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HESI Pediatric Nursing Specialty Exam – 100 Practice Questions
Section 1: Growth & Development (Questions 1–20)
1. A nurse is assessing a 6-month-old infant. Which fine motor skill should the nurse
expect?
A. Pincer grasp
B. Palmar grasp
C. Transferring objects hand to hand
D. Building a tower of two cubes
Answer: B – Palmar grasp
Rationale: Palmar grasp is present at 6 months. Pincer grasp develops at 9–10 months.
Transferring objects occurs at 7–8 months. Building a tower of two cubes is expected at 15
months.
2. A nurse is teaching parents about toddler development. Which statement indicates
understanding?
A. "My 2-year-old should be able to share toys."
B. "My 2-year-old will want to do things independently."
C. "My 2-year-old should understand the concept of death."
D. "My 2-year-old should have a vocabulary of 500 words."
Answer: B – "My 2-year-old will want to do things independently."
Rationale: Toddlers (1–3 years) are in Erikson's Autonomy vs. Shame and Doubt stage. They
seek independence. Sharing and understanding death are not expected at this age. A 2-year-
old typically has 50–300 words.
3. A nurse is assessing a 4-month-old infant. Which finding requires further investigation?
A. Moro reflex present
B. Head lag when pulled to sitting
C. Able to hold head steady when upright
D. Rolls from prone to supine
Answer: B – Head lag when pulled to sitting
Rationale: Head lag should resolve by 4 months. Persistent head lag at 4 months may
indicate developmental delay. The Moro reflex disappears by 4 months but may still be
present. Rolling prone to supine occurs at 5–6 months.
4. A nurse is providing anticipatory guidance for a 15-month-old. Which instruction is
priority?
A. "Begin toilet training now."
B. "Use a forward-facing car seat."
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C. "Childproof cabinets and stairs."
D. "Introduce whole milk."
Answer: C – "Childproof cabinets and stairs."
Rationale: Safety is the priority for toddlers, who are mobile and curious. Childproofing
prevents injury. Toilet training typically begins around 18–24 months. Forward-facing car
seats are for children 2+ years or meeting weight/height criteria.
5. A parent asks when their child should receive the first dose of the MMR vaccine. What
is the nurse's best response?
A. "At birth, before leaving the hospital"
B. "At 2 months of age"
C. "At 12 to 15 months of age"
D. "At 4 to 6 years of age"
Answer: C – "At 12 to 15 months of age."
Rationale: The first MMR (measles, mumps, rubella) vaccine is given at 12–15 months, with
the second dose at 4–6 years.
6. A 2-year-old is admitted and insists on choosing their own clothes, becoming upset
when parents help. According to Erikson, this behavior reflects which stage?
A. Autonomy versus shame and doubt
B. Industry versus inferiority
C. Trust versus mistrust
D. Initiative versus guilt
Answer: A – Autonomy versus shame and doubt
Rationale: Toddlers are in the autonomy versus shame and doubt stage, striving for
independence and control.
7. A nurse is assessing a 4-month-old during a well-child visit. Which finding indicates
expected gross motor development?
A. Sits unsupported
B. Holds head steady and erect when held upright
C. Rolls from back to front smoothly
D. Bears weight on legs when held standing
Answer: B – Holds head steady and erect when held upright
Rationale: By 4 months, head control is expected. Sitting unsupported and rolling over occur
later.
8. A nurse is caring for an 8-year-old hospitalized child. According to Erikson, this child is in
which stage?
, 3
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: D – Industry vs. Inferiority
Rationale: School-age children (6–12 years) are in Industry vs. Inferiority, developing
competence through achievements.
9. When assessing an adolescent, which behavior indicates normal progression through
Identity vs. Role Confusion?
A. Dependence on parents for all decisions
B. Experimentation with clothing styles and peer groups
C. Regression to earlier childhood behaviors
D. Complete isolation from peers
Answer: B – Experimentation with clothing styles and peer groups
Rationale: Adolescents normally experiment with roles and appearances as part of identity
formation.
10. A nurse is teaching parents about age-appropriate activities for an 18-month-old.
Which toy is most appropriate?
A. 500-piece puzzle
B. Push-pull toys
C. Board games with simple rules
D. Craft supplies with small beads
Answer: B – Push-pull toys
Rationale: Push-pull toys support gross motor development and encourage walking. Small
pieces pose choking hazards.
11. A nurse is assessing a 5-month-old infant. Which finding should be reported to the
provider?
A. Head lags when pulled from lying to sitting
B. Absence of startle and crawl reflexes
C. Inability to pick up a rattle after dropping it
D. Rolls from back to side
Answer: A – Head lags when pulled from lying to sitting
Rationale: At 5 months, the infant should have no head lag when pulled to sitting. This
finding warrants reporting.
12. A nurse is teaching a parent about peek-a-boo. This game helps develop which
concept?
