1
HESI RN Pediatrics Actual Exam 2026/2027 Questions
and All Correct Answers | 100% Solved with
Comprehensive Rationales | Complete Questions and
Answers | Pass Guaranteed - A+ Graded
SECTION 1: GROWTH & DEVELOPMENT (15 Questions)
Q1: A nurse is assessing a 6-month-old infant during a well-child visit. Which developmental
milestone would the nurse expect to observe?
A. The infant walks while holding onto furniture
B. The infant transfers objects from hand to hand
C. The infant builds a tower of two cubes
D. The infant uses a pincer grasp to pick up small objects
Correct Answer: B
Rationale: By 6 months, infants typically transfer objects from hand to hand, demonstrating
developing bilateral coordination. Option A (cruising) occurs around 9-10 months. Option C
(tower building) appears at 15 months. Option D (pincer grasp) develops around 9-10 months.
Understanding these milestones is critical for early identification of developmental delays.
Q2: According to Erikson's psychosocial development theory, which developmental crisis is
most relevant for a hospitalized 4-year-old child?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Correct Answer: C
Rationale: The preschool years (3-6 years) center on Initiative vs. Guilt. Children seek to initiate
activities and assert control. Hospitalization threatens this initiative, potentially causing guilt
about being "bad" and needing punishment. Option A (infancy), B (toddlerhood), and D (school
age) represent incorrect developmental stages for this age group.
Q3: A nurse is educating parents of a 2-year-old about appropriate toys. Which toy
recommendation demonstrates the best understanding of Piaget's cognitive development?
,2
A. A board game with complex rules
B. A set of nesting cups and simple shape sorters
C. A chemistry set for beginners
D. A jigsaw puzzle with 50 pieces
Correct Answer: B
Rationale: Two-year-olds are in Piaget's sensorimotor (transitioning to preoperational) stage,
requiring toys that explore object permanence, causality, and simple problem-solving. Nesting
cups and shape sorters support cognitive development through tactile exploration. Option A
requires concrete operational thinking (age 7+). Option C is unsafe and developmentally
inappropriate. Option D exceeds fine motor capabilities.
Q4: Using the CDC growth chart below, a nurse plots a 12-month-old female infant's
measurements: Weight = 8.5 kg (10th percentile), Length = 72 cm (50th percentile), Head
circumference = 44 cm (25th percentile). What is the nurse's priority assessment?
Table
Percentile Weight (kg) Length (cm) Head Circumference (cm)
3rd 7.0 67 42
10th 8.5 70 43.5
25th 9.2 72 44.5
50th 10.2 74 46
75th 11.3 76 47
A. Normal growth pattern; continue routine monitoring
B. Possible failure to thrive; investigate nutritional intake
C. Disproportionate growth; assess for genetic syndrome
D. Macrocephaly; evaluate for hydrocephalus
Correct Answer: B
Rationale: The infant shows weight at 10th percentile while length is at 50th percentile,
indicating wasting or inadequate weight gain relative to length—classic signs of failure to thrive.
,3
This disproportion warrants immediate nutritional assessment. Option A is unsafe as it ignores
the significant weight-length discrepancy. Option C would show more extreme disproportion.
Option D is incorrect as head circumference is normal.
Q5: A nurse is caring for a hospitalized 8-year-old. Based on cognitive development, which
nursing intervention is most appropriate?
A. Provide detailed explanations of disease pathology using medical terminology
B. Allow the child to handle equipment and participate in care decisions
C. Use simple, concrete explanations without offering choices
D. Focus exclusively on parental education as the child cannot understand
Correct Answer: B
Rationale: School-age children (6-12 years) are in Piaget's concrete operational stage, capable of
logical thought about concrete objects. They benefit from participation, hands-on learning, and
limited choices that foster industry and control. Option A exceeds their abstract thinking
capacity. Option C underestimates their abilities. Option D violates family-centered care
principles and developmental needs.
Q6: A nurse assesses a 3-month-old infant. Which finding requires immediate follow-up?
A. The infant smiles responsively to mother's face
B. The infant does not yet reach for objects
C. The infant fails to fixate on and follow a moving toy
D. The infant has a strong Moro reflex
Correct Answer: C
Rationale: By 3 months, infants should demonstrate visual tracking (fixating and following
objects 180 degrees). Failure to do so suggests possible visual impairment or neurological
dysfunction requiring immediate evaluation. Option A (social smile) typically appears by 2
months and is normal. Option B is expected as reaching begins around 4 months. Option D is
normal in infants under 4-6 months.
