HESI Pediatrics V1, V2 & V3 Exam 2026/27 –
Practice Test Bank
**1. The mother of a 15-month-old asks if it's normal that her child is not walking independently.
What is the nurse's best response?**
A) "Most walk by 12 months; this is a significant delay."
B) "Some normal children walk as late as 18 months. Let's assess other milestones."
C) "You should start physical therapy immediately."
D) "This always indicates a neurological problem."
**Answer: B**
*Rationale:* Independent walking typically occurs between 12 and 15 months, with a normal range
extending up to 18 months. Assessing other milestones is the most appropriate first step before any
intervention or concern .
**2. The nurse is assessing a 9-month-old infant. Which finding requires immediate follow-up?**
A) Cannot sit unsupported
B) Babinski reflex present
C) Stranger anxiety present
D) Babbling "mama/dada"
**Answer: A**
*Rationale:* By 9 months, infants should sit unsupported; failure to do so warrants evaluation for a
motor delay. Babinski reflex can persist up to 12 months. Stranger anxiety and babbling "mama/dada"
are expected at this age .
**3. At what age should an infant be able to roll from back to front?**
A) 2 months
B) 4–6 months
C) 8 months
D) 10 months
**Answer: B**
,*Rationale:* Rolling over (back to front and front to back) is typically achieved by 4 to 6 months of
age .
**4. A mother reports that her 9-month-old is not yet crawling. What is the nurse's best response?**
A) "This is a sign of developmental delay."
B) "Some infants skip crawling and go straight to walking."
C) "You should start physical therapy immediately."
D) "This always indicates a neurological problem."
**Answer: B**
*Rationale:* Crawling typically appears between 6 and 10 months, but some infants skip it entirely
and proceed to walking. Lack of crawling alone is not a concern without other developmental delays .
**5. Which statement by a parent indicates a need for further teaching regarding infant safety?**
A) "I will place my baby on his back to sleep."
B) "I will put soft pillows in the crib to make it comfortable."
C) "I will keep small objects out of my baby's reach."
D) "I will never leave my baby unattended on the changing table."
**Answer: B**
*Rationale:* Soft pillows, blankets, and toys are a suffocation risk for infants. Infants should sleep on
a firm mattress with no loose bedding to reduce the risk of SIDS .
**6. Which developmental milestone is expected in a 24-month-old (2-year-old) toddler?**
A) Ride a tricycle
B) Build a tower of 6–7 blocks
C) Brush teeth independently
D) Skip on one foot
**Answer: B**
*Rationale:* At 24 months, a toddler can build a tower of 6–7 blocks. Riding a tricycle is a 3–4 year
milestone. Brushing teeth independently and skipping are later milestones .
**7. A 2-year-old throws a tantrum when told it is time for bed. Which action demonstrates
understanding of toddler development?**
,A) Spank the child for misbehavior
B) Offer two choices: "Do you want to hop or skip to bed?"
C) Ignore the child until the tantrum stops
D) Tell the child, "Big boys don't cry"
**Answer: B**
*Rationale:* Toddlers seek autonomy. Offering limited choices gives control while setting limits. This
approach respects the developmental stage of autonomy versus shame and doubt .
**8. A mother asks about toilet training. The nurse knows that readiness is indicated by which sign?**
A) The child can remain dry for 1 hour
B) The child can pull pants up and down
C) The child is 12 months old
D) The child can feed themselves
**Answer: B**
*Rationale:* Physical readiness for toilet training includes the ability to pull pants up and down, walk
to the potty, and communicate the need. Chronological age and staying dry for shorter periods are
less reliable indicators .
**9. Which play pattern is most typical for a 3-year-old?**
A) Cooperative play in teams
B) Parallel play
C) Solitary play with no regard for others
D) Competitive play with rules
**Answer: B**
*Rationale:* Parallel play (playing alongside but not with others) peaks at 2–3 years. Cooperative play
begins around 4–5 years .
**10. A 4-year-old child is hospitalized. Which behavior should the nurse expect?**
A) Boasts aggressively when telling a story
B) Is cooperative with all procedures
C) Is quiet and withdrawn
, D) Has difficulty separating from parents
**Answer: A**
*Rationale:* Four-year-old children are aggressive in their behavior and enjoy telling tales. They are in
the initiative versus guilt stage and may boast about their accomplishments .
**11. The nurse is assessing a 3-year-old boy who attends a daycare center. Following an upper
respiratory tract infection, he developed acute otitis media. Which factor places this child at greatest
risk for developing acute otitis media?**
A) A child's Eustachian tube is shorter and straighter than an adult's
B) Attending a daycare center causes frequent exposure to infections
C) A child's inner ear is more narrow than an adult's
D) The immunity he received at birth is no longer effective
**Answer: A**
*Rationale:* The shorter, straighter Eustachian tube in children allows bacteria from the nasopharynx
to reach the middle ear more easily, increasing the risk of otitis media .
**12. A 5-year-old insists that her doll is "sad because she lost her mommy." This is an example of:**
A) Animism
B) Egocentrism
C) Centration
D) Conservation
**Answer: A**
*Rationale:* Animism (preoperational stage, ages 2–7) attributes lifelike qualities to inanimate
objects. This is normal for preschool-age children .
**13. Which statement by a 5-year-old indicates correct understanding of conservation?**
A) "The tall glass has more juice even though you poured it from the short fat glass."
B) "If you break my cookie in half, I have more pieces."
C) "My sister is older so she is taller."
D) "The cookie is the same size even though it's in pieces."
