EVOLVE HESI PEDS EXAM PREP NEWEST 2026/2027
EXAM COMPLETE 100 QUESTIONS AND CORRECT
DETAILE
SECTION 1: GROWTH & DEVELOPMENT (Questions 1–15)
1. A nurse is assessing a 6-month-old infant during a well-child visit. Which finding should the
nurse report to the provider?
A. Infant has a positive Babinski reflex
B. Infant does not turn toward a loud noise
C. Infant has a Moro reflex present at birth only
D. Infant can sit briefly with support
Rationale: A 6-month-old should turn toward sounds (auditory localization develops by 4–6
months). Failure to respond to sound may indicate hearing loss and requires further evaluation.
The Babinski reflex is normal until about 12–24 months, sitting with support is expected at 6
months, and the Moro reflex disappears by 3–4 months, so its presence only at birth is not a
concern.
2. Which developmental milestone should a nurse expect a 15-month-old toddler to achieve?
A. Walks independently and says 3–5 words
B. Builds a tower of 6 blocks
C. Rides a tricycle
D. Draws a circle
Rationale: A 15-month-old typically walks alone, may walk up stairs with help, and uses 3–5
words. Building a 6-block tower is expected at 2 years, riding a tricycle at 3 years, and drawing a
circle at 3–4 years.
3. A nurse is teaching parents about toilet training. Which statement indicates understanding?
A. "We should start training at 12 months."
B. "We should wait until our child shows signs of readiness, usually around 18–24 months."
C. "Punishment speeds up the process."
D. "Nighttime dryness always comes before daytime dryness."
Rationale: Toilet training readiness usually occurs at 18–24 months, signaled by staying dry
for 2 hours, showing interest, and communicating needs. Daytime control typically precedes
nighttime control. Punishment is never appropriate and can cause regression.
,4. According to Erikson, which psychosocial stage is a 4-year-old child in?
A. Trust vs. mistrust
B. Autonomy vs. shame and doubt
C. Initiative vs. guilt
D. Industry vs. inferiority
Rationale: Initiative vs. guilt (ages 3–6) is the preschool stage, characterized by exploration,
imagination, and taking initiative. Trust vs. mistrust is infancy, autonomy vs. shame is
toddlerhood, and industry vs. inferiority is school age.
5. A nurse observes a 9-month-old infant. Which behavior indicates a possible developmental
delay?
A. Sits without support
B. Does not bear weight on legs when held standing
C. Transfers objects hand to hand
D. Says "mama" and "dada" nonspecifically
Rationale: By 9 months, an infant should bear weight on the legs when held upright. Sitting
without support, transferring objects, and babbling are all expected at this age; the inability to
bear weight warrants further assessment.
6. Which toy is most appropriate for a 4-month-old infant?
A. Soft rattle with contrasting colors
B. Small building blocks
C. Push-pull toy
D. Board game with small pieces
Rationale: Infants at 4 months enjoy rattles, mobiles, and soft toys with high-contrast colors
that stimulate visual development and grasping. Small blocks and board game pieces are
choking hazards. Push-pull toys are for toddlers.
7. A nurse is assessing a 5-year-old. Which finding is most concerning?
A. Height increased 2 inches in 1 year
B. Weight loss with decreased appetite for 2 months
C. Uses 5–6 word sentences
D. Can hop on one foot
Rationale: Persistent weight loss and appetite decline in a preschooler are red flags for
organic or psychosocial pathology. Growth of 2 inches/year, 5–6 word sentences, and hopping
on one foot are all developmentally appropriate for a 5-year-old.
,8. A nurse is teaching parents about stranger anxiety. At what age does it typically peak?
A. 2 months
B. 7–9 months
C. 2 years
D. 4 years
Rationale: Stranger anxiety peaks at 7–9 months as infants develop object permanence and
recognize familiar vs. unfamiliar faces. It generally resolves by 2 years.
9. Which statement by a parent of a 2-year-old indicates a need for further teaching about
dental care?
A. "We brush his teeth twice a day with a pea-sized amount of fluoride toothpaste."
B. "We schedule dental visits every 6 months."
C. "We give him a bottle of milk at bedtime to help him sleep."
D. "We limit juice to 4 ounces per day."
Rationale: Bottles at bedtime pool milk around teeth, causing early childhood caries (baby
bottle tooth decay). Milk or juice at bedtime should be avoided; water is acceptable. The other
statements reflect correct dental care.
