HESI RN Pediatrics Exam 2024/2025 – High-Yield Questions
with 100% Correct Answers for Clinical Success
80 High-Yield Questions with Answers and Rationales
Pediatric Growth and Development
Question 1: A nurse is assessing a 6-month-old infant during a well-child visit. Which
developmental milestone is expected at this age?
A. Sits without support
B. Walks independently
C. Speaks two-word phrases
D. Uses a pincer grasp
Correct Answer: A. Sits without support
Rationale: At 6 months, infants typically achieve the milestone of sitting without support.
Walking independently occurs around 12 months, two-word phrases around 24 months,
and the pincer grasp around 9–12 months. This milestone is critical for assessing motor
development.
Reference: Web:6
Question 2: A 3-year-old child is observed throwing temper tantrums during a hospital
visit. The nurse recognizes this as:
A. A sign of developmental delay
B. Normal toddler behavior
C. A symptom of autism spectrum disorder
D. A response to poor parenting
Correct Answer: B. Normal toddler behavior
Rationale: Temper tantrums are common in toddlers (1–3 years) as they develop auton-
omy and struggle with emotional regulation, aligning with Erikson’s stage of autonomy
vs. shame and doubt. This is not indicative of developmental delay, autism, or parenting
issues unless other symptoms are present.
Reference: Web:6
Question 3: A nurse is teaching parents about a 2-year-old’s language development. What
is an expected milestone?
A. Uses 10–20 words
B. Forms 3–4 word sentences
C. Understands complex instructions
D. Reads simple words
Correct Answer: B. Forms 3–4 word sentences
Rationale: By age 2, children typically form short sentences of 3–4 words and have
a vocabulary of about 200–300 words. Using 10–20 words is expected at 18 months,
1
,understanding complex instructions at 4–5 years, and reading simple words is a school-
age milestone.
Reference: Web:16
Question 4: A 5-year-old is expected to perform which self-care task independently?
A. Tie shoelaces
B. Prepare a meal
C. Bathe without supervision
D. Manage homework
Correct Answer: A. Tie shoelaces
Rationale: A 5-year-old, in Erikson’s industry vs. inferiority stage, can typically tie
shoelaces, fostering independence. Preparing meals, bathing without supervision, and
managing homework are more complex tasks expected at older ages.
Reference: Web:6
Question 5: During a well-child visit, a 12-month-old infant does not respond to their
name. The nurse should:
A. Reassure the parents this is normal
B. Recommend immediate speech therapy
C. Assess for hearing or developmental concerns
D. Suggest increasing visual stimulation
Correct Answer: C. Assess for hearing or developmental concerns
Rationale: Responding to one’s name is a milestone expected by 12 months. Failure to do
so may indicate hearing issues or developmental delays, such as autism spectrum disorder,
requiring further assessment. Reassurance or therapy without evaluation is premature.
Reference: Web:16
Pediatric Disease Conditions
Question 6: A 3-year-old post-cardiac catheterization via the right femoral artery has a
cool, pale right foot. This indicates:
A. Normal postoperative finding
B. Arterial obstruction
C. Venous thrombosis
D. Hypovolemia
Correct Answer: B. Arterial obstruction
Rationale: A cool, pale foot post-catheterization suggests arterial obstruction, likely due
to thrombus formation at the catheter site, reducing blood flow. This is a critical finding
requiring immediate intervention. Venous thrombosis would cause swelling, not pallor.
Reference: Web:3, Web:18
Question 7: An infant with tetralogy of Fallot becomes acutely cyanotic and hyperpneic.
The nurse’s first action is:
2
, A. Administer morphine sulfate
B. Start IV fluids
C. Place the infant in a knee-chest position
D. Provide 100% oxygen by face mask
Correct Answer: C. Place the infant in a knee-chest position
Rationale: The knee-chest position increases systemic vascular resistance, reducing right-
to-left shunting in tetralogy of Fallot, improving oxygenation during a cyanotic spell.
Oxygen and morphine may follow, but positioning is the priority.
Reference: Web:3, Web:7
Question 8: A child with diabetic ketoacidosis (DKA) exhibits Kussmaul respirations.
This is a compensatory mechanism for:
A. Metabolic alkalosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic acidosis
Correct Answer: D. Metabolic acidosis
Rationale: Kussmaul respirations (rapid, deep breathing) compensate for metabolic aci-
dosis in DKA by eliminating excess carbon dioxide to reduce blood acidity. This is a
hallmark of DKA due to ketone accumulation.
Reference: Web:3, Web:7
Question 9: A 7-year-old with persistent vomiting has a nasogastric tube on low inter-
mittent suction. The nurse should report:
A. Gastric output of 100 mL in 8 hours
B. IV fluid intake of 640 mL
C. Serum potassium of 3.0 mEq/L
D. Serum pH of 7.45
Correct Answer: C. Serum potassium of 3.0 mEq/L
Rationale: A serum potassium of 3.0 mEq/L indicates hypokalemia, a critical finding
due to vomiting-induced electrolyte loss, requiring immediate reporting. Other findings
are within expected ranges for a child with a nasogastric tube.
Reference: Web:3
Question 10: A child with celiac disease selects which food, indicating effective dietary
teaching?
