PEDIATRICS HESI PRACTICE EXAM
(EVOLVE) QUESTIONS WITH VERIFIED
ANSWERS
The nurse observes the interactions of a 2-year-old child who says, "No" even when
"Yes" is what the child really wants to say. The parent says to the nurse,
"We are such positive people. Why is our child so negative?" How should the nurse
respond?
a. A 2-year-old often acts in the opposite way to get attention.
b. A child at this age is testing the limits of the parent's patience.
c. The toddler is exhibiting an example of ritualistic behavior.
d. The child is trying to assert autonomy through negativism. - ANSWER-d. The child
is trying to assert autonomy through negativism.
As a toddler tests autonomy and ego boundaries, sometimes they clash with
parental restrictions and respond with recital of prompts that parents often say. "No"
is a favorite repeated word and is the child's way of exploring autonomy through
negativism.
When administering a gavage feeding to a school-age child, which action should the
nurse implement?
a. Administer feedings over 5 to 10 minutes.
b. Position the child on the right side after administering the feeding.
c. Check the placement of the tube by inserting 20 mL of sterile water.
d. Lubricate the tip of the feeding tube with petroleum jelly to facilitate passage. -
ANSWER-b. Position the child on the right side after administering the feeding.
The child should be positioned on the right side with the head of the bed elevated 30
degrees after administering the feeding to facilitate gastric emptying and prevent
gastric reflux. Gavage feedings should be given to allow slow gastric filling over 15 to
30 minutes.
While assessing the apical pulse of a 13-year-old, the nurse determines that the rate
is 88 beats/minute, and the rhythm is irregular. The heart rate is phasic with
respirations, increasing during inspiration and decreasing with expiration. Which
action should the nurse take?
a. Continue the cardiac examination.
b. Inquire about daily caffeine intake.
c. Reassess the apical pulse in 15 minutes.
d. Schedule a consultation with a cardiologist. - ANSWER-a. Continue the cardiac
examination.
Sinus arrhythmia is characterized by phasic irregularity of the heart rate that occurs
with changes in intrathoracic pressure during respiration and is a common
,phenomenon during childhood and adolescence. No intervention is required. The
nurse should continue with the cardiac exam.
A 6-year-old child is brought to the emergency department with a systolic blood
pressure of 58 mmHg. What action should the nurse take first?
a. Comfort the child.
b. Assess responsiveness.
c. Alert the healthcare provider.
d. Initiate IV fluid replacement. - ANSWER-c. Alert the healthcare provider.
The lower limit for systolic blood pressure for a child older than 1 year of age is 70
mmHg plus 2 times the child's age in years. The healthcare provider should be
notified immediately of the child's hypotension and anticipate a prescription for IV
fluids.
The nurse is caring for a client with scoliosis who had a posterior spinal fusion and is
in a body jacket cast. Which assessment finding indicates to the nurse that the client
is developing superior mesenteric artery syndrome?
a. Abdominal distention.
b. "Hot spot" felt on cast.
c. Diminished pulses in the foot.
d. Musty, unpleasant odor to cast. - ANSWER-a. Abdominal distention.
Superior mesenteric artery syndrome occurs when the cast is applied too tightly and
is compressing the superior mesenteric artery against the duodenum. Abdominal
distention, pain, nausea, and vomiting may result.
A 4-month-old breastfeeding infant is at the 80th percentile for weight and the 75th
percentile for height. How should the nurse interpret this finding?
a. Milk allergy.
b. Failure to thrive.
c. Inadequate milk supply in mother.
d. Normal growth curve of a breastfed infant. - ANSWER-d. Normal growth curve of
a breastfed infant.
When plotting weights and heights on a standard growth chart both breastfed and
formula-fed infants, the breastfed infant grows more rapidly during the first 2 months
of life, and then growth slows from 3 to 12 months. A breastfed infant is leaner and
has less body fat than a formula-fed infant. Normal patterns of infants who are
breastfed differ from those who are formula fed.
A 3-year-old boy is brought to the emergency department because of a possible
diazepam overdose. He is lethargic and confused. His vital signs are: pulse rate 100
beats/minute, respiratory rate 20 breaths/minute, and blood pressure 70/30 mmHg.
Which nursing intervention has the highest priority?
a. Insert an orogastric tube for gastric lavage.