10. A nurse is evaluating a 12-month-old's language development. Which finding is expected?
A. Says 2–3 words with meaning
B. Speaks in 2-word phrases
C. Knows 50 words
D. Tells simple stories
Rationale: A 12-month-old typically says 2–3 words with meaning and uses gestures. Two-
word phrases appear around 18–24 months, 50-word vocabulary around 2 years, and
storytelling at 3–4 years.
11. According to Piaget, a 10-year-old is in which cognitive stage?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Rationale: Concrete operational (7–11 years) involves logical thought about concrete
objects, conservation, and classification. Sensorimotor is 0–2 years, preoperational is 2–7 years,
and formal operational begins at 11 years.
, 12. A nurse is assessing a 3-year-old. Which behavior would the nurse document as normal?
A. Parallel play with other children
B. Cooperative play with rules
C. Sharing toys willingly
D. Playing board games competitively
Rationale: Parallel play (playing alongside but not with others) is typical for toddlers and
preschoolers. Cooperative play with rules and sharing develop in school age. Competitive board
games require cognitive skills of school-age children.
13. A parent asks when a child should be able to ride a tricycle. The nurse responds:
A. 18 months
B. 2 years
C. 3 years
D. 5 years
Rationale: Tricycle riding requires coordination typically achieved by age 3. At 18–24
months, children can walk well and climb; tricycle riding at 3 reflects gross motor progression.
14. A nurse is teaching about injury prevention for a 6-month-old. Which instruction is
priority?
A. Place the infant on the back to sleep and remove loose bedding
B. Teach the child not to touch the stove
C. Install a safety gate at the top of stairs
D. Use a helmet when riding a bike
Rationale: At 6 months, the priority is safe sleep to prevent SIDS and suffocation; loose
bedding and prone sleeping are risks. Stove safety and stair gates become more relevant with
crawling/walking. Bike helmets are for older children.
15. Which finding indicates a 4-month-old has achieved an expected gross motor milestone?
A. Rolls from back to stomach
B. Holds head steady without support (head control)
C. Sits alone without support
D. Pulls to standing
Rationale: Head control without support is achieved by 4 months. Rolling back-to-stomach
typically occurs at 5–6 months, sitting alone at 8 months, and pulling to stand at 9–10 months.
SECTION 2: PEDIATRIC ASSESSMENT & VITAL SIGNS (Questions 16–28)
EXAM COMPLETE 100 QUESTIONS AND CORRECT
DETAILE
SECTION 1: GROWTH & DEVELOPMENT (Questions 1–15)
1. A nurse is assessing a 6-month-old infant during a well-child visit. Which finding should the
nurse report to the provider?
A. Infant has a positive Babinski reflex
B. Infant does not turn toward a loud noise
C. Infant has a Moro reflex present at birth only
D. Infant can sit briefly with support
Rationale: A 6-month-old should turn toward sounds (auditory localization develops by 4–6
months). Failure to respond to sound may indicate hearing loss and requires further evaluation.
The Babinski reflex is normal until about 12–24 months, sitting with support is expected at 6
months, and the Moro reflex disappears by 3–4 months, so its presence only at birth is not a
concern.
2. Which developmental milestone should a nurse expect a 15-month-old toddler to achieve?
A. Walks independently and says 3–5 words
B. Builds a tower of 6 blocks
C. Rides a tricycle
D. Draws a circle
Rationale: A 15-month-old typically walks alone, may walk up stairs with help, and uses 3–5
words. Building a 6-block tower is expected at 2 years, riding a tricycle at 3 years, and drawing a
circle at 3–4 years.
3. A nurse is teaching parents about toilet training. Which statement indicates understanding?
A. "We should start training at 12 months."
B. "We should wait until our child shows signs of readiness, usually around 18–24 months."
C. "Punishment speeds up the process."
D. "Nighttime dryness always comes before daytime dryness."
Rationale: Toilet training readiness usually occurs at 18–24 months, signaled by staying dry
for 2 hours, showing interest, and communicating needs. Daytime control typically precedes
nighttime control. Punishment is never appropriate and can cause regression.
,4. According to Erikson, which psychosocial stage is a 4-year-old child in?
A. Trust vs. mistrust
B. Autonomy vs. shame and doubt
C. Initiative vs. guilt
D. Industry vs. inferiority
Rationale: Initiative vs. guilt (ages 3–6) is the preschool stage, characterized by exploration,
imagination, and taking initiative. Trust vs. mistrust is infancy, autonomy vs. shame is
toddlerhood, and industry vs. inferiority is school age.
