Evolve HESI Pediatrics Practice Exam |
Complete Exam with Questions, Verified
Answers & Detailed Rationales | Latest
Update 2026 Edition
Question 1
A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir.
Which observation by the nurse warrants immediate intervention?
A. Sweating across the forehead.
B. Doesn't suck well.
C. Apical heart rate of 60.
D. Respiratory rate of 30 breaths per minute.
Answer: C
Rationale: Heart rate of 60 is bradycardic for a 6-month-old (normal 80-150 awake)
and may indicate digoxin toxicity.
Question 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 parents understand?
A. Perform postural drainage before starting aerosol therapy.
B. Give respiratory treatments when the child is coughing a lot.
C. Administer aerosol therapy followed by postural drainage before meals.
D. Ensure respiratory therapy is done daily during any respiratory infection.
Answer: C
Rationale: Aerosol therapy opens airways, then postural drainage removes secretions;
best done before meals to prevent vomiting.
Question 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?
A. Use sunscreen when lying by the pool.
pg. 1
,B. Cleanse the skin at least 4 times a day.
C. Take the medication with a glass of milk.
D. Menstrual periods may become irregular.
Answer: A
Rationale: Tetracycline causes photosensitivity; severe sunburn can occur with
minimal sun exposure.
Question 4
What preoperative nursing intervention should be included in the plan of care for an
infant with pyloric stenosis?
A. Monitor for signs of metabolic acidosis.
B. Estimate the quantity of diarrhea stools.
C. Place in a supine position after feeding.
D. Observe for projectile vomiting.
Answer: D
Rationale: Projectile vomiting is the classic sign of pyloric stenosis.
Question 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?
A. Stop the flow of unoxygenated blood into systemic circulation.
B. Increase the flow of unoxygenated blood to the lungs.
C. Prevent the return of oxygenated blood to the lungs.
D. Reduce peripheral tissue hypoxia and nailbed clubbing.
Answer: C
Rationale: VSD closure prevents oxygenated blood from shunting from left ventricle to
right ventricle.
Question 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
pg. 2
, adequate intake? (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.
Answer: A, B, D, E
Rationale: Monitor weight/wet diapers; increase feeding volume gradually; allow rest
with frequent feeding; softer nipple reduces work of breathing. Do NOT mix antibiotics
in full bottle (dose not fully consumed).
Question 7
Preoperative nursing care for a child with Wilms' tumor should include which
intervention?
A. Gently percuss the abdomen for evidence of trapped air.
B. Observe the abdomen for any noticeable discolorations.
C. Apply cold compresses to the abdomen to reduce edema.
D. Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
Answer: D
Rationale: Palpation can rupture the encapsulated tumor, causing metastasis.
Question 8
At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a
female adolescent client with acute glomerulonephritis has a blood pressure of 210/110.
The 4 a.m. blood pressure reading was 170/88. The client reports to the UAP that she is
upset because her boyfriend did not visit last night. What action should the nurse take
first?
A. Give the client her 9 a.m. prescription for an oral diuretic early.
B. Administer PRN prescription of nifedipine (Procardia) sublingually.
C. Notify the healthcare provider and inform the nursing supervisor of the client's
condition.
D. Attempt to calm the client and retake the blood pressure in thirty minutes.
Answer: B
Rationale: Sublingual Procardia lowers BP rapidly; this is the priority before notifying
HCP.
pg. 3
Complete Exam with Questions, Verified
Answers & Detailed Rationales | Latest
Update 2026 Edition
Question 1
A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir.
Which observation by the nurse warrants immediate intervention?
A. Sweating across the forehead.
B. Doesn't suck well.
C. Apical heart rate of 60.
D. Respiratory rate of 30 breaths per minute.
Answer: C
Rationale: Heart rate of 60 is bradycardic for a 6-month-old (normal 80-150 awake)
and may indicate digoxin toxicity.
Question 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 parents understand?
A. Perform postural drainage before starting aerosol therapy.
B. Give respiratory treatments when the child is coughing a lot.
C. Administer aerosol therapy followed by postural drainage before meals.
D. Ensure respiratory therapy is done daily during any respiratory infection.
Answer: C
Rationale: Aerosol therapy opens airways, then postural drainage removes secretions;
best done before meals to prevent vomiting.
Question 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?
A. Use sunscreen when lying by the pool.
pg. 1
,B. Cleanse the skin at least 4 times a day.
C. Take the medication with a glass of milk.
D. Menstrual periods may become irregular.
Answer: A
Rationale: Tetracycline causes photosensitivity; severe sunburn can occur with
minimal sun exposure.
Question 4
What preoperative nursing intervention should be included in the plan of care for an
infant with pyloric stenosis?
A. Monitor for signs of metabolic acidosis.
B. Estimate the quantity of diarrhea stools.
C. Place in a supine position after feeding.
D. Observe for projectile vomiting.
Answer: D
Rationale: Projectile vomiting is the classic sign of pyloric stenosis.
Question 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?
A. Stop the flow of unoxygenated blood into systemic circulation.
B. Increase the flow of unoxygenated blood to the lungs.
C. Prevent the return of oxygenated blood to the lungs.
D. Reduce peripheral tissue hypoxia and nailbed clubbing.
Answer: C
Rationale: VSD closure prevents oxygenated blood from shunting from left ventricle to
right ventricle.
Question 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
pg. 2
, adequate intake? (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.
Answer: A, B, D, E
Rationale: Monitor weight/wet diapers; increase feeding volume gradually; allow rest
with frequent feeding; softer nipple reduces work of breathing. Do NOT mix antibiotics
in full bottle (dose not fully consumed).
Question 7
Preoperative nursing care for a child with Wilms' tumor should include which
intervention?
A. Gently percuss the abdomen for evidence of trapped air.
B. Observe the abdomen for any noticeable discolorations.
C. Apply cold compresses to the abdomen to reduce edema.
D. Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
Answer: D
Rationale: Palpation can rupture the encapsulated tumor, causing metastasis.
Question 8
At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a
female adolescent client with acute glomerulonephritis has a blood pressure of 210/110.
The 4 a.m. blood pressure reading was 170/88. The client reports to the UAP that she is
upset because her boyfriend did not visit last night. What action should the nurse take
first?
A. Give the client her 9 a.m. prescription for an oral diuretic early.
B. Administer PRN prescription of nifedipine (Procardia) sublingually.
C. Notify the healthcare provider and inform the nursing supervisor of the client's
condition.
D. Attempt to calm the client and retake the blood pressure in thirty minutes.
Answer: B
Rationale: Sublingual Procardia lowers BP rapidly; this is the priority before notifying
HCP.
pg. 3
