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EVOLVE HESI PEDS PRACTICE QUESTIONS WITH CORRECT ANSWERS
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EVOLVE HESI PEDS PRACTICE QUESTIONS WITH CORRECT ANSWERS
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EVOLVE HESI PEDS PRACTICEQUESTIONS WITH CORRECT ANSWERS
A66-month-
old6infant6with6congestive6heart6failure6(CHF)6is6receiving6digoxin6elixir.6Which6observati
on6by6the6nurse6warrants6immediate6intervention?
6Apical6heart6rate6of660.
6Sweating6across6the6forehead.
6Doesn't6suck6well.
6Respiratory6rate6of6306breaths6per6minute.6-6ans--Apical6heart6rate6of660.
A6heart6rate6of6606(A)6is6much6lower6than6normal6for6a66-month-
old6and6warrants6immediate6intervention.6The6normal6heart6rate6for6a66-month-
old6is6806to61506BPM6when6awake,6and6a6rate6of6706while6sleeping6is6considered6within6
normal6limits.6(B6and6C)6are6expected6symptoms6of6heart6failure6in6an6infant.6(D)6is6within
6normal6limits6for6an6infant.
The6nurse6is6teaching6the6parents6of6a65-year-
old6with6cystic6fibrosis6about6respiratory6treatments.6Which6statement6indicates6to6the6nu
rse6that6the6parents6understand?
6Perform6postural6drainage6before6starting6aerosol6therapy.
6Give6respiratory6treatments6when6the6child6is6coughing6a6lot.
6Administer6aerosol6therapy6followed6by6postural6drainage6before6meals.
6Ensure6respiratory6therapy6is6done6daily6during6any6respiratory6infection.6-6ans--
Administer6aerosol6therapy6followed6by6postural6drainage6before6meals.
Postural6drainage6for6a6child6with6cystic6fibrosis6is6most6effective6when6performed6after6n
ebulization6and6before6meals6(C)6or6at6least616hour6after6eating6to6prevent6nausea6and6v
omiting.6Postural6drainage6uses6gravity6to6promote6mucous6removal6after6nebulization6(
A)6treatments6which6open6the6airways.6Pulmonary6toileting6or6respiratory6treatments6sho
uld6be6given636to646times6daily,6not6episodically6(B6and6D).
A6female6teenager6is6taking6oral6tetracycline6HCL6(Achromycin6V)6for6acne6vulgaris.6Wh
at6is6the6most6important6instruction6for6the6nurse6to6include6in6this6client's6teaching6plan?
6Use6sunscreen6when6lying6by6the6pool.6
6Cleanse6the6skin6at6least646times6a6day.
6Take6the6medication6with6a6glass6of6milk.
6Menstrual6periods6may6become6irregular.6-6ans--
Use6sunscreen6when6lying6by6the6pool.6
,Photosensitivity6is6a6common6side6effect6of6tetracycline6HCL6(Achromycin6V)6therapy.6Se
vere6sunburn6can6occur6with6minimal6sun6exposure6and6clients6should6be6instructed6to6a
void6sunlight6and6to6use6sunscreen6(A).6(B6and6D)6are6not6related6to6tetracycline6HCL6(A
chromycin6V)6therapy.6(C)6should6be6avoided6because6dairy6products6interfere6with6the6a
bsorption6of6tetracyclines.
What6preoperative6nursing6intervention6should6be6included6in6the6plan6of6care6for6an6infa
nt6with6pyloric6stenosis?
6Monitor6for6signs6of6metabolic6acidosis.
6Estimate6the6quantity6of6diarrhea6stools.
6Place6in6a6supine6position6after6feeding.
6Observe6for6projectile6vomiting.6-6ans--Observe6for6projectile6vomiting.
Projectile6vomiting6(D),6which6contributes6to6metabolic6alkalosis6(A),6is6the6classic6sign6of
6pyloric6stenosis.6(B)6is6not6indicated.6(C)6is6dangerous,6due6to6the6potential6for6aspiratio
n6with6frequent6vomiting.
An6infant6is6born6with6a6ventricular6septal6defect6(VSD)6and6surgery6is6planned6to6correct
6the6defect.6The6nurse6recognizes6that6surgical6correction6is6designed6to6achieve6which6
outcome?
6Stop6the6flow6of6unoxygenated6blood6into6systemic6circulation.
6Increase6the6flow6of6unoxygenated6blood6to6the6lungs.6
6Prevent6the6return6of6oxygenated6blood6to6the6lungs.6
6Reduce6peripheral6tissue6hypoxia6and6nailbed6clubbing6-6ans--
Prevent6the6return6of6oxygenated6blood6to6the6lungs.6
Closure6of6VSDs6stops6oxygenated6blood6from6being6shunted6from6the6left6ventricle6to6th
e6right6ventricle6(C).6VSDs6are6acyanotic6defects,6which6means6that6no6unoxygenated6bl
ood6enters6the6systemic6circulation6(A6and6B).6(D)6is6common6with6Tetrology6of6Fallot,6w
hich6is6a6cyanotic6defect.