Q7: During a well-child visit, parents of a 15-month-old express concern that their child says
only three words. Which response by the nurse is most appropriate?
A. "This indicates a significant language delay requiring immediate speech therapy referral"
B. "Most 15-month-olds have a vocabulary of 3-5 words, so this is within normal limits"
C. "Your child should have at least 50 words by now; this is concerning"
D. "Boys typically develop language slower than girls, so this is expected"
, 4
Correct Answer: B
Rationale: Normal language development at 15 months includes 3-5 words in addition to jargon
and pointing. This child's vocabulary falls within expected parameters. Option A creates
unnecessary alarm. Option C describes 24-month milestones. Option D perpetuates an inaccurate
stereotype and provides false reassurance without proper assessment.
Q8: A nurse is teaching parents about toilet training readiness. Which indicator suggests a child
is NOT yet ready for toilet training?
A. The child can pull pants up and down independently
B. The child shows interest when parents use the toilet
C. The child has bowel movements at predictable times
D. The child is 18 months old and walks steadily
Correct Answer: D
Rationale: While 18-month-olds may show physical readiness, successful toilet training requires
physiological maturity (sphincter control), cognitive understanding, and emotional readiness
typically achieved between 24-36 months. Age alone is insufficient; forcing training too early
leads to power struggles and regression. Options A, B, and C are valid readiness indicators per
the Brazelton child-oriented approach.
Q9: A school nurse is conducting scoliosis screening. At what age does idiopathic scoliosis most
commonly appear, requiring focused assessment?
A. 2-4 years (infantile)
B. 5-8 years (juvenile)
C. 10-14 years (adolescent)
D. 16-18 years (late adolescent)
Correct Answer: C
Rationale: Adolescent idiopathic scoliosis (AIS) accounts for 80% of cases, typically emerging
during the growth spurt (10-14 years in girls, 12-16 years in boys). This coincides with Tanner
stages 2-3 and requires annual screening during these years. Option A represents only 1% of
cases. Option B represents 10-15%. Option D is past the typical onset window.
Q10: A nurse is assessing a 9-month-old. Which fine motor skill demonstrates appropriate
development?
A. Scribbling with a crayon
B. Using a mature pincer grasp
HESI RN Pediatrics Actual Exam 2026/2027 Questions
and All Correct Answers | 100% Solved with
Comprehensive Rationales | Complete Questions and
Answers | Pass Guaranteed - A+ Graded
SECTION 1: GROWTH & DEVELOPMENT (15 Questions)
Q1: A nurse is assessing a 6-month-old infant during a well-child visit. Which developmental
milestone would the nurse expect to observe?
A. The infant walks while holding onto furniture
B. The infant transfers objects from hand to hand
C. The infant builds a tower of two cubes
D. The infant uses a pincer grasp to pick up small objects
Correct Answer: B
Rationale: By 6 months, infants typically transfer objects from hand to hand, demonstrating
developing bilateral coordination. Option A (cruising) occurs around 9-10 months. Option C
(tower building) appears at 15 months. Option D (pincer grasp) develops around 9-10 months.
Understanding these milestones is critical for early identification of developmental delays.
Q2: According to Erikson's psychosocial development theory, which developmental crisis is
most relevant for a hospitalized 4-year-old child?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Correct Answer: C
Rationale: The preschool years (3-6 years) center on Initiative vs. Guilt. Children seek to initiate
activities and assert control. Hospitalization threatens this initiative, potentially causing guilt
about being "bad" and needing punishment. Option A (infancy), B (toddlerhood), and D (school
age) represent incorrect developmental stages for this age group.
Q3: A nurse is educating parents of a 2-year-old about appropriate toys. Which toy
recommendation demonstrates the best understanding of Piaget's cognitive development?
,2
A. A board game with complex rules
B. A set of nesting cups and simple shape sorters
C. A chemistry set for beginners
D. A jigsaw puzzle with 50 pieces
Correct Answer: B
Rationale: Two-year-olds are in Piaget's sensorimotor (transitioning to preoperational) stage,
requiring toys that explore object permanence, causality, and simple problem-solving. Nesting
cups and shape sorters support cognitive development through tactile exploration. Option A
requires concrete operational thinking (age 7+). Option C is unsafe and developmentally
inappropriate. Option D exceeds fine motor capabilities.
Q4: Using the CDC growth chart below, a nurse plots a 12-month-old female infant's
measurements: Weight = 8.5 kg (10th percentile), Length = 72 cm (50th percentile), Head
circumference = 44 cm (25th percentile). What is the nurse's priority assessment?
