EVOLVE HESI PEDS PRACTICE EXAM
QUESTIONS WITH CORRECT
ANSWERS
The parents of a 3-week-old infant report that the child eats well but vomits after
each feeding. What information is most important for the nurse to obtain?
Description of vomiting episodes in past 24 hours.
Number of wet diapers in last 24 hours.
Feeding and sleep schedule.
Amount of formula consumed during the past 24 hours. - ANSWER-Description of
vomiting episodes in past 24 hours.
A description of the vomiting episodes (A) will assist the nurse in determining the
reason for the symptoms, which may be helpful in developing a plan of care for this
infant. (B and C) provide related information but are not as helpful as (A). (D) may be
related to the vomiting, but the nurse should first obtain a better description of the
vomiting episodes.
A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician
prescribes dextrose 5% and 0.25% normal saline with 2 mEq KCl/100 ml to be
infused at 25 ml/hour. Prior to initiating the infusion, the nurse should obtain which
assessment finding?
Frequency of emesis in the last 8 hours.
Serum BUN and creatinine levels.
Current blood sugar level.
Appearance of the stool. - ANSWER-Serum BUN and creatinine levels.
Regardless of a client's age, adequate renal function must be present before adding
potassium to IV fluids (B). (A) is important in determining the need for fluid
replacement. (C) is not indicated. (D) is useful information, but will not impact
administration of the prescribed IV solution.
Which finding in a 19-year-old female client should trigger further assessment by the
nurse?
Menstruation has not occurred.
Reports no tetanus immunization since childhood.
Denies having any wisdom teeth.
History of painful, inward growth on bottom of foot. - ANSWER-Menstruation has not
occurred.
Menstruation is an expected secondary sex characteristic that occurs with
pubescence and typically occurs by age 18, so (A) should prompt further
investigation to determine the cause of this primary amenorrhea. Children receive
tetanus as part of the DPT childhood immunization series, and a booster is not
typically given until age 16 (B). Wisdom teeth are the third molar teeth of the
permanent dentition and are the last to erupt, so (C) is a normal finding. (D)
,describes a plantar surface wart, harmless but painful because of the pressure with
walking or standing.
The nurse is giving a liquid iron preparation to a 3-year-old child. Which technique
should the nurse implement to engage the child's cooperation?
Use a colorful straw.
Mix the medication in water.
Administer the medication using an oral syringe.
Ask the pharmacy to provide an enteric tablet. - ANSWER-Use a colorful straw.
A liquid iron preparation administered through a straw may help the child to accept
the medication since young children consider drinking from a colorful straw fun (A).
(B) may cause staining of the child's teeth. (C) is often used if the child is
uncooperative. (D) is ineffective and should be requested from the healthcare
provider.
When evaluating the effectiveness of interventions to improve the nutritional status of
an infant with gastro-esophageal reflux, which intervention is most important for the
nurse to implement?
Record weight daily.
Assess for signs of anemia.
Document sleeping patterns.
Teach parenting skills. - ANSWER-Record weight daily.
The most definitive measure of improved nutrition in an infant is obtaining the child's
daily weight (A). (B, C, and D) may also be useful, but they are not as definitive as a
daily weight measurement.
A three-month old boy weighing 10 lbs 15 oz has an axillary temperature of 98.9° F.
The nurse determines the daily caloric need for this child is approximately
400 calories per day.
500 calories per day.
600 calories per day.
700 calories per day. - ANSWER-600 calories per day.
10 lbs 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2; 10.9/2.2 = 4.954
kg, rounded to 5 kg. An infant requires 108 calories/kg/day (108 × 5 = 540
calories/day). However, this infant requires 10% more calories because he has one
degree temperature elevation. 10% of 540 is 54 and 540 + 54 = 594. This infant will
require approximately 600 calories/day. Tough question! You know that 400 calories
are too few and 700 are too much, and a temperature elevation necessitates
consumption of more calories, so choose the higher of the two choices left!
Which measurements should be used to accurately calculate a pediatric medication
dosage? (Select all that apply.)
Child's height and weight.
Adult dosage of medication.
Body surface area of child.
Average adult's body surface area.
Average pediatric dosage of medication.
, Nomogram determined mathematical constant. - ANSWER-Child's height and
weight.
