Evolve HESI peds Practice Test Questions hg hg hg hg hg hg
And Answers hg
A 6-month-
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old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the nurse w
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arrants immediate intervention? hg hg
Apical heart rate of 60. Swea hg hg hg hg hg
ting across the forehead. Doe
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sn't suck well. hg hg
Respiratory rate of 30 breaths per minute. A hg hg hg hg hg hg hg
pical heart rate of 60. hg hg hg hg
A heart rate of 60 (A) is much lower than normal for a 6-month-
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old and warrants immediate intervention. The normal heart rate for a 6-month-
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old is 80 to 150 BPM when awake, and a rate of 70 while sleeping is considered within normal limits. (
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B and C) are expected symptoms of heart failure in an infant. (D) is within normal limits for an infant.
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The nurse is teaching the parents of a 5-year-
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old with cystic fibrosis about respiratory treatments. Which statement indicates to the nurse that the p
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arents understand? hg
Perform postural drainage before starting aerosol therapy.
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Give respiratory treatments when the child is coughing a lot.
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Administer aerosol therapy followed by postural drainage before meals.
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Ensure respiratory therapy is done daily during any respiratory infection.
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Administer aerosol therapy followed by postural drainage before meals.
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Postural drainage for a child with cystic fibrosis is most effective when performed after nebulization and
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before meals (C) or at least 1 hour after eating to prevent nausea and vomiting. Postural drainage uses
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gravity to promote mucous removal after nebulization (A) treatments which open the airways.
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Pulmonary toileting or respiratory treatments should be given 3 to 4 times daily, not episodically (B and
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D).
A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most imp
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ortant instruction for the nurse to include in this client's teaching plan?
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Use sunscreen when lying by the pool. C
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leanse the skin at least 4 times a day. Ta
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ke the medication with a glass of milk.
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Menstrual periods may become irregular. hg hg hg hg
Downloaded by michael ndiema ( hg hg hg hg
,Use sunscreen when lying by the pool.
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Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) therapy. Severe sunburn can
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occur with minimal sun exposure and clients should be instructed to avoid sunlight and to use sunscreen
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(A). (B and D) are not related to tetracycline HCL (Achromycin V) therapy. (C) should be avoided because
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dairy products interfere with the absorption of tetracyclines.
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What preoperative nursing intervention should be included in the plan of care for an infant with pyloric s
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tenosis?
Monitor for signs of metabolic acidosis. Esti hg hg hg hg hg hg
mate the quantity of diarrhea stools. Place in
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a supine position after feeding. Observe fo
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r projectile vomiting.
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Observe for projectile vomiting. hg hg hg
Projectile vomiting (D), which contributes to metabolic alkalosis (A), is the classic sign of pyloric stenosis.
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(B) is not indicated. (C) is dangerous, due to the potential for aspiration with frequent vomiting.
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An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect. The
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nurse recognizes that surgical correction is designed to achieve which outcome?
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Stop the flow of unoxygenated blood into systemic circulation. Incre
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ase the flow of unoxygenated blood to the lungs.
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Prevent the return of oxygenated blood to the lungs.
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Reduce peripheral tissue hypoxia and nailbed clubbing
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Prevent the return of oxygenated blood to the lungs.
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Closure of VSDs stops oxygenated blood from being shunted from the left ventricle to the right ventricle
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(C). VSDs are acyanotic defects, which means that no unoxygenated blood enters the systemic circulation
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(A and B). (D) is common with Tetrology of Fallot, which is a cyanotic defect.
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A 3-week-old newborn is brought to the clinic for follow-
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up after a home birth. The mother reports that her child bottle feeds for 5 minutes only and then falls
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asleep. The nurse auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and fin
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ds the newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should t
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he nurse provide the mother to ensure the infant is receiving adequate intake? (Select all that apply.)
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A. Monitor the the infant's weight and number of wet diapers per day.
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B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
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C. Mix the dose of prophylactic antibiotic in a full bottle of formula.
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D. Allow the infant to rest and refeed on demand or every 2 hours.
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E. Use a softer nipple or increase the size of the nipple opening.
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A. Monitor the the infant's weight and number of wet diapers per day.
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B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
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D. Allow the infant to rest and refeed on demand or every 2 hours.
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E. Use a softer nipple or increase the size of the nipple opening.
