HESI PEDIATRICS EXAM:
COMPREHENSIVE TOPIC TEST
Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
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SECTION A: Growth & Development (Questions 1–15)
1. A 4-month-old infant is brought to the clinic for a well-child visit. Which
developmental milestone should the nurse expect to observe?
A. Sitting without support
B. Transferring objects from hand to hand
C. Rolling from abdomen to back
D. Pincer grasp
Rationale: Rolling from abdomen to back typically occurs around 4 months.
Sitting without support (6-8 months), transferring objects (7 months), and pincer
grasp (9-10 months) occur later.
2. The nurse is assessing a 2-year-old toddler. Which behavior is most
characteristic of this age group?
A. Parallel play
B. Cooperative play
C. Solitary play
D. Associative play
Rationale: Toddlers engage in parallel play (playing alongside but not with
others). Cooperative/associative play emerges in preschool years.
,3. A school nurse is teaching parents about developmental milestones for a 7-
year-old child. Which skill is expected?
A. Understanding conservation of mass
B. Abstract reasoning
C. Logical thinking about concrete events
D. Hypothetical problem-solving
Rationale: Concrete operational stage (7–11 years) involves logical thinking about
concrete events. Abstract reasoning emerges in adolescence.
4. Which immunization is contraindicated in a child with a severe egg allergy?
A. MMR
B. Influenza (live attenuated, intranasal)
C. Hepatitis B
D. IPV
Rationale: Live attenuated influenza vaccine (LAIV, FluMist) is contraindicated in
severe egg allergy. Inactivated flu vaccine (injectable) may be given with
precautions. MMR is safe despite egg allergy.
5. The nurse is evaluating the fine motor skills of a 10-month-old. Which
finding is consistent with normal development?
A. Builds a tower of 2 cubes
B. Pincer grasp using thumb and forefinger
C. Scribbles spontaneously
D. Uses spoon without spilling
Rationale: Pincer grasp develops around 9–10 months. Tower of 2 cubes (12-15
months), scribbling (15 months), using spoon (18 months).
6. A parent asks when their child should first see a dentist. The nurse advises:
A. Age 1 year
B. By first birthday or when first tooth erupts
C. Age 3 years
D. After all primary teeth erupt
, Rationale: AAPD recommends first dental visit by age 1 or within 6 months of
first tooth eruption.
7. Which play activity is most appropriate for a 3-year-old hospitalized child?
A. Board games with rules
B. Dress-up clothes and puppets
C. Video games
D. Model building
Rationale: Preschoolers enjoy imaginative play. Board games require rules
(school-age), video games (older child).
8. A 14-year-old girl asks the nurse about normal changes of puberty. Which
finding is a common variation?
A. Menarche occurring at age 9
B. Asynchronous breast development
C. Pubic hair before breast development
D. No growth spurt by age 15
Rationale: Asynchronous (uneven) breast development is normal. Menarche
before 10 is precocious; pubic hair before breast development (adrenarche) can be
normal but less common; growth spurt should occur by 15.
9. The nurse is assessing a 6-month-old. Which reflex should have disappeared
by this age?
A. Babinski reflex
B. Moro reflex
C. Palmar grasp
D. Rooting reflex
Rationale: Palmar grasp disappears by 3-4 months. Babinski may persist up to 12
months; Moro by 4-6 months; rooting by 4 months.
10. A child has a fear of the dark and monsters at bedtime. This is most typical
for which age?
COMPREHENSIVE TOPIC TEST
Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct /Instant
Download
SECTION A: Growth & Development (Questions 1–15)
1. A 4-month-old infant is brought to the clinic for a well-child visit. Which
developmental milestone should the nurse expect to observe?
A. Sitting without support
B. Transferring objects from hand to hand
C. Rolling from abdomen to back
D. Pincer grasp
Rationale: Rolling from abdomen to back typically occurs around 4 months.
Sitting without support (6-8 months), transferring objects (7 months), and pincer
grasp (9-10 months) occur later.
2. The nurse is assessing a 2-year-old toddler. Which behavior is most
characteristic of this age group?
A. Parallel play
B. Cooperative play
C. Solitary play
D. Associative play
Rationale: Toddlers engage in parallel play (playing alongside but not with
others). Cooperative/associative play emerges in preschool years.
,3. A school nurse is teaching parents about developmental milestones for a 7-
year-old child. Which skill is expected?
A. Understanding conservation of mass
B. Abstract reasoning
C. Logical thinking about concrete events
D. Hypothetical problem-solving
Rationale: Concrete operational stage (7–11 years) involves logical thinking about
concrete events. Abstract reasoning emerges in adolescence.
4. Which immunization is contraindicated in a child with a severe egg allergy?
A. MMR
B. Influenza (live attenuated, intranasal)
C. Hepatitis B
D. IPV
Rationale: Live attenuated influenza vaccine (LAIV, FluMist) is contraindicated in
severe egg allergy. Inactivated flu vaccine (injectable) may be given with
precautions. MMR is safe despite egg allergy.
5. The nurse is evaluating the fine motor skills of a 10-month-old. Which
finding is consistent with normal development?
A. Builds a tower of 2 cubes
B. Pincer grasp using thumb and forefinger
C. Scribbles spontaneously
D. Uses spoon without spilling
Rationale: Pincer grasp develops around 9–10 months. Tower of 2 cubes (12-15
months), scribbling (15 months), using spoon (18 months).
6. A parent asks when their child should first see a dentist. The nurse advises:
A. Age 1 year
B. By first birthday or when first tooth erupts
C. Age 3 years
D. After all primary teeth erupt
, Rationale: AAPD recommends first dental visit by age 1 or within 6 months of
first tooth eruption.
7. Which play activity is most appropriate for a 3-year-old hospitalized child?
A. Board games with rules
B. Dress-up clothes and puppets
C. Video games
D. Model building
Rationale: Preschoolers enjoy imaginative play. Board games require rules
(school-age), video games (older child).
8. A 14-year-old girl asks the nurse about normal changes of puberty. Which
finding is a common variation?
A. Menarche occurring at age 9
B. Asynchronous breast development
C. Pubic hair before breast development
D. No growth spurt by age 15
Rationale: Asynchronous (uneven) breast development is normal. Menarche
before 10 is precocious; pubic hair before breast development (adrenarche) can be
normal but less common; growth spurt should occur by 15.
9. The nurse is assessing a 6-month-old. Which reflex should have disappeared
by this age?
A. Babinski reflex
B. Moro reflex
C. Palmar grasp
D. Rooting reflex
Rationale: Palmar grasp disappears by 3-4 months. Babinski may persist up to 12
months; Moro by 4-6 months; rooting by 4 months.
10. A child has a fear of the dark and monsters at bedtime. This is most typical
for which age?