Body surface area of child.
Nomogram determined mathematical constant.
Correct selections are (A, C, and F). The most accurate calculations of pediatric
dosages use the child's height and weight (A). The child's BSA is calculated using
the square root of weight in kg times height in cm divided by 3600 or the square root
of weight in lb times height in inches divided by 3131 (C), then the child's BSA is
multiplied by the recommended published dose per BSA. The nomogram (F) is used
to plot the child's height and weight, and the point at which they intersect is the BSA
mathematical constant used to calculate the child's dose. (B, D, and E) are not used
to calculate pediatric dosages.
The nurse is assessing a 2-year-old. What behavior indicates that the child's
language development is within normal limits?
Is able to name four colors.
Can count five blocks.
Is capable of making a three word sentence.
Half of child's speech is understandable. - ANSWER-Half of child's speech is
understandable.
Between approximately 15 and 24 months of age, a child's speech is only half
understandable (D). (A and B) usually occur between 3 and 5 years of age. (C) is
usually accomplished by 18 months of age.
The nurse reviews the latest laboratory results for a child who received
chemotherapy last week and identifies a reduced neutrophil count. Which nursing
diagnosis has the highest priority for this child?
Risk for infection.
Risk for hemorrhage.
Altered skin integrity.
Disturbance in body image. - ANSWER-Risk for infection.
Chemotherapy (CT) suppresses phagocytotic neutrophils and places the child at risk
for infection (A), which is the priority nursing diagnosis. (B, C, and D) may be related
to the care of a child receiving CT are not related to neutropenia.
A child falls on the playground and is brought to the school nurse with a small
laceration on the forearm. Which action should the nurse implement first?
Slowly pour hydrogen peroxide over the open wound.
Apply ice to the area before rinsing with cold water.
Wash the wound gently with mild soap and water.
Gently cleanse with a sterile pad using povidone-iodine. - ANSWER-Wash the
wound gently with mild soap and water.
A small, superficial laceration to the skin should be washed gently with mild soap
and water (C) for several minutes, followed by thorough rinsing. (A and D) are
antiseptics that can be traumatic (painful) when cleaning fresh, open wounds.
QUESTIONS WITH CORRECT
ANSWERS
The parents of a 3-week-old infant report that the child eats well but vomits after
each feeding. What information is most important for the nurse to obtain?
Description of vomiting episodes in past 24 hours.
Number of wet diapers in last 24 hours.
Feeding and sleep schedule.
Amount of formula consumed during the past 24 hours. - ANSWER-Description of
vomiting episodes in past 24 hours.
A description of the vomiting episodes (A) will assist the nurse in determining the
reason for the symptoms, which may be helpful in developing a plan of care for this
infant. (B and C) provide related information but are not as helpful as (A). (D) may be
related to the vomiting, but the nurse should first obtain a better description of the
vomiting episodes.
A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician
prescribes dextrose 5% and 0.25% normal saline with 2 mEq KCl/100 ml to be
infused at 25 ml/hour. Prior to initiating the infusion, the nurse should obtain which
assessment finding?
Frequency of emesis in the last 8 hours.
Serum BUN and creatinine levels.
Current blood sugar level.
Appearance of the stool. - ANSWER-Serum BUN and creatinine levels.
Regardless of a client's age, adequate renal function must be present before adding
potassium to IV fluids (B). (A) is important in determining the need for fluid
replacement. (C) is not indicated. (D) is useful information, but will not impact
administration of the prescribed IV solution.
Which finding in a 19-year-old female client should trigger further assessment by the
nurse?
Menstruation has not occurred.
Reports no tetanus immunization since childhood.
Denies having any wisdom teeth.
History of painful, inward growth on bottom of foot. - ANSWER-Menstruation has not
occurred.
Menstruation is an expected secondary sex characteristic that occurs with
pubescence and typically occurs by age 18, so (A) should prompt further
investigation to determine the cause of this primary amenorrhea. Children receive
tetanus as part of the DPT childhood immunization series, and a booster is not
typically given until age 16 (B). Wisdom teeth are the third molar teeth of the
permanent dentition and are the last to erupt, so (C) is a normal finding. (D)
,describes a plantar surface wart, harmless but painful because of the pressure with
walking or standing.
