EVOLVE HESI PEDS PRACTICE EXAM
QUESTIONS AND ANSWERS
To assess the effectiveness of an analgesic administered to a 4-year-old, what
intervention is best for the nurse to implement?
Use a happy-face/sad-face pain scale.
Ask the mother if she thinks the analgesic is working.
Assess for changes in the child's vital signs.
Teach the child to point to a numeric pain scale. - ANSWER-Use a happy-face/sad-
face pain scale.
A 4-year-old can readily identify with simple pictures (A) to show the nurse how
he/she is feeling. (B) could be used to validate what the child is telling the nurse via
the "faces" pain scale, but it is best to elicit the child's assessment of his/her pain
level. (C) may not accurately reflect the effectiveness of pain medication as they can
also be affected by other variables, such as fear. (D) requires abstract number skills
beyond the level of a 4-year-old.
A 4-year-old girl continues to interrupt her mother during a routine clinic visit. The
mother appears irritated with the child and asks the nurse, "Is this normal behavior
for a child this age?" The nurse's response should be based on which information?
Children need to retain a sense of initiative without impinging on the rights and
privileges of others.
Negative feelings of doubt and shame are characteristic of 4-year-old children.
Role conflict is a common problem of children this age. She is just wondering where
she fits into society.
At this age children compete and like to produce and carry through with tasks. She
is just competing with her mother. - ANSWER-Children need to retain a sense of
initiative without impinging on the rights and privileges of others.
Children aged 3 to 6 are in Erickson's "Initiative vs. Guilt" stage, which is
characterized by vigorous, intrusive behavior, enterprise, and strong imagination. At
this age, children develop a conscience and must learn to retain a sense of initiative
without impinging on the rights of others (A). (B) describes the "Autonomy vs. Shame
and Doubt," stage (1 to 3 years of age). (C) describes an adolescent (12 to 18 years
of age), the "Identity vs. Role Confusion" stage. (D) describes a child 6 to 12 years of
age, the "Industry vs. Inferiority" stage.
A child is rescued from a burning house and brought to the emergency room with
partial-thickness burns on the face and chest. Which action should the nurse
implemented first?
Insert an indwelling urinary catheter.
Administer IV pain medication.
Collect blood specimen for laboratory studies.
Assess the child's respiratory status. - ANSWER-Assess the child's respiratory
status.
,Assessing the airway and the respiratory status is the highest priority (D) since burns
to the face and chest place the child at risk for smoke inhalation injury and
compromised airway. (A, B, and C) are implemented after (D).
A 17-year-old male student reports to the school clinic one morning for a scheduled
health exam. He tells the nurse that he just finished football practice and is on his
way to class. The nurse assesses his vital signs: temperature 100° F, pulse 80,
respirations 20, and blood pressure 122/82. What is the best action for the nurse to
take?
Tell the student to proceed directly to his regularly scheduled class.
Call the parent and suggest re-taking the student's temperature at home.
Give the student a glass of cool fluids, then retake his temperature.
Send the student to class, but re-verify his temperature after lunch. - ANSWER-Tell
the student to proceed directly to his regularly scheduled class.
This student has just completed football practice, and increased muscle activity
increases body heat production. A temperature of 100° F is normal for this student at
this time. The student should attend class (A) since no further nursing action is
required. (B) would alarm the parents unnecessarily. (C) would provide a false
reading of body temperature. (D) is unnecessary since these findings are within
normal limits.
A 6-year-old is admitted to the pediatric unit after falling off a bicycle. Which
intervention should the nurse implement to assist the child's adjustment to
hospitalization?
Explain hospital schedules to the child, such as mealtimes.
Use terms, such as "honey" and "dear," to show a caring attitude.
Provide a list of rules that limits visitation of siblings in the hospital.
Orient the parents to the hospital unit and refreshment areas. - ANSWER-Explain
hospital schedules to the child, such as mealtimes.
Altered daily schedules and loss of rituals are upsetting to children and increase
separation anxiety, and active sensitivity to the needs of children can minimize the
negative effects of hospitalization. Explaining the hospital schedules (A) and
establishing an individual schedule familiarizes the child to the hospital environment
and decreases anxiety. (B) depersonalizes the child who should be addressed by
name. Family and sibling visitation should be recommended and encouraged without
limitation (C). Although (D) should be implemented, the direct involvement of the
school-aged child incorporates the child's sense of initiate and cooperation.
The nurse is giving preoperative instructions to a 14-year-old female client who is
scheduled for surgery to correct a spinal curvature. Which statement by the client
best demonstrates that learning has taken place?
I will read all the literature you gave me before surgery.
I have had surgery before when I broke my wrist in a bike accident, so I know what
to expect.
All the things people have told me will help me take care of my back.
I understand that I will be in a body cast and I will show you how you taught me to
turn. - ANSWER-I understand that I will be in a body cast and I will show you how
you taught me to turn.
, Outcome of learning is best demonstrated when the client not only verbalizes an
understanding but can also provide a return demonstration (D). A 14-year-old may or
may not follow through with (A), and there is no measurement of that learning.
Having previous surgery (B) may help the client understand the surgical process, but
wrist surgery is very different from spinal surgery and emergency surgery is different
from elective surgery. In (C), the client may be saying what the nurse wants to hear,
without expressing any real understanding of what to do after surgery.
A burned child is brought to the emergency room. In estimating the percentage of the
body burned, the nurse uses a modified "Rule of Nines." Which part of a child's body
is calculated as a larger percentage of total body surface than an adult's?
Head and neck.
Arms and chest.
Legs and abdomen.
Back and abdomen. - ANSWER-Head and neck.
A child's head and neck are proportionately larger to their body than an adult's (A).
The standard "Rule of Nines" is inaccurate for determining burned body surface
areas with children, and must be modified for use with children. Specially designed
charts for children are commonly used to determine body surface area involvement.
(B, C, and D) are not proportionately different.
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. - ANSWER-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 nurse who is working in the Poison Control Center receives several telephone calls
from parents whose children have ingested possible poisons. The nurse should
recommend inducing vomiting for which child?
8-month-old who ate 4 to 6 ibuprofen tablets.
3-year-old who drank an unknown amount of charcoal lighter fluid.
16-month old who drank 2 ounces of acetaminophen (Tylenol) elixir.
2-year-old who ate a handful of automatic dishwasher detergent. - ANSWER-16-
month old who drank 2 ounces of acetaminophen (Tylenol) elixir.
Emesis should be induced for the child who drank the large dose of acetaminophen
(Tylenol) elixir (C) because this medication is hepatotoxic. Vomiting is
contraindicated for: children under 1 year of age (A), petroleum distillates (B) such as
charcoal lighter fluid, and corrosives (D) such as dishwasher detergents.
QUESTIONS AND ANSWERS
To assess the effectiveness of an analgesic administered to a 4-year-old, what
intervention is best for the nurse to implement?
Use a happy-face/sad-face pain scale.
Ask the mother if she thinks the analgesic is working.
Assess for changes in the child's vital signs.
Teach the child to point to a numeric pain scale. - ANSWER-Use a happy-face/sad-
face pain scale.
A 4-year-old can readily identify with simple pictures (A) to show the nurse how
he/she is feeling. (B) could be used to validate what the child is telling the nurse via
the "faces" pain scale, but it is best to elicit the child's assessment of his/her pain
level. (C) may not accurately reflect the effectiveness of pain medication as they can
also be affected by other variables, such as fear. (D) requires abstract number skills
beyond the level of a 4-year-old.
A 4-year-old girl continues to interrupt her mother during a routine clinic visit. The
mother appears irritated with the child and asks the nurse, "Is this normal behavior
for a child this age?" The nurse's response should be based on which information?
Children need to retain a sense of initiative without impinging on the rights and
privileges of others.
Negative feelings of doubt and shame are characteristic of 4-year-old children.
Role conflict is a common problem of children this age. She is just wondering where
she fits into society.
At this age children compete and like to produce and carry through with tasks. She
is just competing with her mother. - ANSWER-Children need to retain a sense of
initiative without impinging on the rights and privileges of others.
Children aged 3 to 6 are in Erickson's "Initiative vs. Guilt" stage, which is
characterized by vigorous, intrusive behavior, enterprise, and strong imagination. At
this age, children develop a conscience and must learn to retain a sense of initiative
without impinging on the rights of others (A). (B) describes the "Autonomy vs. Shame
and Doubt," stage (1 to 3 years of age). (C) describes an adolescent (12 to 18 years
of age), the "Identity vs. Role Confusion" stage. (D) describes a child 6 to 12 years of
age, the "Industry vs. Inferiority" stage.
A child is rescued from a burning house and brought to the emergency room with
partial-thickness burns on the face and chest. Which action should the nurse
implemented first?
Insert an indwelling urinary catheter.
Administer IV pain medication.
Collect blood specimen for laboratory studies.
