HESI PEDIATRICS EXAM/Latest Updated/
Chamberlain College of Nursing
SECTION I: GROWTH & DEVELOPMENT (Questions 1-20)
1. The nurse is assessing a 4-month-old infant during a well-child visit. Which developmental
milestone should the nurse expect to observe?
• A. Rolling from supine to prone
• B. Sitting without support
• C. Holding head steady when upright
• D. Transferring objects hand to hand
Correct Answer: C
Rationale: By 4 months, infants should demonstrate good head control and hold their head
steady when held in an upright position . Rolling from supine to prone typically occurs around 5-
6 months, independent sitting at 7-8 months, and transferring objects at 6-7 months .
2. A 2-year-old toddler insists on choosing their own clothes and becomes upset when a
parent tries to help. According to Erikson, which psychosocial stage is this child
demonstrating?
• A. Trust vs. mistrust
• B. Autonomy vs. shame and doubt
• C. Initiative vs. guilt
• D. Industry vs. inferiority
Correct Answer: B
Rationale: Toddlers (1-3 years) are in Erikson's autonomy vs. shame and doubt stage, where
they strive for independence and control over their environment . Trust vs. mistrust is infancy
(0-1 year), initiative vs. guilt is preschool (3-5 years), and industry vs. inferiority is school-age (6-
12 years).
3. The nurse is teaching a parent about safe sleep practices for a 2-month-old infant. Which
instruction should the nurse include?
, • A. Place the infant prone with a soft pillow for neck support
• B. Place the infant supine on a firm surface without soft bedding
• C. Allow side-sleeping with a wedge to prevent aspiration
• D. Share the adult bed for the first 6 months to facilitate breastfeeding
Correct Answer: B
Rationale: Supine positioning on a firm flat surface without soft objects is the
recommended safe sleep practice to reduce SIDS risk . Prone and side-sleeping positions, soft
bedding, and bed-sharing increase risk and are not recommended.
4. A 6-month-old infant has doubled their birth weight. Which additional finding would
indicate the need for further developmental evaluation?
• A. The infant babbles and responds to their name
• B. The infant demonstrates the startle reflex
• C. The infant sits briefly with support
• D. The infant turns head to locate sound
Correct Answer: B
Rationale: The startle (Moro) reflex should disappear by 4-6 months of age . Persistence of
this primitive reflex at 6 months requires further evaluation. Babbling, supported sitting, and
turning to sound are all appropriate milestones for this age.
5. A mother asks when her infant's anterior fontanel should close. What is the nurse's best
response?
• A. "It should close by 2 months of age."
• B. "It typically closes between 12-18 months of age."
• C. "It closes around 6 months when the infant begins sitting."
• D. "The fontanel remains open until 2 years of age."
Correct Answer: B
Rationale: The anterior fontanel is diamond-shaped and normally closes between 12-18
months of age . The posterior fontanel closes by 2-3 months. An open anterior fontanel at 2
months is an expected finding.
,6. The nurse is assessing a 9-month-old infant who has not yet developed a pincer grasp.
Which additional finding would most support the need for further developmental evaluation?
• A. The infant babbles and responds to their name
• B. The infant does not transfer objects between hands
• C. The infant sits briefly with support and reaches for toys
• D. The infant has doubled birth weight
Correct Answer: B
Rationale: Failure to transfer objects from one hand to the other along with limited
exploratory interest at 9 months are red flags for developmental delay . Babbling, supported
sitting, and appropriate growth are reassuring findings.
7. A 15-month-old toddler is seen for a well visit. Which anticipatory guidance has the highest
priority for injury prevention at this age?
• A. Encourage unsupervised outdoor play to build independence
• B. Secure cabinets, cover outlets, and supervise near water and stairs
• C. Delay car seat use until the child can sit independently
• D. Introduce whole nuts and popcorn as healthy finger foods
Correct Answer: B
Rationale: Toddlers explore actively and are at high risk for falls, drowning, poisoning, and
electrical injury. Supervision and environmental controls are essential . Choking foods and
delayed car seat use increase risk.
8. A 4-year-old child is observed in the waiting room playing next to other children but not
interacting with them. The nurse recognizes this as which type of play?
• A. Solitary play
• B. Parallel play
• C. Associative play
• D. Cooperative play
Correct Answer: B
, Rationale: Toddlers engage in parallel play (playing alongside but not with others).
Preschoolers transition to associative play (sharing materials but not goals). True cooperative
play with shared goals develops in school-age children .
9. The nurse is assessing a 7-year-old child according to Piaget's theory. Which cognitive
ability should the nurse expect?
• A. Abstract reasoning and hypothetical thinking
• B. Conservation and logical reasoning about concrete events
• C. Symbolic play and magical thinking
• D. Object permanence
Correct Answer: B
Rationale: School-age children (7-11 years) are in Piaget's concrete operational stage,
characterized by conservation and logical reasoning about concrete events . Abstract reasoning
develops in the formal operational stage (adolescence). Symbolic play is preoperational (2-7
years).
10. A 12-year-old adolescent is in which Erikson stage of psychosocial development?
• A. Industry vs. inferiority
• B. Identity vs. role confusion
• C. Intimacy vs. isolation
• D. Initiative vs. guilt
Correct Answer: B
Rationale: Adolescents (12-18 years) are in Erikson's identity vs. role confusion stage, where
they explore independence and self-identity . Industry vs. inferiority is school-age (6-12 years),
and intimacy vs. isolation is young adulthood.
11. A 5-year-old child is scheduled for a tonsillectomy. Which preoperative teaching approach
is most developmentally appropriate?