A63-week-old6newborn6is6brought6to6the6clinic6for6follow-
up6after6a6home6birth.6The6mother6reports6that6her6child6bottle6feeds6for656minutes6only6a
nd6then6falls6asleep.6The6nurse6auscultates6a6loud6murmur6characteristic6of6a6ventricular
6septal6defect6(VSD),6and6finds6the6newborn6is6acyanotic6with6a6respiratory6rate6of6646bre
aths6per6minute.6What6instruction6should6the6nurse6provide6the6mother6to6ensure6the6infa
nt6is6receiving6adequate6intake?6(Select6all6that6apply.)
A.6Monitor6the6the6infant's6weight6and6number6of6wet6diapers6per6day.6
B.6Increase6the6infant's6intake6per6feeding6by616to626ounces6per6week.6
C.6Mix6the6dose6of6prophylactic6antibiotic6in6a6full6bottle6of6formula.
D.6Allow6the6infant6to6rest6and6refeed6on6demand6or6every626hours.
E.6Use6a6softer6nipple6or6increase6the6size6of6the6nipple6opening.6-6ans--
A.6Monitor6the6the6infant's6weight6and6number6of6wet6diapers6per6day.
B.6Increase6the6infant's6intake6per6feeding6by616to626ounces6per6week.6
D.6Allow6the6infant6to6rest6and6refeed6on6demand6or6every626hours.
, E.6Use6a6softer6nipple6or6increase6the6size6of6the6nipple6opening.
Antibiotic6prophylaxis6is6recommended6for6infants6with6VSDs,6but6should6not6be6mixed6in
6a6bottle6of6formula6(C)6because6it6is6difficult6to6ensure6that6the6total6dose6is6consumed.
They6should6be6monitored6for6weight6gain6and6at6least666wet6diapers6per6day6(A).6A6one-
month6old6infant6should6ingest626to646ounces6of6formula6per6feeding6and6progress6to6abo
ut6306ounces6per6day6by64-months6of6age6(B)
Preoperative6nursing6care6for6a6child6with6Wilms'6tumor6should6include6which6interventio
n?
6Gently6percuss6the6abdomen6for6evidence6of6trapped6air.
6Observe6the6abdomen6for6any6noticeable6discolorations.
6Apply6cold6compresses6to6the6abdomen6to6reduce6edema.
6Put6a6sign6on6the6bed6reading,6"DO6NOT6PALPATE6ABDOMEN."6-6ans--
Put6a6sign6on6the6bed6reading,6"DO6NOT6PALPATE6ABDOMEN."
Prevention6of6abdominal6palpation6(D)6minimizes6the6risk6of6rupturing6the6encapsulated6t
umor6and6subsequent6metastasis.6(A)6is6unnecessary,6and6this6action6could6traumatize6t
he6tumor6in6the6same6manner6as6palpation.6(B6and6C)6are6incorrect6since6the6abdomen6i
s6not6discolored6and6cold6compresses6are6not6indicated.
At686a.m.6the6unlicensed6assistive6personnel6(UAP)6informs6the6charge6nurse6that6a6fem
ale6adolescent6client6with6acute6glomerulonephritis6has6a6blood6pressure6of6210/110.6Th
e646a.m.6blood6pressure6reading6was6170/88.6The6client6reports6to6the6UAP6that6she6is6u
pset6because6her6boyfriend6did6not6visit6last6night.6What6action6should6the6nurse6take6firs
t?
6Give6the6client6her696a.m.6prescription6for6an6oral6diuretic6early.
6Administer6PRN6prescription6of6nifedipine6(Procardia)6sublingually.6
6Notify6the6healthcare6provider6and6inform6the6nursing6supervisor6of6the6client's6condition
.
6Attempt6to6calm6the6client6and6retake6the6blood6pressure6in6thirty6minutes.6-6ans--
Administer6PRN6prescription6of6nifedipine6(Procardia)6sublingually.
Sublingual6Procardia6(B)6lowers6blood6pressure6very6quickly,6and6this6should6be6done6fir
st.6(A)6may6also6be6done,6but6oral6diuretics6do6not6work6as6rapidly6as6the6sublingual6anti
hypertensive.6When6notifying6the6healthcare6provider,6the6first6thing6he/
she6will6want6to6know6is6if6the6PRN6antihypertensive6has6been6administered6(C).6(D)6doe
s6not6consider6the6seriousness6of6this6finding.6The6nurse6should6stay6with6the6client6until6
the6blood6pressure6is6reduced.
The6nurse6is6assessing6an68-month-
old6child6who6has6a6medical6diagnosis6of6Tetrology6of6Fallot.6Which6symptom6is6this6clien
t6most6likely6to6exhibit?
6Bradycardia.
6Machinery6murmur.
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