1
2025/2026 HESI RN Pediatric
Exam Version 1 & Version 2 –
Actual Questions and Correct
Answers | A+ Verified
HESI RN Pediatric Exam – Version 1 (75 Questions)
Question 1
A nurse is assessing a 4-year-old child’s developmental milestones. Which behavior is expected
at this age?
A) Ties shoelaces independently
B) Reads simple sentences
C) Draws a recognizable person with three parts
D) Performs complex addition
Rationale: A 4-year-old can draw a person with at least three parts (e.g., head, body, legs), per
developmental milestones. Tying shoelaces and reading are typical of older children. [Ref:
Growth and Development, Preschool]
Question 2
A 6-month-old infant presents with dehydration due to vomiting. Which assessment finding is
most concerning?
A) Dry lips
B) Irritability
C) Sunken fontanels
D) Decreased urine output
Rationale: Sunken fontanels in an infant indicate severe dehydration, a critical finding requiring
immediate intervention. Other signs are concerning but less specific. [Ref: Pediatric
Emergencies, Dehydration]
Question 3
A nurse is teaching parents about administering acetaminophen to their 2-year-old. What is the
priority instruction?
, 2
A) Give with a high-fat meal
B) Use a weight-based dose
C) Administer every 2 hours
D) Mix with juice for taste
Rationale: Acetaminophen dosing in children is weight-based (10–15 mg/kg) to ensure safety
and efficacy. Incorrect dosing risks toxicity or under-treatment. [Ref: Medications, Pediatric
Dosing]
Question 4
A parent asks how to communicate with their 3-year-old about a hospital stay. What should the
nurse recommend?
A) Use complex medical terms
B) Avoid discussing the hospital
C) Use simple, concrete explanations
D) Tell the child it’s a vacation
Rationale: Simple, concrete explanations match a 3-year-old’s cognitive level, reducing fear and
confusion. Complex terms or avoidance are inappropriate. [Ref: Communication with Family]
Question 5
A 10-year-old with asthma experiences an acute exacerbation. Which medication should the
nurse administer first?
A) Prednisone
B) Albuterol
C) Montelukast
D) Fluticasone
Rationale: Albuterol, a short-acting beta-agonist, is the first-line treatment for acute asthma
exacerbations to relieve bronchospasm. [Ref: Pediatric Emergencies, Asthma]
Question 6
A nurse is assessing a 2-year-old’s growth. Which measurement is most indicative of nutritional
status?
A) Head circumference
B) Weight-for-age
C) Chest circumference
D) Mid-arm circumference
Rationale: Weight-for-age reflects nutritional status and growth trends in toddlers, unlike head
or chest measurements. [Ref: Growth and Development, Toddler]
Question 7
A 5-year-old with a fever of 102°F is prescribed ibuprofen. What is the nurse’s priority action?
A) Administer with milk
, 3
B) Check the child’s weight
C) Give a double dose for high fever
D) Monitor for rash after 24 hours
Rationale: Ibuprofen dosing is weight-based (5–10 mg/kg), so checking weight ensures accurate
administration. Double dosing risks toxicity. [Ref: Medications, Pediatric Dosing]
Question 8
A parent reports their 8-year-old has a persistent cough after choking on food. What should the
nurse suspect?
A) Allergic reaction
B) Asthma
C) Foreign body aspiration
D) Pneumonia
Rationale: A persistent cough after choking suggests foreign body aspiration, a pediatric
emergency requiring immediate evaluation. [Ref: Pediatric Emergencies, Airway Obstruction]
Question 9
A nurse is teaching parents about safety for their 1-year-old. Which recommendation is most
appropriate?
A) Allow small toys for play
B) Secure cabinet locks
C) Keep medicines on a low shelf
D) Use a front-facing car seat
Rationale: Cabinet locks prevent access to hazardous items, a key safety measure for a 1-year-
old. Small toys and low shelves pose risks. [Ref: Growth and Development, Safety]
Question 10
A 12-year-old with type 1 diabetes has a blood glucose of 50 mg/dL. What is the nurse’s first
action?
