HESI Pediatrics Exam 2025/2026 –
correct Verified Questions with
Rationales
Growth and Development (Questions 1-12)
Question 1: A 6-month-old infant is at a well-child visit. The nurse assesses the infant's
development and notes that the infant can sit without support and transfers objects from hand to
hand. Which milestone is this infant most likely to achieve next?
A. Says "mama" and "dada" nonspecifically
B. Pulls to a standing position
C. Rolls from back to front
D. Bears weight on legs when supported
Correct answer: B
Rationale: At 6 months, infants typically sit without support and transfer objects. The next gross
motor milestone is pulling to stand around 7-9 months, preceding walking. Option A is language
(9-12 months), C is earlier (4-6 months), and D is concurrent but not sequential.
Question 2: A 2-year-old toddler is evaluated for developmental delay. The parent reports the
child can run, climb stairs with alternating feet, and builds a tower of 6 blocks. However, the
child does not speak in 2-word sentences. What is the most appropriate initial action?
A. Refer for speech therapy evaluation
B. Reassure that language delays resolve spontaneously
C. Order a hearing test
D. Prescribe speech-stimulating activities
Correct answer: C
Rationale: By 2 years, children should use 2-word sentences. Hearing impairment must be
ruled out first as a common reversible cause of language delay before assuming developmental
delay. Options A and D follow confirmation, and B is inappropriate without assessment.
Question 3: During a routine checkup, a 4-month-old infant demonstrates the ability to reach for
a rattle and bring it to the mouth. The nurse recognizes this as development in which domain?
A. Gross motor
B. Fine motor
C. Cognitive
,D. Social-emotional
Correct answer: B
Rationale: Reaching and grasping a rattle involves fine motor skills (hand-eye coordination).
Gross motor would be rolling or kicking; cognitive involves problem-solving; social-emotional
includes smiling responsively.
Question 4: A 9-month-old infant is brought to the clinic. The parent states the infant says
"dada" specifically and waves "bye-bye." What immunization or developmental concern should
the nurse prioritize?
A. Assess for stranger anxiety onset
B. Screen for autism spectrum disorder
C. Ensure DTaP vaccine is up to date
D. Evaluate for iron deficiency anemia
Correct answer: A
Rationale: At 9 months, stranger anxiety typically emerges alongside specific words like "dada"
and gestures like waving. This is a normal social-emotional milestone. B is premature without
red flags; C is routine but not priority here; D relates to feeding but not directly to these
behaviors.
Question 5: A 3-year-old child is in the preschool screening. The child can hop on one foot,
copy a circle, and recount a simple story. Which theory best explains this parallel development?
A. Freud's psychosexual stages
B. Erikson's psychosocial stages
C. Piaget's preoperational stage
D. Vygotsky's zone of proximal development
Correct answer: C
Rationale: At 3 years, children enter Piaget's preoperational stage, marked by symbolic play,
drawing shapes like circles, and narrative skills. Freud focuses on oral/anal; Erikson on initiative
vs. guilt; Vygotsky on social learning.
Question 6: A newborn is assessed using the Apgar score at 1 minute: heart rate 140,
respiratory effort good, muscle tone active, reflex irritability strong cry, color pink. What is the
total score?
A. 7
B. 8
C. 9
D. 10
, Correct answer: D
Rationale: Apgar scoring: HR (2), respiration (2), tone (2), reflexes (2), color (2) = 10/10,
indicating excellent adaptation. Scores <7 suggest need for intervention.
Question 7: A 15-month-old toddler weighs 22 lbs (10 kg), which is below the 5th percentile for
age. The child has achieved all motor milestones. What is the most likely cause?
A. Failure to thrive due to neglect
B. Constitutional growth delay
C. Celiac disease
D. Hypothyroidism
Correct answer: B
Rationale: Normal milestones with low weight suggest constitutional delay (familial short stature
pattern). A requires social history; C/D need labs (e.g., anti-tTG, TSH) if persistent.
Question 8: In assessing a 5-year-old's development, the nurse observes the child can dress
independently, skip on alternate feet, and understands concepts like "yesterday" and
"tomorrow." This aligns with which age-appropriate expectation?
A. School readiness
B. Parallel play dominance
C. Egocentrism peak
D. Separation anxiety resolution
Correct answer: A
Rationale: At 5 years, children achieve school readiness skills in self-care, gross/fine motor,
and time concepts. B is 2-3 years; C is preoperational (2-7 years) but not peak; D resolves by 3
years.
Question 9: A 10-month-old infant is starting to crawl and says "ba-ba." The parent asks when
the infant will walk. What is the nurse's best response?
A. "Most infants walk by 18 months."
B. "Expect walking in the next month."
C. "Delay indicates cerebral palsy."
D. "Walking is not a milestone concern."
Correct answer: A
Rationale: Independent walking occurs by 12-18 months; 10 months is early for concern. B is
premature; C unfounded without other signs; D incorrect as it is a key milestone.
correct Verified Questions with
Rationales
Growth and Development (Questions 1-12)
Question 1: A 6-month-old infant is at a well-child visit. The nurse assesses the infant's
development and notes that the infant can sit without support and transfers objects from hand to
hand. Which milestone is this infant most likely to achieve next?