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Downloaded by michael ndiema ( hg hg hg
, Antibiotic prophylaxis is recommended for infants with VSDs, but should not be mixed in a bottle of form
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ula (C) because it is difficult to ensure that the total dose is consumed.
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They should be monitored for weight gain and at least 6 wet diapers per day (A). A one-
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month old infant should ingest 2 to 4 ounces of formula per feeding and progress to about 30 ounces p
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er day by 4-months of age (B)
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Preoperative nursing care for a child with Wilms' tumor should include which intervention?
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Gently percuss the abdomen for evidence of trapped air.
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Observe the abdomen for any noticeable discolorations. Ap
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ply cold compresses to the abdomen to reduce edema. Put
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a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
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Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
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Prevention of abdominal palpation (D) minimizes the risk of rupturing the encapsulated tumor and su
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bsequent metastasis. (A) is unnecessary, and this action could traumatize the tumor in the same man
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ner as palpation. (B and C) are incorrect since the abdomen is not discolored and cold compresses are
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not indicated. hg
At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent c
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lient with acute glomerulonephritis has a blood pressure of 210/110. The 4 a.m. blood pressure reading
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was 170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night
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. What action should the nurse take first?
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Give the client her 9 a.m. prescription for an oral diuretic early. A
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dminister PRN prescription of nifedipine (Procardia) sublingually.
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Notify the healthcare provider and inform the nursing supervisor of the client's condition. A
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ttempt to calm the client and retake the blood pressure in thirty minutes.
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Administer PRN prescription of nifedipine (Procardia) sublingually.
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Sublingual Procardia (B) lowers blood pressure very quickly, and this should be done first. (A) may also be
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done, but oral diuretics do not work as rapidly as the sublingual antihypertensive. When notifying the
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healthcare provider, the first thing he/she will want to know is if the PRN antihypertensive has been a
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dministered (C). (D) does not consider the seriousness of this finding. The nurse should stay with the cl
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ient until the blood pressure is reduced.
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The nurse is assessing an 8-month-
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old child who has a medical diagnosis of Tetrology of Fallot. Which symptom is this client most likely to
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exhibit?
Bradycardia. Machin hg
ery murmur. hg
Downloaded by michael ndiema ( hg hg hg hg
And Answers hg
A 6-month-
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old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the nurse w
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arrants immediate intervention? hg hg
Apical heart rate of 60. Swea hg hg hg hg hg
ting across the forehead. Doe
hg hg hg hg
sn't suck well. hg hg
Respiratory rate of 30 breaths per minute. A hg hg hg hg hg hg hg
pical heart rate of 60. hg hg hg hg
A heart rate of 60 (A) is much lower than normal for a 6-month-
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old and warrants immediate intervention. The normal heart rate for a 6-month-
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old is 80 to 150 BPM when awake, and a rate of 70 while sleeping is considered within normal limits. (
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B and C) are expected symptoms of heart failure in an infant. (D) is within normal limits for an infant.
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The nurse is teaching the parents of a 5-year-
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old with cystic fibrosis about respiratory treatments. Which statement indicates to the nurse that the p
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arents understand? hg
Perform postural drainage before starting aerosol therapy.
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Give respiratory treatments when the child is coughing a lot.
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Administer aerosol therapy followed by postural drainage before meals.
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Ensure respiratory therapy is done daily during any respiratory infection.
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Administer aerosol therapy followed by postural drainage before meals.
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Postural drainage for a child with cystic fibrosis is most effective when performed after nebulization and
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before meals (C) or at least 1 hour after eating to prevent nausea and vomiting. Postural drainage uses
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gravity to promote mucous removal after nebulization (A) treatments which open the airways.
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Pulmonary toileting or respiratory treatments should be given 3 to 4 times daily, not episodically (B and
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D).
A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most imp
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ortant instruction for the nurse to include in this client's teaching plan?
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Use sunscreen when lying by the pool. C
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leanse the skin at least 4 times a day. Ta
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ke the medication with a glass of milk.
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Menstrual periods may become irregular. hg hg hg hg
Downloaded by michael ndiema ( hg hg hg hg
,Use sunscreen when lying by the pool.
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Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) therapy. Severe sunburn can
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occur with minimal sun exposure and clients should be instructed to avoid sunlight and to use sunscreen
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(A). (B and D) are not related to tetracycline HCL (Achromycin V) therapy. (C) should be avoided because
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dairy products interfere with the absorption of tetracyclines.
