PEDIATRICS HESI RN EXIT EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Growth and Development Across the Pediatric Continuum
- Pediatric Health Assessment and Screening
- Common Pediatric Diseases and Disorders
- Pediatric Pharmacology and Medication Safety
- Family-Centered Care and Communication
- Nutrition, Hydration, and Feeding Techniques
- Safety, Injury Prevention, and Child Abuse Recognition
- Pediatric Emergency Care and Resuscitation
- Chronic and Acute Illness Management
- Ethical, Legal, and Regulatory Compliance in Pediatric Nursing
Introduction
This comprehensive assessment is designed to prepare nursing students for the Pediatrics HESI RN Exit Exam
by evaluating critical knowledge and clinical decision-making skills essential for safe, effective pediatric care.
The exam consists of 100 multiple-choice and scenario-based questions that assess foundational theory,
applied professional knowledge, regulatory and legal compliance, ethics, and real-world clinical judgment.
Each question emphasizes real-world application, requiring candidates to prioritize interventions, recognize
subtle clinical changes, and make sound decisions in complex pediatric situations. Mastery of this content
ensures readiness for transition into registered nursing practice with infants, children, and adolescents.
,Section One: Questions 1–100
Question 1
A 4-year-old child is admitted with asthma exacerbation. The nurse assesses wheezing, increased respiratory
rate, and use of accessory muscles. Which intervention should the nurse prioritize first?
A. Administer oxygen to maintain SpO₂ ≥ 94%
B. Administer nebulized albuterol per protocol
C. Obtain a complete set of vital signs
D. Notify the healthcare provider immediately
🟢 Correct answer: A
🔴 RATIONALE: Oxygen therapy is the first priority in any child with respiratory distress to prevent hypoxia.
Albuterol is critical but follows oxygenation. Vital signs and notification occur after stabilizing the child.
Question 2
A nurse is assessing a 6-month-old infant. Which developmental milestone should the infant reliably
demonstrate?
A. Walking with assistance
B. Sitting without support
C. Speaking two-word sentences
D. Pulling to stand
🟢 Correct answer: B
,🔴 RATIONALE: By 6 months, infants typically sit without support. Walking with assistance occurs around 9–
12 months, two-word sentences around 18–24 months, and pulling to stand around 9 months.
Question 3
A 10-year-old with type 1 diabetes presents with nausea, vomiting, and abdominal pain. Blood glucose is 350
mg/dL, and urine is positive for ketones. Which condition is the nurse most concerned about?
A. Hyperglycemic hyperosmolar state
B. Diabetic ketoacidosis (DKA)
C. Insulin overdose
D. Gastroparesis
🟢 Correct answer: B
🔴 RATIONALE: DKA is characterized by hyperglycemia, ketonuria, and symptoms like nausea, vomiting, and
abdominal pain in children with type 1 diabetes. Hyperglycemic hyperosmolar state is more common in type 2
diabetes.
Question 4
A parent asks how to prevent car seat injuries for their 2-year-old. Which recommendation is most appropriate?
A. Use a forward-facing seat in the front passenger seat
B. Use a rear-facing seat until age 4
C. Use a forward-facing seat with harness in the back seat
D. Use a booster seat until age 5
, 🟢 Correct answer: C
🔴 RATIONALE: Children should transition to forward-facing seats with harnesss after outgrowing rear-facing
limits (usually around 2 years), always in the back seat. Rear-facing until age 4 is ideal but not required by all
guidelines; booster seats are for older children.
Question 5
A 3-year-old with tetralogy of Fallot suddenly becomes pale, tachypneic, and exhibits increased cyanosis during
crying. What is the nurse's immediate action?
A. Administer IV morphine
B. Place the child in knee-chest position
C. Start oxygen at 2 L/min
D. Prepare for emergency intubation
🟢 Correct answer: B
🔴 RATIONALE: Knee-chest position increases systemic vascular resistance, reducing right-to-left shunting
and improving oxygenation in tetralogy spell. Oxygen is adjunctive; morphine and intubation are not first-line
for acute spell.
Question 6
Which medication calculation is correct for a 15 kg child receiving amoxicillin 40 mg/kg/day divided twice
daily?