A. Says "mama" and "dada" nonspecifically
B. Pulls to a standing position
C. Rolls from back to front
D. Bears weight on legs when supported
Correct answer: B
Rationale: At 6 months, infants typically sit without support and transfer objects. The next gross
motor milestone is pulling to stand around 7-9 months, preceding walking. Option A is language
(9-12 months), C is earlier (4-6 months), and D is concurrent but not sequential.
Question 2: A 2-year-old toddler is evaluated for developmental delay. The parent reports the
child can run, climb stairs with alternating feet, and builds a tower of 6 blocks. However, the
child does not speak in 2-word sentences. What is the most appropriate initial action?
A. Refer for speech therapy evaluation
B. Reassure that language delays resolve spontaneously
C. Order a hearing test
D. Prescribe speech-stimulating activities
Correct answer: C
Rationale: By 2 years, children should use 2-word sentences. Hearing impairment must be
ruled out first as a common reversible cause of language delay before assuming developmental
delay. Options A and D follow confirmation, and B is inappropriate without assessment.
Question 3: During a routine checkup, a 4-month-old infant demonstrates the ability to reach for
a rattle and bring it to the mouth. The nurse recognizes this as development in which domain?
A. Gross motor
B. Fine motor
C. Cognitive
,D. Social-emotional
Correct answer: B
Rationale: Reaching and grasping a rattle involves fine motor skills (hand-eye coordination).
Gross motor would be rolling or kicking; cognitive involves problem-solving; social-emotional
includes smiling responsively.
Question 4: A 9-month-old infant is brought to the clinic. The parent states the infant says
"dada" specifically and waves "bye-bye." What immunization or developmental concern should
the nurse prioritize?
A. Assess for stranger anxiety onset
B. Screen for autism spectrum disorder
C. Ensure DTaP vaccine is up to date
D. Evaluate for iron deficiency anemia
Correct answer: A
Rationale: At 9 months, stranger anxiety typically emerges alongside specific words like "dada"
and gestures like waving. This is a normal social-emotional milestone. B is premature without
red flags; C is routine but not priority here; D relates to feeding but not directly to these
behaviors.
Question 5: A 3-year-old child is in the preschool screening. The child can hop on one foot,
copy a circle, and recount a simple story. Which theory best explains this parallel development?
A. Freud's psychosexual stages
B. Erikson's psychosocial stages
C. Piaget's preoperational stage
D. Vygotsky's zone of proximal development
Correct answer: C
Rationale: At 3 years, children enter Piaget's preoperational stage, marked by symbolic play,
drawing shapes like circles, and narrative skills. Freud focuses on oral/anal; Erikson on initiative
vs. guilt; Vygotsky on social learning.
Question 6: A newborn is assessed using the Apgar score at 1 minute: heart rate 140,
respiratory effort good, muscle tone active, reflex irritability strong cry, color pink. What is the
total score?
A. 7
B. 8
C. 9
D. 10
, Correct answer: D
Rationale: Apgar scoring: HR (2), respiration (2), tone (2), reflexes (2), color (2) = 10/10,
indicating excellent adaptation. Scores <7 suggest need for intervention.
Question 7: A 15-month-old toddler weighs 22 lbs (10 kg), which is below the 5th percentile for
age. The child has achieved all motor milestones. What is the most likely cause?
A. Failure to thrive due to neglect
B. Constitutional growth delay
C. Celiac disease
D. Hypothyroidism
Correct answer: B
Rationale: Normal milestones with low weight suggest constitutional delay (familial short stature
pattern). A requires social history; C/D need labs (e.g., anti-tTG, TSH) if persistent.
Question 8: In assessing a 5-year-old's development, the nurse observes the child can dress
independently, skip on alternate feet, and understands concepts like "yesterday" and
"tomorrow." This aligns with which age-appropriate expectation?
A. School readiness
B. Parallel play dominance
C. Egocentrism peak
D. Separation anxiety resolution
Correct answer: A
Rationale: At 5 years, children achieve school readiness skills in self-care, gross/fine motor,
and time concepts. B is 2-3 years; C is preoperational (2-7 years) but not peak; D resolves by 3
years.
Question 9: A 10-month-old infant is starting to crawl and says "ba-ba." The parent asks when
the infant will walk. What is the nurse's best response?
A. "Most infants walk by 18 months."
B. "Expect walking in the next month."
C. "Delay indicates cerebral palsy."
D. "Walking is not a milestone concern."
Correct answer: A
Rationale: Independent walking occurs by 12-18 months; 10 months is early for concern. B is
premature; C unfounded without other signs; D incorrect as it is a key milestone.