• A. Provide a detailed explanation of the surgical procedure
• B. Use play therapy with a doll to demonstrate the procedure
• C. Give the child a pamphlet to read about the surgery
Chamberlain College of Nursing
SECTION I: GROWTH & DEVELOPMENT (Questions 1-20)
1. The nurse is assessing a 4-month-old infant during a well-child visit. Which developmental
milestone should the nurse expect to observe?
• A. Rolling from supine to prone
• B. Sitting without support
• C. Holding head steady when upright
• D. Transferring objects hand to hand
Correct Answer: C
Rationale: By 4 months, infants should demonstrate good head control and hold their head
steady when held in an upright position . Rolling from supine to prone typically occurs around 5-
6 months, independent sitting at 7-8 months, and transferring objects at 6-7 months .
2. A 2-year-old toddler insists on choosing their own clothes and becomes upset when a
parent tries to help. According to Erikson, which psychosocial stage is this child
demonstrating?
• A. Trust vs. mistrust
• B. Autonomy vs. shame and doubt
• C. Initiative vs. guilt
• D. Industry vs. inferiority
Correct Answer: B
Rationale: Toddlers (1-3 years) are in Erikson's autonomy vs. shame and doubt stage, where
they strive for independence and control over their environment . Trust vs. mistrust is infancy
(0-1 year), initiative vs. guilt is preschool (3-5 years), and industry vs. inferiority is school-age (6-
12 years).
3. The nurse is teaching a parent about safe sleep practices for a 2-month-old infant. Which
instruction should the nurse include?
, • A. Place the infant prone with a soft pillow for neck support
• B. Place the infant supine on a firm surface without soft bedding
• C. Allow side-sleeping with a wedge to prevent aspiration
• D. Share the adult bed for the first 6 months to facilitate breastfeeding
Correct Answer: B
Rationale: Supine positioning on a firm flat surface without soft objects is the
recommended safe sleep practice to reduce SIDS risk . Prone and side-sleeping positions, soft
bedding, and bed-sharing increase risk and are not recommended.
4. A 6-month-old infant has doubled their birth weight. Which additional finding would
indicate the need for further developmental evaluation?
• A. The infant babbles and responds to their name
• B. The infant demonstrates the startle reflex
• C. The infant sits briefly with support
• D. The infant turns head to locate sound
Correct Answer: B
Rationale: The startle (Moro) reflex should disappear by 4-6 months of age . Persistence of
this primitive reflex at 6 months requires further evaluation. Babbling, supported sitting, and
turning to sound are all appropriate milestones for this age.
5. A mother asks when her infant's anterior fontanel should close. What is the nurse's best
response?
• A. "It should close by 2 months of age."
• B. "It typically closes between 12-18 months of age."
• C. "It closes around 6 months when the infant begins sitting."
• D. "The fontanel remains open until 2 years of age."
Correct Answer: B
Rationale: The anterior fontanel is diamond-shaped and normally closes between 12-18
months of age . The posterior fontanel closes by 2-3 months. An open anterior fontanel at 2
months is an expected finding.
,6. The nurse is assessing a 9-month-old infant who has not yet developed a pincer grasp.
Which additional finding would most support the need for further developmental evaluation?
• A. The infant babbles and responds to their name
• B. The infant does not transfer objects between hands
• C. The infant sits briefly with support and reaches for toys
• D. The infant has doubled birth weight
Correct Answer: B
Rationale: Failure to transfer objects from one hand to the other along with limited
exploratory interest at 9 months are red flags for developmental delay . Babbling, supported
sitting, and appropriate growth are reassuring findings.
7. A 15-month-old toddler is seen for a well visit. Which anticipatory guidance has the highest
priority for injury prevention at this age?
• A. Encourage unsupervised outdoor play to build independence
• B. Secure cabinets, cover outlets, and supervise near water and stairs
• C. Delay car seat use until the child can sit independently
• D. Introduce whole nuts and popcorn as healthy finger foods
Correct Answer: B
Rationale: Toddlers explore actively and are at high risk for falls, drowning, poisoning, and
electrical injury. Supervision and environmental controls are essential . Choking foods and
delayed car seat use increase risk.
8. A 4-year-old child is observed in the waiting room playing next to other children but not
interacting with them. The nurse recognizes this as which type of play?
• A. Solitary play
• B. Parallel play
• C. Associative play
• D. Cooperative play
Correct Answer: B
, Rationale: Toddlers engage in parallel play (playing alongside but not with others).
Preschoolers transition to associative play (sharing materials but not goals). True cooperative
play with shared goals develops in school-age children .
9. The nurse is assessing a 7-year-old child according to Piaget's theory. Which cognitive
ability should the nurse expect?
• A. Abstract reasoning and hypothetical thinking
• B. Conservation and logical reasoning about concrete events
• C. Symbolic play and magical thinking
• D. Object permanence
Correct Answer: B
Rationale: School-age children (7-11 years) are in Piaget's concrete operational stage,
characterized by conservation and logical reasoning about concrete events . Abstract reasoning
develops in the formal operational stage (adolescence). Symbolic play is preoperational (2-7
years).
10. A 12-year-old adolescent is in which Erikson stage of psychosocial development?
• A. Industry vs. inferiority
• B. Identity vs. role confusion
• C. Intimacy vs. isolation
• D. Initiative vs. guilt
Correct Answer: B
Rationale: Adolescents (12-18 years) are in Erikson's identity vs. role confusion stage, where
they explore independence and self-identity . Industry vs. inferiority is school-age (6-12 years),
and intimacy vs. isolation is young adulthood.
11. A 5-year-old child is scheduled for a tonsillectomy. Which preoperative teaching approach
is most developmentally appropriate?
• A. Provide a detailed explanation of the surgical procedure
• B. Use play therapy with a doll to demonstrate the procedure
• C. Give the child a pamphlet to read about the surgery