A) Administer insulin
B) Give 15 g of fast-acting carbohydrate
C) Encourage exercise
D) Monitor for 30 minutes
Rationale: A blood glucose of 50 mg/dL indicates hypoglycemia; 15 g of fast-acting
carbohydrate (e.g., juice) is the first-line treatment. [Ref: Pediatric Emergencies, Hypoglycemia]
Question 11
A 3-year-old is admitted with croup. Which symptom requires immediate intervention?
A) Hoarse voice
B) Barking cough
C) Stridor at rest
, 4
D) Low-grade fever
Rationale: Stridor at rest indicates severe airway obstruction in croup, requiring urgent treatment
to prevent respiratory distress. [Ref: Pediatric Emergencies, Croup]
Question 12
A nurse is discussing immunizations with a parent of a 6-month-old. Which vaccine is due at this
age?
A) MMR
B) DTaP
C) Varicella
D) HPV
Rationale: The DTaP vaccine is scheduled at 6 months, per CDC guidelines, to protect against
diphtheria, tetanus, and pertussis. [Ref: Growth and Development, Immunizations]
Question 13
A 7-year-old with a fracture is prescribed codeine for pain. What is the nurse’s priority teaching?
A) Take with a high-fiber meal
B) Monitor for respiratory depression
C) Expect increased alertness
D) Administer every 2 hours
Rationale: Codeine, an opioid, risks respiratory depression in children, requiring close
monitoring. [Ref: Medications, Opioid Safety]
Question 14
A parent asks how to help their 5-year-old cope with a sibling’s hospitalization. What should the
nurse suggest?
A) Avoid discussing the sibling
B) Encourage drawing or play to express feelings
C) Tell the child it’s temporary
D) Limit family visits
Rationale: Drawing or play allows a 5-year-old to express emotions age-appropriately,
supporting coping. [Ref: Communication with Family]
Question 15
A 9-year-old with epilepsy has a seizure lasting 6 minutes. What is the nurse’s priority action?
A) Administer oral phenytoin
B) Restrain the child
C) Administer lorazepam IV
D) Place a tongue depressor
Rationale: Seizures lasting over 5 minutes (status epilepticus) require IV lorazepam to stop the
seizure and prevent complications. [Ref: Pediatric Emergencies, Seizures]
2025/2026 HESI RN Pediatric
Exam Version 1 & Version 2 –
Actual Questions and Correct
Answers | A+ Verified
HESI RN Pediatric Exam – Version 1 (75 Questions)
Question 1
A nurse is assessing a 4-year-old child’s developmental milestones. Which behavior is expected
at this age?
A) Ties shoelaces independently
B) Reads simple sentences
C) Draws a recognizable person with three parts
D) Performs complex addition
Rationale: A 4-year-old can draw a person with at least three parts (e.g., head, body, legs), per
developmental milestones. Tying shoelaces and reading are typical of older children. [Ref:
Growth and Development, Preschool]
Question 2
A 6-month-old infant presents with dehydration due to vomiting. Which assessment finding is
most concerning?
A) Dry lips
B) Irritability
C) Sunken fontanels
D) Decreased urine output
Rationale: Sunken fontanels in an infant indicate severe dehydration, a critical finding requiring
immediate intervention. Other signs are concerning but less specific. [Ref: Pediatric
Emergencies, Dehydration]
Question 3
A nurse is teaching parents about administering acetaminophen to their 2-year-old. What is the
priority instruction?
, 2
A) Give with a high-fat meal
B) Use a weight-based dose
C) Administer every 2 hours
D) Mix with juice for taste
Rationale: Acetaminophen dosing in children is weight-based (10–15 mg/kg) to ensure safety
and efficacy. Incorrect dosing risks toxicity or under-treatment. [Ref: Medications, Pediatric
Dosing]
Question 4
A parent asks how to communicate with their 3-year-old about a hospital stay. What should the
nurse recommend?
A) Use complex medical terms
B) Avoid discussing the hospital
C) Use simple, concrete explanations
D) Tell the child it’s a vacation
Rationale: Simple, concrete explanations match a 3-year-old’s cognitive level, reducing fear and
confusion. Complex terms or avoidance are inappropriate. [Ref: Communication with Family]
Question 5
A 10-year-old with asthma experiences an acute exacerbation. Which medication should the
nurse administer first?
