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2024 EVOLVE PEDIATRICS HESI PRACTICE EXAM WITH ANSWERS
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2024 EVOLVE PEDIATRICS HESI PRACTICE EXAM WITH ANSWERS
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2024 EVOLVE PEDIATRICS HESIPRACTICE EXAM WITH ANSWERS
The nurse is examining a neonate at age 10 minutes. Which site should the
nurse expect to see nonpathologic cyanosis?
a. Feet and hands.
b. Bridge of nose.
c. Circumoral area.
d. Mucous membranes. - CORRECT-ANSWERSa. Feet and hands.
Acrocyanosis, nonpathologic cyanosis of the hands and feet, is an expectant
finding in a newborn.
Which should the nurse assess last when examining a 5-year-old child?
a. Heart.
b. Lungs.
c. Throat.
d. Abdomen. - CORRECT-ANSWERSc. Throat.
The low birthweight (LBW) infant requires a neutral thermal environment.
Which action should the nurse implement?
a. Use wool blankets for covers.
b. Avoid using disposable diapers.
c. Maintain a temperature-controlled, high-humidity atmosphere.
d. Continue cool oxygenation via a hood. - CORRECT-ANSWERSc. Maintain a
temperature-controlled, high-humidity atmosphere.
A temperature-controlled neutral thermal environment with high humidity
provides adequate warmth so the LBW infant can maintain a normal core
temperature with minimum oxygen consumption and caloric expenditure.
LBW infants are especially vulnerable to temperature instability since they
are usually premature and neurologically have difficulty maintaining their
temperature. Their skin has not matured enough to provide adequate
protection from heat and water loss. A high-humidity atmosphere in an
incubator contributes to body homeostasis by reducing evaporative heat loss
and insensible water loss. The three primary methods for maintaining a
neutral thermal environment are the use of an incubator, a radiant warmer,
and an open bassinet with cotton blankets. Microenvironments for
,humidification can include items such as food-grade plastic bags or plastic
wrap, humidified reservoirs for incubators, and humidified plastic heat
shields covered with plastic wrap.
When assessing the breath sounds of an 18-month-old child who is crying,
what action should the nurse take?
a. Ask the parent to quiet the child so breath sounds can be auscultated.
b. Auscultate and document breath sounds, noting that the child was crying
at the time.
c. Document that the assessment was not available because the child was
crying.
d. Allow the child to initially play with the stethoscope, and distract the child
during auscultation. - CORRECT-ANSWERSd. Allow the child to initially play
with the stethoscope, and distract the child during auscultation.
Engaging the child with an interesting activity, such as playing with the
stethoscope before its use, often distracts the child long enough to stop
crying so that breath sounds can be auscultated accurately.
Which is a priority nursing problem for a child in the subacute stage of
Kawasaki disease (KD)?
a. Alterations in skin integrity.
b. High risk for altered tissue perfusion, cardiopulmonary.
c. Risk for imbalanced body temperature, hyperthermia.
d. High risk for fluid volume deficit. - CORRECT-ANSWERSb. High risk for
altered tissue perfusion, cardiopulmonary.
KD is an acute systemic vasculitis that places the child at risk for coronary
artery aneurysm, which is most likely to occur during the subacute phase
resulting in reduced cardiac output. KD causes a rash and desquamation of
the hands and feet. This is not as life-threatening as cardiac involvement.
When plotting a 20-week-old infant's weight on a standardized growth chart,
the nurse determines that the child's weight is between the 2nd and 3rd
percentiles. Based on this finding, which action should the nurse take?
a. Teach the parents about interventions for failure to thrive syndrome.
b. Compare this weight with previous weights recorded in the child's record.
c. Evaluate the parent's body build in relation to the infant's weight.
d. Obtain a 24-hour nutritional history before making any conclusions. -
CORRECT-ANSWERSb. Compare this weight with previous weights recorded
in the child's record.
, Evaluation of weight using a growth chart requires comparison of current
weight with previous weight measurements. An infant is defined as having
"failure to thrive" if their height or weight falls below the 3rd percentile, but
first the nurse should review the infant's health record to assess the infant's
weight history.
A 15-year-old girl tells the school nurse that she wants to have a baby. How
should the nurse respond?
a. "Will you be able to support the baby?"
b. "Do you have plans to continue school?"
c. "Have you talked with your parents about this?"
d. "Can you tell me how your life will be if you have an infant?" - CORRECT-
ANSWERSd. "Can you tell me how your life will be if you have an infant?"
Developing a dialogue with the teen is important. By using an open-ended
question the nurse will encourage communication and explanation. This
question directs the teen to consider real life experiences and allows the
nurse to assess the teen's perception and reality orientation.
When assessing a preschooler, which finding warrants further assessment by
the nurse?
a. Able to ride a tricycle.
b. Talks about an imaginary friend.
c. Dresses independently.
d. Gains 2 pounds (0.9 kg) in 12 months. - CORRECT-ANSWERSd. Gains 2
pounds (0.9 kg) in 12 months.
Preschool children gain an average of 5 pounds (2.3 kg) per year. Therefore,
a gain of 2 pounds (0.9 kg) is less than half of the expected weight gain and
should be investigated further.
The nurse is developing a plan of care for a newborn with a colostomy due to
anal agenesis. The infant has had continuous loose stools since surgery
yesterday. Which nursing problem has the highest priority given the infant's
condition?
a. Fluid volume deficit.
b. Alteration in bowel elimination.
c. Pain due to postoperative condition.
d. Anxiety of parents due to newborn's condition. - CORRECT-ANSWERSa.
Fluid volume deficit.
All stated nursing problems are appropriate for a postoperative colostomy
client. However, fluid balance is the priority concern for any infant and is
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