The nurse is giving a liquid iron preparation to a 3-year-old child. Which technique
should the nurse implement to engage the child's cooperation?
Use a colorful straw.
Mix the medication in water.
Administer the medication using an oral syringe.
Ask the pharmacy to provide an enteric tablet. - ANSWER-Use a colorful straw.
A liquid iron preparation administered through a straw may help the child to accept
the medication since young children consider drinking from a colorful straw fun (A).
(B) may cause staining of the child's teeth. (C) is often used if the child is
uncooperative. (D) is ineffective and should be requested from the healthcare
provider.
When evaluating the effectiveness of interventions to improve the nutritional status of
an infant with gastro-esophageal reflux, which intervention is most important for the
nurse to implement?
Record weight daily.
Assess for signs of anemia.
Document sleeping patterns.
Teach parenting skills. - ANSWER-Record weight daily.
The most definitive measure of improved nutrition in an infant is obtaining the child's
daily weight (A). (B, C, and D) may also be useful, but they are not as definitive as a
daily weight measurement.
A three-month old boy weighing 10 lbs 15 oz has an axillary temperature of 98.9° F.
The nurse determines the daily caloric need for this child is approximately
400 calories per day.
500 calories per day.
600 calories per day.
700 calories per day. - ANSWER-600 calories per day.
10 lbs 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2; 10.9/2.2 = 4.954
kg, rounded to 5 kg. An infant requires 108 calories/kg/day (108 × 5 = 540
calories/day). However, this infant requires 10% more calories because he has one
degree temperature elevation. 10% of 540 is 54 and 540 + 54 = 594. This infant will
require approximately 600 calories/day. Tough question! You know that 400 calories
are too few and 700 are too much, and a temperature elevation necessitates
consumption of more calories, so choose the higher of the two choices left!
Which measurements should be used to accurately calculate a pediatric medication
dosage? (Select all that apply.)
Child's height and weight.
Adult dosage of medication.
Body surface area of child.
Average adult's body surface area.
Average pediatric dosage of medication.
, Nomogram determined mathematical constant. - ANSWER-Child's height and
weight.
Body surface area of child.
Nomogram determined mathematical constant.
Correct selections are (A, C, and F). The most accurate calculations of pediatric
dosages use the child's height and weight (A). The child's BSA is calculated using
the square root of weight in kg times height in cm divided by 3600 or the square root
of weight in lb times height in inches divided by 3131 (C), then the child's BSA is
multiplied by the recommended published dose per BSA. The nomogram (F) is used
to plot the child's height and weight, and the point at which they intersect is the BSA
mathematical constant used to calculate the child's dose. (B, D, and E) are not used
to calculate pediatric dosages.
The nurse is assessing a 2-year-old. What behavior indicates that the child's
language development is within normal limits?
Is able to name four colors.
Can count five blocks.
Is capable of making a three word sentence.
Half of child's speech is understandable. - ANSWER-Half of child's speech is
understandable.
Between approximately 15 and 24 months of age, a child's speech is only half
understandable (D). (A and B) usually occur between 3 and 5 years of age. (C) is
usually accomplished by 18 months of age.
The nurse reviews the latest laboratory results for a child who received
chemotherapy last week and identifies a reduced neutrophil count. Which nursing
diagnosis has the highest priority for this child?
Risk for infection.
Risk for hemorrhage.
Altered skin integrity.
Disturbance in body image. - ANSWER-Risk for infection.
Chemotherapy (CT) suppresses phagocytotic neutrophils and places the child at risk
for infection (A), which is the priority nursing diagnosis. (B, C, and D) may be related
to the care of a child receiving CT are not related to neutropenia.
A child falls on the playground and is brought to the school nurse with a small
laceration on the forearm. Which action should the nurse implement first?
Slowly pour hydrogen peroxide over the open wound.
Apply ice to the area before rinsing with cold water.
Wash the wound gently with mild soap and water.
Gently cleanse with a sterile pad using povidone-iodine. - ANSWER-Wash the
wound gently with mild soap and water.
A small, superficial laceration to the skin should be washed gently with mild soap
and water (C) for several minutes, followed by thorough rinsing. (A and D) are
antiseptics that can be traumatic (painful) when cleaning fresh, open wounds.
