2025/2026 PEDIATRICS HESI RN EXIT EXAM PREP: 300+ VERIFIED QUESTIONS & RATIONALES |
PASS ON YOUR FIRST ATTEMPT AND AVOID RESITS | BASED ON HESI COMPREHENSIVE
REVIEW FOR THE NCLEX-RN EXAMINATION 7TH EDITION BY HES QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains
Pediatric Growth and Development
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Psychosocial Integrity
Safe and Effective Care Environment
Management of Care
Legal and Ethical Responsibilities in Pediatric Nursing
Introduction
This comprehensive assessment tool is designed to evaluate and reinforce critical pediatric nursing
knowledge required for success on the HESI RN Exit Examination and the NCLEX-RN. It assesses
clinical judgment, pharmacological safety, and the synthesis of foundational growth and development
theories. Featuring a blend of standard multiple-choice and complex, scenario-based items, this
document mimics high-stakes testing environments. An intense focus is placed on real-world clinical
application, prioritization, and ethical decision-making across diverse pediatric healthcare settings. By
engaging with these rigorous items, candidates will refine their critical thinking skills, bridge theoretical
gaps, and solidify the competence necessary to achieve passing scores and practice safely as entry-
level registered nurses.*
,Section One: Questions 1–100
Question 1
A 4-year-old child is admitted to the pediatric unit with a diagnosis of acute epiglottitis. Which nursing
intervention is the highest priority?
A. Obtain a throat culture to identify the causative organism.
B. Assess vital signs and prepare intubation equipment at the bedside.
C. Administer an intramuscular dose of antibiotics as prescribed.
D. Place the child in a supine position to facilitate a full physical assessment.
🟢 B. Assess vital signs and prepare intubation equipment at the bedside.
🔴 RATIONALE: Acute epiglottitis is a medical emergency that can progress rapidly to total airway
occlusion. Preparing emergency airway equipment takes precedence over diagnostic tests or
medications. Throat cultures or inspecting the mouth with a tongue blade can cause laryngospasm and
must never be attempted. The child should be allowed to sit upright in a position of comfort.
Question 2
A 10-month-old infant is brought to the clinic for a routine check-up. The nurse notes that the infant
cannot sit unsupported and does not transfer objects from hand to hand. What is the most appropriate
action by the nurse?
A. