Evolve HESI Practice Question/ Pediatrics
NCLEX Review exam
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.
Explanation: A heart rate of 60 is too low for a 6-month-old and
indicates possible digoxin toxicity.
2. The nurse is teaching the parents of a 5-year-old with cystic fibrosis
about respiratory treatments. Which statement indicates
understanding?
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.
Explanation: Aerosol therapy opens airways; postural drainage
afterward helps remove secretions most effectively.
3. A female teenager is taking tetracycline HCL for acne. Most
important instruction?
✅ 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.
,Explanation: Tetracycline causes photosensitivity. Avoiding sun
exposure is critical.
4. Preoperative nursing intervention 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.
Explanation: Projectile vomiting is a hallmark sign of pyloric stenosis.
5. An infant is born with a ventricular septal defect (VSD). Goal of
surgical correction?
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.
Explanation: Surgery prevents left-to-right shunting of oxygenated
blood.
6. A 3-week-old with VSD has difficulty feeding. What should the nurse
instruct the mother? (Select all that apply)
✅ A. Monitor 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.
Explanation: These interventions support adequate intake and reduce
feeding fatigue.
NCLEX Review exam
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.
Explanation: A heart rate of 60 is too low for a 6-month-old and
indicates possible digoxin toxicity.
2. The nurse is teaching the parents of a 5-year-old with cystic fibrosis
about respiratory treatments. Which statement indicates
understanding?
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.
Explanation: Aerosol therapy opens airways; postural drainage
afterward helps remove secretions most effectively.
3. A female teenager is taking tetracycline HCL for acne. Most
important instruction?
✅ 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.
,Explanation: Tetracycline causes photosensitivity. Avoiding sun
exposure is critical.
4. Preoperative nursing intervention 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.
Explanation: Projectile vomiting is a hallmark sign of pyloric stenosis.
5. An infant is born with a ventricular septal defect (VSD). Goal of
surgical correction?
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.
Explanation: Surgery prevents left-to-right shunting of oxygenated
blood.
6. A 3-week-old with VSD has difficulty feeding. What should the nurse
instruct the mother? (Select all that apply)
✅ A. Monitor 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.
Explanation: These interventions support adequate intake and reduce
feeding fatigue.
