2024 HESI PEDIATRICS (PEDS) PRACTICE EXAM 400
PRACTICE QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES
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. - Answer 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.
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. - Answer 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. - Answer 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. - Answer 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 -
Answer 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.)
PRACTICE QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES
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. - Answer 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.
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. - Answer 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. - Answer 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. - Answer 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 -
Answer 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.)