Assess the child's respiratory status. - ANSWER-Assess the child's respiratory
status.
,Assessing the airway and the respiratory status is the highest priority (D) since burns
to the face and chest place the child at risk for smoke inhalation injury and
compromised airway. (A, B, and C) are implemented after (D).
A 17-year-old male student reports to the school clinic one morning for a scheduled
health exam. He tells the nurse that he just finished football practice and is on his
way to class. The nurse assesses his vital signs: temperature 100° F, pulse 80,
respirations 20, and blood pressure 122/82. What is the best action for the nurse to
take?
Tell the student to proceed directly to his regularly scheduled class.
Call the parent and suggest re-taking the student's temperature at home.
Give the student a glass of cool fluids, then retake his temperature.
Send the student to class, but re-verify his temperature after lunch. - ANSWER-Tell
the student to proceed directly to his regularly scheduled class.
This student has just completed football practice, and increased muscle activity
increases body heat production. A temperature of 100° F is normal for this student at
this time. The student should attend class (A) since no further nursing action is
required. (B) would alarm the parents unnecessarily. (C) would provide a false
reading of body temperature. (D) is unnecessary since these findings are within
normal limits.
A 6-year-old is admitted to the pediatric unit after falling off a bicycle. Which
intervention should the nurse implement to assist the child's adjustment to
hospitalization?
Explain hospital schedules to the child, such as mealtimes.
Use terms, such as "honey" and "dear," to show a caring attitude.
Provide a list of rules that limits visitation of siblings in the hospital.
Orient the parents to the hospital unit and refreshment areas. - ANSWER-Explain
hospital schedules to the child, such as mealtimes.
Altered daily schedules and loss of rituals are upsetting to children and increase
separation anxiety, and active sensitivity to the needs of children can minimize the
negative effects of hospitalization. Explaining the hospital schedules (A) and
establishing an individual schedule familiarizes the child to the hospital environment
and decreases anxiety. (B) depersonalizes the child who should be addressed by
name. Family and sibling visitation should be recommended and encouraged without
limitation (C). Although (D) should be implemented, the direct involvement of the
school-aged child incorporates the child's sense of initiate and cooperation.
The nurse is giving preoperative instructions to a 14-year-old female client who is
scheduled for surgery to correct a spinal curvature. Which statement by the client
best demonstrates that learning has taken place?
I will read all the literature you gave me before surgery.
I have had surgery before when I broke my wrist in a bike accident, so I know what
to expect.
All the things people have told me will help me take care of my back.
I understand that I will be in a body cast and I will show you how you taught me to
turn. - ANSWER-I understand that I will be in a body cast and I will show you how
you taught me to turn.
, Outcome of learning is best demonstrated when the client not only verbalizes an
understanding but can also provide a return demonstration (D). A 14-year-old may or
may not follow through with (A), and there is no measurement of that learning.
Having previous surgery (B) may help the client understand the surgical process, but
wrist surgery is very different from spinal surgery and emergency surgery is different
from elective surgery. In (C), the client may be saying what the nurse wants to hear,
without expressing any real understanding of what to do after surgery.
A burned child is brought to the emergency room. In estimating the percentage of the
body burned, the nurse uses a modified "Rule of Nines." Which part of a child's body
is calculated as a larger percentage of total body surface than an adult's?
Head and neck.
Arms and chest.
Legs and abdomen.
Back and abdomen. - ANSWER-Head and neck.
A child's head and neck are proportionately larger to their body than an adult's (A).
The standard "Rule of Nines" is inaccurate for determining burned body surface
areas with children, and must be modified for use with children. Specially designed
charts for children are commonly used to determine body surface area involvement.
(B, C, and D) are not proportionately different.
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. - ANSWER-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 nurse who is working in the Poison Control Center receives several telephone calls
from parents whose children have ingested possible poisons. The nurse should
recommend inducing vomiting for which child?
8-month-old who ate 4 to 6 ibuprofen tablets.
3-year-old who drank an unknown amount of charcoal lighter fluid.
16-month old who drank 2 ounces of acetaminophen (Tylenol) elixir.
2-year-old who ate a handful of automatic dishwasher detergent. - ANSWER-16-
month old who drank 2 ounces of acetaminophen (Tylenol) elixir.
Emesis should be induced for the child who drank the large dose of acetaminophen
(Tylenol) elixir (C) because this medication is hepatotoxic. Vomiting is
contraindicated for: children under 1 year of age (A), petroleum distillates (B) such as
charcoal lighter fluid, and corrosives (D) such as dishwasher detergents.
