old returns from surgery with elbow restraints in place. What
nursing care should be included when caring for any restrained child?
Keep restraints on at all times.
Remove restraints one at a time and provide range of motion exercises.
Remove all restraints simultaneously and provide play activities.
Renew the healthcare provider's prescription for restraints every 72 hours. -
CORRECT ANSWERS-Remove restraints one at a time and provide range of
motion exercises.
Removing restraints one at a time (B) is safer than removing all of them at
once (C). The child needs to exercise and should not be kept in restraints at
all times (A). The renewal of the healthcare provider's prescription varies
with hospitals (D), and it does not really answer the question.
All of the following interventions can be used to evaluate the effectiveness of
nursing and medical interventions used to treat diarrhea. Which intervention
is least useful in the nurse's evaluation of a 20-month-old child?
Weighing diapers.
Assessing fontanels.
Checking skin turgor.
Observing mucous membranes for moisture. - CORRECT ANSWERS-
Assessing fontanels.
All of these interventions evaluate fluid status in infants. But, how old is this
child? Posterior fontanel closes at 2 months and anterior fontanel closes by
18 months of age (B)! Remember normal growth and development!
As part of the physical assessment of children, the nurse observes and
palpates the fontanels. Which child's fontanel finding should be reported to
the healthcare provider?
A 6-month-old with failure to thrive that has a closed anterior fontanel.
A 24-month-old with gastroenteritis that has a closed posterior fontanel.
A 2-month-old with chickenpox that has an open posterior fontanel.
, A 28-month-old with hydrocephalus that has an open anterior fontanel. -
CORRECT ANSWERS-A 6-month-old with failure to thrive that has a closed
anterior fontanel.
At six months of age the anterior fontanel should be open, and it should not
be closed until approximately 18 months of age. (B and C) are normal
findings. A child with hydrocephalus may have a delayed closing of the
fontanel (D).
The nurse receives a lab report stating a child with asthma has a
theophylline level of 15 mcg/dl. What action will the nurse take?
Pass the information on in the report.
Notify the healthcare provider because the value is high.
Repeat the lab study because the value is too high.
Hold the next dose of theophylline. - CORRECT ANSWERS-Pass the
information on in the report.
The therapeutic level of theophylline is 10 to 20 mcg/dl, so the child's level is
within the therapeutic range. This information evaluates the prescribed
therapy and should be communicated in the nurse's report (A). (B, C, and D)
would be inappropriate actions in view of the laboratory finding.
The nurse is teaching the parents of a 5-year-old with cystic fibrosis about
respiratory treatments. Which statement indicates to the nurse that the
parents understand?
Perform postural drainage before starting aerosol therapy.
Give respiratory treatments when the child is coughing a lot.
Administer aerosol therapy followed by postural drainage before meals.
Ensure respiratory therapy is done daily during any respiratory infection. -
CORRECT ANSWERS-Administer aerosol therapy followed by postural
drainage before meals.
Postural drainage for a child with cystic fibrosis is most effective when
performed after nebulization and before meals (C) or at least 1 hour after
eating to prevent nausea and vomiting. Postural drainage uses gravity to
promote mucous removal after nebulization (A) treatments which open the
airways. Pulmonary toileting or respiratory treatments should be given 3 to 4
times daily, not episodically (B and D).
A female teenager is taking oral tetracycline HCL (Achromycin V) for acne
vulgaris. What is the most important instruction for the nurse to include in
this client's teaching plan?
Use sunscreen when lying by the pool.
, Cleanse the skin at least 4 times a day.
Take the medication with a glass of milk.
Menstrual periods may become irregular. - CORRECT ANSWERS-Use
sunscreen when lying by the pool.
Photosensitivity is a common side effect of tetracycline HCL (Achromycin V)
therapy. Severe sunburn can occur with minimal sun exposure and clients
should be instructed to avoid sunlight and to use sunscreen (A). (B and D)
are not related to tetracycline HCL (Achromycin V) therapy. (C) should be
avoided because dairy products interfere with the absorption of
tetracyclines.
What preoperative nursing intervention should be included in the plan of
care for an infant with pyloric stenosis?
Monitor for signs of metabolic acidosis.
Estimate the quantity of diarrhea stools.
Place in a supine position after feeding.
Observe for projectile vomiting. - CORRECT ANSWERS-Observe for projectile
vomiting.
Projectile vomiting (D), which contributes to metabolic alkalosis (A), is the
classic sign of pyloric stenosis. (B) is not indicated. (C) is dangerous, due to
the potential for aspiration with frequent vomiting.
An infant is born with a ventricular septal defect (VSD) and surgery is
planned to correct the defect. The nurse recognizes that surgical correction
is designed to achieve which outcome?
Stop the flow of unoxygenated blood into systemic circulation.
Increase the flow of unoxygenated blood to the lungs.
Prevent the return of oxygenated blood to the lungs.
Reduce peripheral tissue hypoxia and nailbed clubbing - CORRECT
ANSWERS-Prevent the return of oxygenated blood to the lungs.
Closure of VSDs stops oxygenated blood from being shunted from the left
ventricle to the right ventricle (C). VSDs are acyanotic defects, which means
that no unoxygenated blood enters the systemic circulation (A and B). (D) is
common with Tetrology of Fallot, which is a cyanotic defect.
A 3-week-old newborn is brought to the clinic for follow-up after a home
birth. The mother reports that her child bottle feeds for 5 minutes only and
then falls asleep. The nurse auscultates a loud murmur characteristic of a
ventricular septal defect (VSD), and finds the newborn is acyanotic with a
respiratory rate of 64 breaths per minute. What instruction should the nurse
provide the mother to ensure the infant is receiving adequate intake? (Select
all that apply.)
A. Monitor the the infant's weight and number of wet diapers per day.
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