5. A nurse observes a 9-month-old infant. Which behavior indicates a possible developmental
delay?
A. Sits without support
B. Does not bear weight on legs when held standing
C. Transfers objects hand to hand
D. Says "mama" and "dada" nonspecifically
Rationale: By 9 months, an infant should bear weight on the legs when held upright. Sitting
without support, transferring objects, and babbling are all expected at this age; the inability to
bear weight warrants further assessment.
6. Which toy is most appropriate for a 4-month-old infant?
A. Soft rattle with contrasting colors
B. Small building blocks
C. Push-pull toy
D. Board game with small pieces
Rationale: Infants at 4 months enjoy rattles, mobiles, and soft toys with high-contrast colors
that stimulate visual development and grasping. Small blocks and board game pieces are
choking hazards. Push-pull toys are for toddlers.
7. A nurse is assessing a 5-year-old. Which finding is most concerning?
A. Height increased 2 inches in 1 year
B. Weight loss with decreased appetite for 2 months
C. Uses 5–6 word sentences
D. Can hop on one foot
Rationale: Persistent weight loss and appetite decline in a preschooler are red flags for
organic or psychosocial pathology. Growth of 2 inches/year, 5–6 word sentences, and hopping
on one foot are all developmentally appropriate for a 5-year-old.
,8. A nurse is teaching parents about stranger anxiety. At what age does it typically peak?
A. 2 months
B. 7–9 months
C. 2 years
D. 4 years
Rationale: Stranger anxiety peaks at 7–9 months as infants develop object permanence and
recognize familiar vs. unfamiliar faces. It generally resolves by 2 years.
9. Which statement by a parent of a 2-year-old indicates a need for further teaching about
dental care?
A. "We brush his teeth twice a day with a pea-sized amount of fluoride toothpaste."
B. "We schedule dental visits every 6 months."
C. "We give him a bottle of milk at bedtime to help him sleep."
D. "We limit juice to 4 ounces per day."
Rationale: Bottles at bedtime pool milk around teeth, causing early childhood caries (baby
bottle tooth decay). Milk or juice at bedtime should be avoided; water is acceptable. The other
statements reflect correct dental care.
10. A nurse is evaluating a 12-month-old's language development. Which finding is expected?
A. Says 2–3 words with meaning
B. Speaks in 2-word phrases
C. Knows 50 words
D. Tells simple stories
Rationale: A 12-month-old typically says 2–3 words with meaning and uses gestures. Two-
word phrases appear around 18–24 months, 50-word vocabulary around 2 years, and
storytelling at 3–4 years.
11. According to Piaget, a 10-year-old is in which cognitive stage?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Rationale: Concrete operational (7–11 years) involves logical thought about concrete
objects, conservation, and classification. Sensorimotor is 0–2 years, preoperational is 2–7 years,
and formal operational begins at 11 years.
, 12. A nurse is assessing a 3-year-old. Which behavior would the nurse document as normal?
A. Parallel play with other children
B. Cooperative play with rules
C. Sharing toys willingly
D. Playing board games competitively
Rationale: Parallel play (playing alongside but not with others) is typical for toddlers and
preschoolers. Cooperative play with rules and sharing develop in school age. Competitive board
games require cognitive skills of school-age children.
13. A parent asks when a child should be able to ride a tricycle. The nurse responds:
A. 18 months
B. 2 years
C. 3 years
D. 5 years
Rationale: Tricycle riding requires coordination typically achieved by age 3. At 18–24
months, children can walk well and climb; tricycle riding at 3 reflects gross motor progression.
14. A nurse is teaching about injury prevention for a 6-month-old. Which instruction is
priority?
A. Place the infant on the back to sleep and remove loose bedding
B. Teach the child not to touch the stove
C. Install a safety gate at the top of stairs
D. Use a helmet when riding a bike
Rationale: At 6 months, the priority is safe sleep to prevent SIDS and suffocation; loose
bedding and prone sleeping are risks. Stove safety and stair gates become more relevant with
crawling/walking. Bike helmets are for older children.
15. Which finding indicates a 4-month-old has achieved an expected gross motor milestone?
A. Rolls from back to stomach
B. Holds head steady without support (head control)
C. Sits alone without support
D. Pulls to standing
Rationale: Head control without support is achieved by 4 months. Rolling back-to-stomach
typically occurs at 5–6 months, sitting alone at 8 months, and pulling to stand at 9–10 months.
SECTION 2: PEDIATRIC ASSESSMENT & VITAL SIGNS (Questions 16–28)