Table
Percentile Weight (kg) Length (cm) Head Circumference (cm)
3rd 7.0 67 42
10th 8.5 70 43.5
25th 9.2 72 44.5
50th 10.2 74 46
75th 11.3 76 47
A. Normal growth pattern; continue routine monitoring
B. Possible failure to thrive; investigate nutritional intake
C. Disproportionate growth; assess for genetic syndrome
D. Macrocephaly; evaluate for hydrocephalus
Correct Answer: B
Rationale: The infant shows weight at 10th percentile while length is at 50th percentile,
indicating wasting or inadequate weight gain relative to length—classic signs of failure to thrive.
,3
This disproportion warrants immediate nutritional assessment. Option A is unsafe as it ignores
the significant weight-length discrepancy. Option C would show more extreme disproportion.
Option D is incorrect as head circumference is normal.
Q5: A nurse is caring for a hospitalized 8-year-old. Based on cognitive development, which
nursing intervention is most appropriate?
A. Provide detailed explanations of disease pathology using medical terminology
B. Allow the child to handle equipment and participate in care decisions
C. Use simple, concrete explanations without offering choices
D. Focus exclusively on parental education as the child cannot understand
Correct Answer: B
Rationale: School-age children (6-12 years) are in Piaget's concrete operational stage, capable of
logical thought about concrete objects. They benefit from participation, hands-on learning, and
limited choices that foster industry and control. Option A exceeds their abstract thinking
capacity. Option C underestimates their abilities. Option D violates family-centered care
principles and developmental needs.
Q6: A nurse assesses a 3-month-old infant. Which finding requires immediate follow-up?
A. The infant smiles responsively to mother's face
B. The infant does not yet reach for objects
C. The infant fails to fixate on and follow a moving toy
D. The infant has a strong Moro reflex
Correct Answer: C
Rationale: By 3 months, infants should demonstrate visual tracking (fixating and following
objects 180 degrees). Failure to do so suggests possible visual impairment or neurological
dysfunction requiring immediate evaluation. Option A (social smile) typically appears by 2
months and is normal. Option B is expected as reaching begins around 4 months. Option D is
normal in infants under 4-6 months.
Q7: During a well-child visit, parents of a 15-month-old express concern that their child says
only three words. Which response by the nurse is most appropriate?
A. "This indicates a significant language delay requiring immediate speech therapy referral"
B. "Most 15-month-olds have a vocabulary of 3-5 words, so this is within normal limits"
C. "Your child should have at least 50 words by now; this is concerning"
D. "Boys typically develop language slower than girls, so this is expected"
, 4
Correct Answer: B
Rationale: Normal language development at 15 months includes 3-5 words in addition to jargon
and pointing. This child's vocabulary falls within expected parameters. Option A creates
unnecessary alarm. Option C describes 24-month milestones. Option D perpetuates an inaccurate
stereotype and provides false reassurance without proper assessment.
Q8: A nurse is teaching parents about toilet training readiness. Which indicator suggests a child
is NOT yet ready for toilet training?
A. The child can pull pants up and down independently
B. The child shows interest when parents use the toilet
C. The child has bowel movements at predictable times
D. The child is 18 months old and walks steadily
Correct Answer: D
Rationale: While 18-month-olds may show physical readiness, successful toilet training requires
physiological maturity (sphincter control), cognitive understanding, and emotional readiness
typically achieved between 24-36 months. Age alone is insufficient; forcing training too early
leads to power struggles and regression. Options A, B, and C are valid readiness indicators per
the Brazelton child-oriented approach.
Q9: A school nurse is conducting scoliosis screening. At what age does idiopathic scoliosis most
commonly appear, requiring focused assessment?
A. 2-4 years (infantile)
B. 5-8 years (juvenile)
C. 10-14 years (adolescent)
D. 16-18 years (late adolescent)
Correct Answer: C
Rationale: Adolescent idiopathic scoliosis (AIS) accounts for 80% of cases, typically emerging
during the growth spurt (10-14 years in girls, 12-16 years in boys). This coincides with Tanner
stages 2-3 and requires annual screening during these years. Option A represents only 1% of
cases. Option B represents 10-15%. Option D is past the typical onset window.
Q10: A nurse is assessing a 9-month-old. Which fine motor skill demonstrates appropriate
development?
A. Scribbling with a crayon
B. Using a mature pincer grasp