A. Creamed corn
B. Pancakes
C. Rye crackers
D. Cooked oatmeal
Correct Answer: A. Creamed corn
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with 100% Correct Answers for Clinical Success
80 High-Yield Questions with Answers and Rationales
Pediatric Growth and Development
Question 1: A nurse is assessing a 6-month-old infant during a well-child visit. Which
developmental milestone is expected at this age?
A. Sits without support
B. Walks independently
C. Speaks two-word phrases
D. Uses a pincer grasp
Correct Answer: A. Sits without support
Rationale: At 6 months, infants typically achieve the milestone of sitting without support.
Walking independently occurs around 12 months, two-word phrases around 24 months,
and the pincer grasp around 9–12 months. This milestone is critical for assessing motor
development.
Reference: Web:6
Question 2: A 3-year-old child is observed throwing temper tantrums during a hospital
visit. The nurse recognizes this as:
A. A sign of developmental delay
B. Normal toddler behavior
C. A symptom of autism spectrum disorder
D. A response to poor parenting
Correct Answer: B. Normal toddler behavior
Rationale: Temper tantrums are common in toddlers (1–3 years) as they develop auton-
omy and struggle with emotional regulation, aligning with Erikson’s stage of autonomy
vs. shame and doubt. This is not indicative of developmental delay, autism, or parenting
issues unless other symptoms are present.
Reference: Web:6
Question 3: A nurse is teaching parents about a 2-year-old’s language development. What
is an expected milestone?
A. Uses 10–20 words
B. Forms 3–4 word sentences
C. Understands complex instructions
D. Reads simple words
Correct Answer: B. Forms 3–4 word sentences
Rationale: By age 2, children typically form short sentences of 3–4 words and have
a vocabulary of about 200–300 words. Using 10–20 words is expected at 18 months,
1
,understanding complex instructions at 4–5 years, and reading simple words is a school-
age milestone.
Reference: Web:16
Question 4: A 5-year-old is expected to perform which self-care task independently?
A. Tie shoelaces
B. Prepare a meal
C. Bathe without supervision
D. Manage homework
Correct Answer: A. Tie shoelaces
Rationale: A 5-year-old, in Erikson’s industry vs. inferiority stage, can typically tie
shoelaces, fostering independence. Preparing meals, bathing without supervision, and
managing homework are more complex tasks expected at older ages.
Reference: Web:6
Question 5: During a well-child visit, a 12-month-old infant does not respond to their
name. The nurse should:
A. Reassure the parents this is normal
B. Recommend immediate speech therapy
C. Assess for hearing or developmental concerns
D. Suggest increasing visual stimulation
Correct Answer: C. Assess for hearing or developmental concerns
Rationale: Responding to one’s name is a milestone expected by 12 months. Failure to do
so may indicate hearing issues or developmental delays, such as autism spectrum disorder,
requiring further assessment. Reassurance or therapy without evaluation is premature.
Reference: Web:16
Pediatric Disease Conditions
Question 6: A 3-year-old post-cardiac catheterization via the right femoral artery has a
cool, pale right foot. This indicates:
A. Normal postoperative finding
B. Arterial obstruction
C. Venous thrombosis
D. Hypovolemia
Correct Answer: B. Arterial obstruction
Rationale: A cool, pale foot post-catheterization suggests arterial obstruction, likely due
to thrombus formation at the catheter site, reducing blood flow. This is a critical finding
requiring immediate intervention. Venous thrombosis would cause swelling, not pallor.
Reference: Web:3, Web:18
Question 7: An infant with tetralogy of Fallot becomes acutely cyanotic and hyperpneic.
The nurse’s first action is:
2
, A. Administer morphine sulfate
B. Start IV fluids
C. Place the infant in a knee-chest position
D. Provide 100% oxygen by face mask
Correct Answer: C. Place the infant in a knee-chest position
Rationale: The knee-chest position increases systemic vascular resistance, reducing right-
to-left shunting in tetralogy of Fallot, improving oxygenation during a cyanotic spell.
Oxygen and morphine may follow, but positioning is the priority.
Reference: Web:3, Web:7
Question 8: A child with diabetic ketoacidosis (DKA) exhibits Kussmaul respirations.
This is a compensatory mechanism for:
A. Metabolic alkalosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic acidosis
Correct Answer: D. Metabolic acidosis
Rationale: Kussmaul respirations (rapid, deep breathing) compensate for metabolic aci-
dosis in DKA by eliminating excess carbon dioxide to reduce blood acidity. This is a
hallmark of DKA due to ketone accumulation.
Reference: Web:3, Web:7
Question 9: A 7-year-old with persistent vomiting has a nasogastric tube on low inter-
mittent suction. The nurse should report:
A. Gastric output of 100 mL in 8 hours
B. IV fluid intake of 640 mL
C. Serum potassium of 3.0 mEq/L
D. Serum pH of 7.45
Correct Answer: C. Serum potassium of 3.0 mEq/L
Rationale: A serum potassium of 3.0 mEq/L indicates hypokalemia, a critical finding
due to vomiting-induced electrolyte loss, requiring immediate reporting. Other findings
are within expected ranges for a child with a nasogastric tube.
Reference: Web:3
Question 10: A child with celiac disease selects which food, indicating effective dietary
teaching?
A. Creamed corn
B. Pancakes
C. Rye crackers
D. Cooked oatmeal
Correct Answer: A. Creamed corn
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