, b. Prepare a set-up for an endotracheal intubation.
c. Draw blood for stat chemistries and blood gases.
d. Insert a Foley catheter to monitor renal functioning. - ANSWER-b. Prepare a set-
up for an endotracheal intubation.
Diazepam causes respiratory depression. Preparation for endotracheal intubation to
protect the airway is the priority intervention at this time.
A mother brings her 6-month-old infant to the clinic for a well-baby routine exam.
Which vaccine should the nurse verify the infant has received? (Select all that apply.)
a. Meningococcal polysaccharide vaccine (MPSV4).
b Haemophilus influenzae type b conjugate vaccine (Hib).
c. Inactivated poliovirus vaccine (IPV).
d. Hepatitis B virus vaccine (HepB).
e. Diphtheria, tetanus toxoids, and acellular pertussis (DTaP).
f. Measles, mumps, and rubella vaccine (MMR). - ANSWER-b Haemophilus
influenzae type b conjugate vaccine (Hib).
c. Inactivated poliovirus vaccine (IPV).
d. Hepatitis B virus vaccine (HepB)
e. Diphtheria, tetanus toxoids, and acellular pertussis (DTaP)
.According to the Centers for Disease Control's guidelines for immunizations, a 6-
month-old infant should have received doses 1 and 2 of Hib, IPV, HepB, and DTap
vaccines.
A crying toddler has a blood pressure measurement of 120/70 mmHg. Which action
should the nurse implement?
a. Notify the healthcare provider of the measurement.
b. Quiet the child and retake the blood pressure.
c. Ask the parent if the child has a history of hypertension.
d. Document the finding and recheck in 4 hours. - ANSWER-b. Quiet the child and
retake the blood pressure.
When a child is crying, intrathoracic and abdominal pressures increase and are
reflected in an elevation of systemic blood pressure. The nurse should quiet the child
before retaking the blood pressure.
While assessing an 18-month-old during a well-child visit, the nurse notes that the
toddler has a rounded potbelly abdomen, marked lordosis or swayback, short and
slightly bowed legs, and a large head. Based on these findings, what action should
the nurse implement?
a. Refer the findings to the healthcare provider for diagnostic studies for
hydrocephalus.
b. Document general physical appearance of a normally developed toddler.
c. Plot the findings on the growth chart within the parameters of delayed physical
maturation.
(EVOLVE) QUESTIONS WITH VERIFIED
ANSWERS
The nurse observes the interactions of a 2-year-old child who says, "No" even when
"Yes" is what the child really wants to say. The parent says to the nurse,
"We are such positive people. Why is our child so negative?" How should the nurse
respond?
a. A 2-year-old often acts in the opposite way to get attention.
b. A child at this age is testing the limits of the parent's patience.
c. The toddler is exhibiting an example of ritualistic behavior.
d. The child is trying to assert autonomy through negativism. - ANSWER-d. The child
is trying to assert autonomy through negativism.
As a toddler tests autonomy and ego boundaries, sometimes they clash with
parental restrictions and respond with recital of prompts that parents often say. "No"
is a favorite repeated word and is the child's way of exploring autonomy through
negativism.
When administering a gavage feeding to a school-age child, which action should the
nurse implement?
a. Administer feedings over 5 to 10 minutes.
b. Position the child on the right side after administering the feeding.
c. Check the placement of the tube by inserting 20 mL of sterile water.
d. Lubricate the tip of the feeding tube with petroleum jelly to facilitate passage. -
ANSWER-b. Position the child on the right side after administering the feeding.
The child should be positioned on the right side with the head of the bed elevated 30
degrees after administering the feeding to facilitate gastric emptying and prevent
gastric reflux. Gavage feedings should be given to allow slow gastric filling over 15 to
30 minutes.
While assessing the apical pulse of a 13-year-old, the nurse determines that the rate
is 88 beats/minute, and the rhythm is irregular. The heart rate is phasic with
respirations, increasing during inspiration and decreasing with expiration. Which
action should the nurse take?
a. Continue the cardiac examination.
b. Inquire about daily caffeine intake.
c. Reassess the apical pulse in 15 minutes.
d. Schedule a consultation with a cardiologist. - ANSWER-a. Continue the cardiac
examination.
Sinus arrhythmia is characterized by phasic irregularity of the heart rate that occurs
with changes in intrathoracic pressure during respiration and is a common
,phenomenon during childhood and adolescence. No intervention is required. The
nurse should continue with the cardiac exam.
