1
HESI Pediatrics Exit Exam –
Actual Test Questions and
Verified Correct Answers | A+
Version
Growth and Development
1. A 2-year-old child is assessed for developmental milestones. Which behavior is
expected?
A. Builds a tower of 10 blocks
B. Speaks in 2–3 word sentences
C. Reads simple sentences
D. Rides a bicycle
Rationale: At 2 years, children typically speak in 2–3 word sentences, per developmental
milestones.
2. A 4-year-old is expected to perform which task?
A. Tie shoelaces independently
B. Draw a circle
C. Read a short book
D. Solve simple math problems
Rationale: Drawing a circle is a fine motor skill expected at 4 years, per developmental
milestones.
3. A 6-month-old infant should demonstrate which milestone?
A. Walks independently
B. Sits with support
C. Speaks single words
D. Uses a spoon
Rationale: Sitting with support is a gross motor milestone at 6 months, per
developmental norms.
4. (SATA) Which milestones are expected in a 12-month-old? (Select all that apply)
A. Says “mama” or “dada” specifically
B. Takes a few steps alone
C. Draws a straight line
D. Uses a pincer grasp
E. Rides a tricycle
Rationale: At 12 months, children say specific words, take steps, and use a pincer grasp.
Drawing lines and riding tricycles occur later, per developmental milestones.
, 2
5. A 5-year-old child is unable to hop on one foot. What should the nurse do?
A. Refer to a specialist
B. Assess further and monitor development
C. Document as normal
D. Recommend physical therapy immediately
Rationale: Hopping on one foot is expected by 5 years; inability warrants further
assessment, per developmental evaluation.
6. A 3-year-old refuses to share toys. What should the nurse tell the parents?
A. This indicates a developmental delay
B. This is typical for this age
C. Enroll the child in therapy
D. Discipline the child immediately
Rationale: Egocentrism and difficulty sharing are normal at 3 years, per psychosocial
development.
7. A 9-month-old is assessed for object permanence. Which behavior indicates this
milestone?
A. Ignores hidden toys
B. Looks for a toy hidden under a blanket
C. Says the toy’s name
D. Points to the toy’s location
Rationale: Looking for hidden objects demonstrates object permanence, achieved by 9
months, per cognitive development.
8. A 7-year-old is expected to demonstrate which cognitive skill?
A. Abstract reasoning
B. Conservation of volume
C. Complex problem-solving
D. Symbolic play
Rationale: Conservation of volume is a concrete operational skill achieved by 7 years,
per Piaget’s developmental stages.
9. A 15-month-old does not walk independently. What should the nurse do?
A. Document as normal
B. Refer for developmental evaluation
C. Encourage more playtime
D. Ignore the finding
Rationale: Independent walking is expected by 15 months; delay requires evaluation, per
developmental milestones.
10. A 4-year-old engages in parallel play. Is this appropriate?
A. No, it indicates social delay
B. Yes, it is age-appropriate
C. No, cooperative play is expected
D. Yes, but only in groups
Rationale: Parallel play is typical at 4 years, transitioning to cooperative play later, per
social development.
Pediatric Disease Processes
, 3
11. A 6-year-old with asthma has wheezing and dyspnea. What is the nurse’s priority?
A. Administer oxygen at 6 L/min
B. Administer prescribed albuterol
C. Encourage fluid restriction
D. Place in a supine position
Rationale: Albuterol, a bronchodilator, relieves acute asthma symptoms, per asthma
management guidelines.
12. A 2-year-old with fever and rash is diagnosed with roseola. What should the nurse
expect?
A. Rash persists for weeks
B. Fever resolves before rash appears
C. Severe respiratory distress
D. Rash precedes fever
Rationale: Roseola is characterized by high fever followed by a rash after fever
resolution, per pediatric infectious disease.
13. A 10-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. Monitor for 30 minutes
D. Restrict fluids
Rationale: Hypoglycemia (blood glucose <70 mg/dL) requires fast-acting carbohydrates
to raise glucose levels, per diabetes management.
14. (SATA) Which symptoms indicate dehydration in a 3-year-old with gastroenteritis?
(Select all that apply)
A. Dry mucous membranes
B. Decreased urine output
C. Increased appetite
D. Sunken fontanelles
E. Weight gain
Rationale: Dry mucous membranes, decreased urine output, and sunken fontanelles
indicate dehydration. Increased appetite and weight gain are not associated, per fluid and
electrolyte management.
15. A 5-year-old with sickle cell disease has leg pain and fever. What is the nurse’s priority?
A. Administer antibiotics
B. Notify the provider immediately
C. Encourage ambulation
D. Apply cold packs
Rationale: Leg pain and fever suggest a sickle cell crisis, requiring urgent provider
evaluation, per hematologic disease management.