A) Prednisone
B) Albuterol
C) Montelukast
D) Fluticasone
Rationale: Albuterol, a short-acting beta-agonist, is the first-line treatment for acute asthma
exacerbations to relieve bronchospasm. [Ref: Pediatric Emergencies, Asthma]
Question 6
A nurse is assessing a 2-year-old’s growth. Which measurement is most indicative of nutritional
status?
A) Head circumference
B) Weight-for-age
C) Chest circumference
D) Mid-arm circumference
Rationale: Weight-for-age reflects nutritional status and growth trends in toddlers, unlike head
or chest measurements. [Ref: Growth and Development, Toddler]
Question 7
A 5-year-old with a fever of 102°F is prescribed ibuprofen. What is the nurse’s priority action?
A) Administer with milk
, 3
B) Check the child’s weight
C) Give a double dose for high fever
D) Monitor for rash after 24 hours
Rationale: Ibuprofen dosing is weight-based (5–10 mg/kg), so checking weight ensures accurate
administration. Double dosing risks toxicity. [Ref: Medications, Pediatric Dosing]
Question 8
A parent reports their 8-year-old has a persistent cough after choking on food. What should the
nurse suspect?
A) Allergic reaction
B) Asthma
C) Foreign body aspiration
D) Pneumonia
Rationale: A persistent cough after choking suggests foreign body aspiration, a pediatric
emergency requiring immediate evaluation. [Ref: Pediatric Emergencies, Airway Obstruction]
Question 9
A nurse is teaching parents about safety for their 1-year-old. Which recommendation is most
appropriate?
A) Allow small toys for play
B) Secure cabinet locks
C) Keep medicines on a low shelf
D) Use a front-facing car seat
Rationale: Cabinet locks prevent access to hazardous items, a key safety measure for a 1-year-
old. Small toys and low shelves pose risks. [Ref: Growth and Development, Safety]
Question 10
A 12-year-old with type 1 diabetes has a blood glucose of 50 mg/dL. What is the nurse’s first
action?
A) Administer insulin
B) Give 15 g of fast-acting carbohydrate
C) Encourage exercise
D) Monitor for 30 minutes
Rationale: A blood glucose of 50 mg/dL indicates hypoglycemia; 15 g of fast-acting
carbohydrate (e.g., juice) is the first-line treatment. [Ref: Pediatric Emergencies, Hypoglycemia]
Question 11
A 3-year-old is admitted with croup. Which symptom requires immediate intervention?
A) Hoarse voice
B) Barking cough
C) Stridor at rest
, 4
D) Low-grade fever
Rationale: Stridor at rest indicates severe airway obstruction in croup, requiring urgent treatment
to prevent respiratory distress. [Ref: Pediatric Emergencies, Croup]
Question 12
A nurse is discussing immunizations with a parent of a 6-month-old. Which vaccine is due at this
age?
A) MMR
B) DTaP
C) Varicella
D) HPV
Rationale: The DTaP vaccine is scheduled at 6 months, per CDC guidelines, to protect against
diphtheria, tetanus, and pertussis. [Ref: Growth and Development, Immunizations]
Question 13
A 7-year-old with a fracture is prescribed codeine for pain. What is the nurse’s priority teaching?
A) Take with a high-fiber meal
B) Monitor for respiratory depression
C) Expect increased alertness
D) Administer every 2 hours
Rationale: Codeine, an opioid, risks respiratory depression in children, requiring close
monitoring. [Ref: Medications, Opioid Safety]
Question 14
A parent asks how to help their 5-year-old cope with a sibling’s hospitalization. What should the
nurse suggest?
A) Avoid discussing the sibling
B) Encourage drawing or play to express feelings
C) Tell the child it’s temporary
D) Limit family visits
Rationale: Drawing or play allows a 5-year-old to express emotions age-appropriately,
supporting coping. [Ref: Communication with Family]
Question 15
A 9-year-old with epilepsy has a seizure lasting 6 minutes. What is the nurse’s priority action?
A) Administer oral phenytoin
B) Restrain the child
C) Administer lorazepam IV
D) Place a tongue depressor
Rationale: Seizures lasting over 5 minutes (status epilepticus) require IV lorazepam to stop the
seizure and prevent complications. [Ref: Pediatric Emergencies, Seizures]