HESI Pediatric Nursing Specialty Exam – 100 Practice Questions
Section 1: Growth & Development (Questions 1–20)
1. A nurse is assessing a 6-month-old infant. Which fine motor skill should the nurse
expect?
A. Pincer grasp
B. Palmar grasp
C. Transferring objects hand to hand
D. Building a tower of two cubes
Answer: B – Palmar grasp
Rationale: Palmar grasp is present at 6 months. Pincer grasp develops at 9–10 months.
Transferring objects occurs at 7–8 months. Building a tower of two cubes is expected at 15
months.
2. A nurse is teaching parents about toddler development. Which statement indicates
understanding?
A. "My 2-year-old should be able to share toys."
B. "My 2-year-old will want to do things independently."
C. "My 2-year-old should understand the concept of death."
D. "My 2-year-old should have a vocabulary of 500 words."
Answer: B – "My 2-year-old will want to do things independently."
Rationale: Toddlers (1–3 years) are in Erikson's Autonomy vs. Shame and Doubt stage. They
seek independence. Sharing and understanding death are not expected at this age. A 2-year-
old typically has 50–300 words.
3. A nurse is assessing a 4-month-old infant. Which finding requires further investigation?
A. Moro reflex present
B. Head lag when pulled to sitting
C. Able to hold head steady when upright
D. Rolls from prone to supine
Answer: B – Head lag when pulled to sitting
Rationale: Head lag should resolve by 4 months. Persistent head lag at 4 months may
indicate developmental delay. The Moro reflex disappears by 4 months but may still be
present. Rolling prone to supine occurs at 5–6 months.
4. A nurse is providing anticipatory guidance for a 15-month-old. Which instruction is
priority?
A. "Begin toilet training now."
B. "Use a forward-facing car seat."
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C. "Childproof cabinets and stairs."
D. "Introduce whole milk."
Answer: C – "Childproof cabinets and stairs."
Rationale: Safety is the priority for toddlers, who are mobile and curious. Childproofing
prevents injury. Toilet training typically begins around 18–24 months. Forward-facing car
seats are for children 2+ years or meeting weight/height criteria.
5. A parent asks when their child should receive the first dose of the MMR vaccine. What
is the nurse's best response?
A. "At birth, before leaving the hospital"
B. "At 2 months of age"
C. "At 12 to 15 months of age"
D. "At 4 to 6 years of age"
Answer: C – "At 12 to 15 months of age."
Rationale: The first MMR (measles, mumps, rubella) vaccine is given at 12–15 months, with
the second dose at 4–6 years.
6. A 2-year-old is admitted and insists on choosing their own clothes, becoming upset
when parents help. According to Erikson, this behavior reflects which stage?
A. Autonomy versus shame and doubt
B. Industry versus inferiority
C. Trust versus mistrust
D. Initiative versus guilt
Answer: A – Autonomy versus shame and doubt
Rationale: Toddlers are in the autonomy versus shame and doubt stage, striving for
independence and control.
7. A nurse is assessing a 4-month-old during a well-child visit. Which finding indicates
expected gross motor development?
A. Sits unsupported
B. Holds head steady and erect when held upright
C. Rolls from back to front smoothly
D. Bears weight on legs when held standing
Answer: B – Holds head steady and erect when held upright
Rationale: By 4 months, head control is expected. Sitting unsupported and rolling over occur
later.
8. A nurse is caring for an 8-year-old hospitalized child. According to Erikson, this child is in
which stage?
, 3
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Answer: D – Industry vs. Inferiority
Rationale: School-age children (6–12 years) are in Industry vs. Inferiority, developing
competence through achievements.
9. When assessing an adolescent, which behavior indicates normal progression through
Identity vs. Role Confusion?
A. Dependence on parents for all decisions
B. Experimentation with clothing styles and peer groups
C. Regression to earlier childhood behaviors
D. Complete isolation from peers
Answer: B – Experimentation with clothing styles and peer groups
Rationale: Adolescents normally experiment with roles and appearances as part of identity
formation.
10. A nurse is teaching parents about age-appropriate activities for an 18-month-old.
Which toy is most appropriate?
A. 500-piece puzzle
B. Push-pull toys
C. Board games with simple rules
D. Craft supplies with small beads
Answer: B – Push-pull toys
Rationale: Push-pull toys support gross motor development and encourage walking. Small
pieces pose choking hazards.
11. A nurse is assessing a 5-month-old infant. Which finding should be reported to the
provider?
A. Head lags when pulled from lying to sitting
B. Absence of startle and crawl reflexes
C. Inability to pick up a rattle after dropping it
D. Rolls from back to side
Answer: A – Head lags when pulled from lying to sitting
Rationale: At 5 months, the infant should have no head lag when pulled to sitting. This
finding warrants reporting.
12. A nurse is teaching a parent about peek-a-boo. This game helps develop which
concept?