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
- Growth and Development Across the Pediatric Continuum
- Pediatric Health Assessment and Screening
- Common Pediatric Diseases and Disorders
- Pediatric Pharmacology and Medication Safety
- Family-Centered Care and Communication
- Nutrition, Hydration, and Feeding Techniques
- Safety, Injury Prevention, and Child Abuse Recognition
- Pediatric Emergency Care and Resuscitation
- Chronic and Acute Illness Management
- Ethical, Legal, and Regulatory Compliance in Pediatric Nursing
Introduction
This comprehensive assessment is designed to prepare nursing students for the Pediatrics HESI RN Exit Exam
by evaluating critical knowledge and clinical decision-making skills essential for safe, effective pediatric care.
The exam consists of 100 multiple-choice and scenario-based questions that assess foundational theory,
applied professional knowledge, regulatory and legal compliance, ethics, and real-world clinical judgment.
Each question emphasizes real-world application, requiring candidates to prioritize interventions, recognize
subtle clinical changes, and make sound decisions in complex pediatric situations. Mastery of this content
ensures readiness for transition into registered nursing practice with infants, children, and adolescents.
,Section One: Questions 1–100
Question 1
A 4-year-old child is admitted with asthma exacerbation. The nurse assesses wheezing, increased respiratory
rate, and use of accessory muscles. Which intervention should the nurse prioritize first?
A. Administer oxygen to maintain SpO₂ ≥ 94%
B. Administer nebulized albuterol per protocol
C. Obtain a complete set of vital signs
D. Notify the healthcare provider immediately
🟢 Correct answer: A
🔴 RATIONALE: Oxygen therapy is the first priority in any child with respiratory distress to prevent hypoxia.
Albuterol is critical but follows oxygenation. Vital signs and notification occur after stabilizing the child.
Question 2
A nurse is assessing a 6-month-old infant. Which developmental milestone should the infant reliably
demonstrate?
A. Walking with assistance
B. Sitting without support
C. Speaking two-word sentences
D. Pulling to stand
🟢 Correct answer: B
,🔴 RATIONALE: By 6 months, infants typically sit without support. Walking with assistance occurs around 9–
12 months, two-word sentences around 18–24 months, and pulling to stand around 9 months.
Question 3
A 10-year-old with type 1 diabetes presents with nausea, vomiting, and abdominal pain. Blood glucose is 350
mg/dL, and urine is positive for ketones. Which condition is the nurse most concerned about?
A. Hyperglycemic hyperosmolar state
B. Diabetic ketoacidosis (DKA)
C. Insulin overdose
D. Gastroparesis
🟢 Correct answer: B
🔴 RATIONALE: DKA is characterized by hyperglycemia, ketonuria, and symptoms like nausea, vomiting, and
abdominal pain in children with type 1 diabetes. Hyperglycemic hyperosmolar state is more common in type 2
diabetes.
Question 4
A parent asks how to prevent car seat injuries for their 2-year-old. Which recommendation is most appropriate?
A. Use a forward-facing seat in the front passenger seat
B. Use a rear-facing seat until age 4
C. Use a forward-facing seat with harness in the back seat
D. Use a booster seat until age 5
, 🟢 Correct answer: C
🔴 RATIONALE: Children should transition to forward-facing seats with harnesss after outgrowing rear-facing
limits (usually around 2 years), always in the back seat. Rear-facing until age 4 is ideal but not required by all
guidelines; booster seats are for older children.
Question 5
A 3-year-old with tetralogy of Fallot suddenly becomes pale, tachypneic, and exhibits increased cyanosis during
crying. What is the nurse's immediate action?
A. Administer IV morphine
B. Place the child in knee-chest position
C. Start oxygen at 2 L/min
D. Prepare for emergency intubation
🟢 Correct answer: B
🔴 RATIONALE: Knee-chest position increases systemic vascular resistance, reducing right-to-left shunting
and improving oxygenation in tetralogy spell. Oxygen is adjunctive; morphine and intubation are not first-line
for acute spell.
Question 6
Which medication calculation is correct for a 15 kg child receiving amoxicillin 40 mg/kg/day divided twice
daily?
