2025 Evolve HESI peds Exam Practice with
85 Questions and Rationalized Answers
100% Verified Guaranteed Pass
1. 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.: 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 rat
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.
2. 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 par- ents 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 respirato
therapy is done daily during any respiratory infection.: - Administer aerosol therapy followe
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).
3. 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.: Use sunscreen when lying by the pool.
Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) ther- apy. 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.
4. 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.: 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.
5. 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: Prevent the return of oxygenated
blood to the lungs.
Closure of VSDs stops oxygenated blood from being shunted from the left ven- tricle 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.
, 6. 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.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
C. Mix the dose of prophylactic antibiotic in a full bottle of formula.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening.: A. Monitor the the infant's
weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
85 Questions and Rationalized Answers
100% Verified Guaranteed Pass
1. 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.: 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 rat
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.
2. 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 par- ents 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 respirato
therapy is done daily during any respiratory infection.: - Administer aerosol therapy followe
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).
3. 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.: Use sunscreen when lying by the pool.
Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) ther- apy. 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.
4. 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.: 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.
5. 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: Prevent the return of oxygenated
blood to the lungs.
Closure of VSDs stops oxygenated blood from being shunted from the left ven- tricle 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.
, 6. 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.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
C. Mix the dose of prophylactic antibiotic in a full bottle of formula.
D. Allow the infant to rest and refeed on demand or every 2 hours.
E. Use a softer nipple or increase the size of the nipple opening.: A. Monitor the the infant's
weight and number of wet diapers per day.
B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