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What preoperative nursing intervention should be included in the plan of care for an infant with pyloric s
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tenosis?
Monitor for signs of metabolic acidosis. Esti hg hg hg hg hg hg
mate the quantity of diarrhea stools. Place in
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a supine position after feeding. Observe fo
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r projectile vomiting.
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Observe for projectile vomiting. hg hg hg
Projectile vomiting (D), which contributes to metabolic alkalosis (A), is the classic sign of pyloric stenosis.
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(B) is not indicated. (C) is dangerous, due to the potential for aspiration with frequent vomiting.
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An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect. The
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nurse recognizes that surgical correction is designed to achieve which outcome?
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Stop the flow of unoxygenated blood into systemic circulation. Incre
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ase the flow of unoxygenated blood to the lungs.
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Prevent the return of oxygenated blood to the lungs.
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Reduce peripheral tissue hypoxia and nailbed clubbing
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Prevent the return of oxygenated blood to the lungs.
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Closure of VSDs stops oxygenated blood from being shunted from the left ventricle to the right ventricle
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(C). VSDs are acyanotic defects, which means that no unoxygenated blood enters the systemic circulation
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(A and B). (D) is common with Tetrology of Fallot, which is a cyanotic defect.
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A 3-week-old newborn is brought to the clinic for follow-
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up after a home birth. The mother reports that her child bottle feeds for 5 minutes only and then falls
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asleep. The nurse auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and fin
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ds the newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should t
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he nurse provide the mother to ensure the infant is receiving adequate intake? (Select all that apply.)
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A. Monitor the the infant's weight and number of wet diapers per day.
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B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
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C. Mix the dose of prophylactic antibiotic in a full bottle of formula.
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D. Allow the infant to rest and refeed on demand or every 2 hours.
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E. Use a softer nipple or increase the size of the nipple opening.
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A. Monitor the the infant's weight and number of wet diapers per day.
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B. Increase the infant's intake per feeding by 1 to 2 ounces per week.
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D. Allow the infant to rest and refeed on demand or every 2 hours.
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E. Use a softer nipple or increase the size of the nipple opening.
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Downloaded by michael ndiema ( hg hg hg
, Antibiotic prophylaxis is recommended for infants with VSDs, but should not be mixed in a bottle of form
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ula (C) because it is difficult to ensure that the total dose is consumed.
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They should be monitored for weight gain and at least 6 wet diapers per day (A). A one-
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month old infant should ingest 2 to 4 ounces of formula per feeding and progress to about 30 ounces p
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er day by 4-months of age (B)
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Preoperative nursing care for a child with Wilms' tumor should include which intervention?
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Gently percuss the abdomen for evidence of trapped air.
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Observe the abdomen for any noticeable discolorations. Ap
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ply cold compresses to the abdomen to reduce edema. Put
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a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
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Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN."
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Prevention of abdominal palpation (D) minimizes the risk of rupturing the encapsulated tumor and su
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bsequent metastasis. (A) is unnecessary, and this action could traumatize the tumor in the same man
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ner as palpation. (B and C) are incorrect since the abdomen is not discolored and cold compresses are
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not indicated. hg
At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent c
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lient with acute glomerulonephritis has a blood pressure of 210/110. The 4 a.m. blood pressure reading
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was 170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night
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. What action should the nurse take first?
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Give the client her 9 a.m. prescription for an oral diuretic early. A
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dminister PRN prescription of nifedipine (Procardia) sublingually.
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Notify the healthcare provider and inform the nursing supervisor of the client's condition. A
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ttempt to calm the client and retake the blood pressure in thirty minutes.
hg hg hg hg hg hg hg hg hg hg hg hg
Administer PRN prescription of nifedipine (Procardia) sublingually.
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Sublingual Procardia (B) lowers blood pressure very quickly, and this should be done first. (A) may also be
hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg hg
done, but oral diuretics do not work as rapidly as the sublingual antihypertensive. When notifying the
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healthcare provider, the first thing he/she will want to know is if the PRN antihypertensive has been a
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dministered (C). (D) does not consider the seriousness of this finding. The nurse should stay with the cl
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ient until the blood pressure is reduced.
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The nurse is assessing an 8-month-
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old child who has a medical diagnosis of Tetrology of Fallot. Which symptom is this client most likely to
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exhibit?
Bradycardia. Machin hg
ery murmur. hg
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