A 6-year-old child is brought to the emergency department with a systolic blood
pressure of 58 mmHg. What action should the nurse take first?
a. Comfort the child.
b. Assess responsiveness.
c. Alert the healthcare provider.
d. Initiate IV fluid replacement. - ANSWER-c. Alert the healthcare provider.
The lower limit for systolic blood pressure for a child older than 1 year of age is 70
mmHg plus 2 times the child's age in years. The healthcare provider should be
notified immediately of the child's hypotension and anticipate a prescription for IV
fluids.
The nurse is caring for a client with scoliosis who had a posterior spinal fusion and is
in a body jacket cast. Which assessment finding indicates to the nurse that the client
is developing superior mesenteric artery syndrome?
a. Abdominal distention.
b. "Hot spot" felt on cast.
c. Diminished pulses in the foot.
d. Musty, unpleasant odor to cast. - ANSWER-a. Abdominal distention.
Superior mesenteric artery syndrome occurs when the cast is applied too tightly and
is compressing the superior mesenteric artery against the duodenum. Abdominal
distention, pain, nausea, and vomiting may result.
A 4-month-old breastfeeding infant is at the 80th percentile for weight and the 75th
percentile for height. How should the nurse interpret this finding?
a. Milk allergy.
b. Failure to thrive.
c. Inadequate milk supply in mother.
d. Normal growth curve of a breastfed infant. - ANSWER-d. Normal growth curve of
a breastfed infant.
When plotting weights and heights on a standard growth chart both breastfed and
formula-fed infants, the breastfed infant grows more rapidly during the first 2 months
of life, and then growth slows from 3 to 12 months. A breastfed infant is leaner and
has less body fat than a formula-fed infant. Normal patterns of infants who are
breastfed differ from those who are formula fed.
A 3-year-old boy is brought to the emergency department because of a possible
diazepam overdose. He is lethargic and confused. His vital signs are: pulse rate 100
beats/minute, respiratory rate 20 breaths/minute, and blood pressure 70/30 mmHg.
Which nursing intervention has the highest priority?
a. Insert an orogastric tube for gastric lavage.
, b. Prepare a set-up for an endotracheal intubation.
c. Draw blood for stat chemistries and blood gases.
d. Insert a Foley catheter to monitor renal functioning. - ANSWER-b. Prepare a set-
up for an endotracheal intubation.
Diazepam causes respiratory depression. Preparation for endotracheal intubation to
protect the airway is the priority intervention at this time.
A mother brings her 6-month-old infant to the clinic for a well-baby routine exam.
Which vaccine should the nurse verify the infant has received? (Select all that apply.)
a. Meningococcal polysaccharide vaccine (MPSV4).
b Haemophilus influenzae type b conjugate vaccine (Hib).
c. Inactivated poliovirus vaccine (IPV).
d. Hepatitis B virus vaccine (HepB).
e. Diphtheria, tetanus toxoids, and acellular pertussis (DTaP).
f. Measles, mumps, and rubella vaccine (MMR). - ANSWER-b Haemophilus
influenzae type b conjugate vaccine (Hib).
c. Inactivated poliovirus vaccine (IPV).
d. Hepatitis B virus vaccine (HepB)
e. Diphtheria, tetanus toxoids, and acellular pertussis (DTaP)
.According to the Centers for Disease Control's guidelines for immunizations, a 6-
month-old infant should have received doses 1 and 2 of Hib, IPV, HepB, and DTap
vaccines.
A crying toddler has a blood pressure measurement of 120/70 mmHg. Which action
should the nurse implement?
a. Notify the healthcare provider of the measurement.
b. Quiet the child and retake the blood pressure.
c. Ask the parent if the child has a history of hypertension.
d. Document the finding and recheck in 4 hours. - ANSWER-b. Quiet the child and
retake the blood pressure.
When a child is crying, intrathoracic and abdominal pressures increase and are
reflected in an elevation of systemic blood pressure. The nurse should quiet the child
before retaking the blood pressure.
While assessing an 18-month-old during a well-child visit, the nurse notes that the
toddler has a rounded potbelly abdomen, marked lordosis or swayback, short and
slightly bowed legs, and a large head. Based on these findings, what action should
the nurse implement?
a. Refer the findings to the healthcare provider for diagnostic studies for
hydrocephalus.
b. Document general physical appearance of a normally developed toddler.
c. Plot the findings on the growth chart within the parameters of delayed physical
maturation.