16. A 1-year-old with otitis media is prescribed amoxicillin. What should the nurse monitor?
A. Hyperglycemia
B. Allergic reaction
C. Hypertension
D. Sedation
HESI Pediatrics Exit Exam –
Actual Test Questions and
Verified Correct Answers | A+
Version
Growth and Development
1. A 2-year-old child is assessed for developmental milestones. Which behavior is
expected?
A. Builds a tower of 10 blocks
B. Speaks in 2–3 word sentences
C. Reads simple sentences
D. Rides a bicycle
Rationale: At 2 years, children typically speak in 2–3 word sentences, per developmental
milestones.
2. A 4-year-old is expected to perform which task?
A. Tie shoelaces independently
B. Draw a circle
C. Read a short book
D. Solve simple math problems
Rationale: Drawing a circle is a fine motor skill expected at 4 years, per developmental
milestones.
3. A 6-month-old infant should demonstrate which milestone?
A. Walks independently
B. Sits with support
C. Speaks single words
D. Uses a spoon
Rationale: Sitting with support is a gross motor milestone at 6 months, per
developmental norms.
4. (SATA) Which milestones are expected in a 12-month-old? (Select all that apply)
A. Says “mama” or “dada” specifically
B. Takes a few steps alone
C. Draws a straight line
D. Uses a pincer grasp
E. Rides a tricycle
Rationale: At 12 months, children say specific words, take steps, and use a pincer grasp.
Drawing lines and riding tricycles occur later, per developmental milestones.
, 2
5. A 5-year-old child is unable to hop on one foot. What should the nurse do?
A. Refer to a specialist
B. Assess further and monitor development
C. Document as normal
D. Recommend physical therapy immediately
Rationale: Hopping on one foot is expected by 5 years; inability warrants further
assessment, per developmental evaluation.
6. A 3-year-old refuses to share toys. What should the nurse tell the parents?
A. This indicates a developmental delay
B. This is typical for this age
C. Enroll the child in therapy
D. Discipline the child immediately
Rationale: Egocentrism and difficulty sharing are normal at 3 years, per psychosocial
development.
7. A 9-month-old is assessed for object permanence. Which behavior indicates this
milestone?
A. Ignores hidden toys
B. Looks for a toy hidden under a blanket
C. Says the toy’s name
D. Points to the toy’s location
Rationale: Looking for hidden objects demonstrates object permanence, achieved by 9
months, per cognitive development.
8. A 7-year-old is expected to demonstrate which cognitive skill?
A. Abstract reasoning
B. Conservation of volume
C. Complex problem-solving
D. Symbolic play
Rationale: Conservation of volume is a concrete operational skill achieved by 7 years,
per Piaget’s developmental stages.
9. A 15-month-old does not walk independently. What should the nurse do?
A. Document as normal
B. Refer for developmental evaluation
C. Encourage more playtime
D. Ignore the finding
Rationale: Independent walking is expected by 15 months; delay requires evaluation, per
developmental milestones.
10. A 4-year-old engages in parallel play. Is this appropriate?
A. No, it indicates social delay
B. Yes, it is age-appropriate
C. No, cooperative play is expected
D. Yes, but only in groups
Rationale: Parallel play is typical at 4 years, transitioning to cooperative play later, per
social development.
Pediatric Disease Processes
, 3
11. A 6-year-old with asthma has wheezing and dyspnea. What is the nurse’s priority?
A. Administer oxygen at 6 L/min
B. Administer prescribed albuterol
C. Encourage fluid restriction
D. Place in a supine position
Rationale: Albuterol, a bronchodilator, relieves acute asthma symptoms, per asthma
management guidelines.
12. A 2-year-old with fever and rash is diagnosed with roseola. What should the nurse
expect?
A. Rash persists for weeks
B. Fever resolves before rash appears
C. Severe respiratory distress
D. Rash precedes fever
Rationale: Roseola is characterized by high fever followed by a rash after fever
resolution, per pediatric infectious disease.
13. A 10-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. Monitor for 30 minutes
D. Restrict fluids
Rationale: Hypoglycemia (blood glucose <70 mg/dL) requires fast-acting carbohydrates
to raise glucose levels, per diabetes management.
14. (SATA) Which symptoms indicate dehydration in a 3-year-old with gastroenteritis?
(Select all that apply)
A. Dry mucous membranes
B. Decreased urine output
C. Increased appetite
D. Sunken fontanelles
E. Weight gain
Rationale: Dry mucous membranes, decreased urine output, and sunken fontanelles
indicate dehydration. Increased appetite and weight gain are not associated, per fluid and
electrolyte management.
15. A 5-year-old with sickle cell disease has leg pain and fever. What is the nurse’s priority?
A. Administer antibiotics
B. Notify the provider immediately
C. Encourage ambulation
D. Apply cold packs
Rationale: Leg pain and fever suggest a sickle cell crisis, requiring urgent provider
evaluation, per hematologic disease management.
16. A 1-year-old with otitis media is prescribed amoxicillin. What should the nurse monitor?
A. Hyperglycemia
B. Allergic reaction
C. Hypertension
D. Sedation