**Answer: D**
Practice Test Bank
**1. The mother of a 15-month-old asks if it's normal that her child is not walking independently.
What is the nurse's best response?**
A) "Most walk by 12 months; this is a significant delay."
B) "Some normal children walk as late as 18 months. Let's assess other milestones."
C) "You should start physical therapy immediately."
D) "This always indicates a neurological problem."
**Answer: B**
*Rationale:* Independent walking typically occurs between 12 and 15 months, with a normal range
extending up to 18 months. Assessing other milestones is the most appropriate first step before any
intervention or concern .
**2. The nurse is assessing a 9-month-old infant. Which finding requires immediate follow-up?**
A) Cannot sit unsupported
B) Babinski reflex present
C) Stranger anxiety present
D) Babbling "mama/dada"
**Answer: A**
*Rationale:* By 9 months, infants should sit unsupported; failure to do so warrants evaluation for a
motor delay. Babinski reflex can persist up to 12 months. Stranger anxiety and babbling "mama/dada"
are expected at this age .
**3. At what age should an infant be able to roll from back to front?**
A) 2 months
B) 4–6 months
C) 8 months
D) 10 months
**Answer: B**
,*Rationale:* Rolling over (back to front and front to back) is typically achieved by 4 to 6 months of
age .
**4. A mother reports that her 9-month-old is not yet crawling. What is the nurse's best response?**
A) "This is a sign of developmental delay."
B) "Some infants skip crawling and go straight to walking."
C) "You should start physical therapy immediately."
D) "This always indicates a neurological problem."
**Answer: B**
*Rationale:* Crawling typically appears between 6 and 10 months, but some infants skip it entirely
and proceed to walking. Lack of crawling alone is not a concern without other developmental delays .
**5. Which statement by a parent indicates a need for further teaching regarding infant safety?**
A) "I will place my baby on his back to sleep."
B) "I will put soft pillows in the crib to make it comfortable."
C) "I will keep small objects out of my baby's reach."
D) "I will never leave my baby unattended on the changing table."
**Answer: B**
*Rationale:* Soft pillows, blankets, and toys are a suffocation risk for infants. Infants should sleep on
a firm mattress with no loose bedding to reduce the risk of SIDS .
**6. Which developmental milestone is expected in a 24-month-old (2-year-old) toddler?**
A) Ride a tricycle
B) Build a tower of 6–7 blocks
C) Brush teeth independently
D) Skip on one foot
**Answer: B**
*Rationale:* At 24 months, a toddler can build a tower of 6–7 blocks. Riding a tricycle is a 3–4 year
milestone. Brushing teeth independently and skipping are later milestones .
**7. A 2-year-old throws a tantrum when told it is time for bed. Which action demonstrates
understanding of toddler development?**
,A) Spank the child for misbehavior
B) Offer two choices: "Do you want to hop or skip to bed?"
C) Ignore the child until the tantrum stops
D) Tell the child, "Big boys don't cry"
**Answer: B**
*Rationale:* Toddlers seek autonomy. Offering limited choices gives control while setting limits. This
approach respects the developmental stage of autonomy versus shame and doubt .
**8. A mother asks about toilet training. The nurse knows that readiness is indicated by which sign?**
A) The child can remain dry for 1 hour
B) The child can pull pants up and down
C) The child is 12 months old
D) The child can feed themselves
**Answer: B**
*Rationale:* Physical readiness for toilet training includes the ability to pull pants up and down, walk
to the potty, and communicate the need. Chronological age and staying dry for shorter periods are
less reliable indicators .
**9. Which play pattern is most typical for a 3-year-old?**
A) Cooperative play in teams
B) Parallel play
C) Solitary play with no regard for others
D) Competitive play with rules
**Answer: B**
*Rationale:* Parallel play (playing alongside but not with others) peaks at 2–3 years. Cooperative play
begins around 4–5 years .
**10. A 4-year-old child is hospitalized. Which behavior should the nurse expect?**
A) Boasts aggressively when telling a story
B) Is cooperative with all procedures
C) Is quiet and withdrawn
, D) Has difficulty separating from parents
**Answer: A**
*Rationale:* Four-year-old children are aggressive in their behavior and enjoy telling tales. They are in
the initiative versus guilt stage and may boast about their accomplishments .
**11. The nurse is assessing a 3-year-old boy who attends a daycare center. Following an upper
respiratory tract infection, he developed acute otitis media. Which factor places this child at greatest
risk for developing acute otitis media?**
A) A child's Eustachian tube is shorter and straighter than an adult's
B) Attending a daycare center causes frequent exposure to infections
C) A child's inner ear is more narrow than an adult's
D) The immunity he received at birth is no longer effective
**Answer: A**
*Rationale:* The shorter, straighter Eustachian tube in children allows bacteria from the nasopharynx
to reach the middle ear more easily, increasing the risk of otitis media .
**12. A 5-year-old insists that her doll is "sad because she lost her mommy." This is an example of:**
A) Animism
B) Egocentrism
C) Centration
D) Conservation
**Answer: A**
*Rationale:* Animism (preoperational stage, ages 2–7) attributes lifelike qualities to inanimate
objects. This is normal for preschool-age children .
**13. Which statement by a 5-year-old indicates correct understanding of conservation?**
A) "The tall glass has more juice even though you poured it from the short fat glass."
B) "If you break my cookie in half, I have more pieces."
C) "My sister is older so she is taller."
D) "The cookie is the same size even though it's in pieces."
**Answer: D**
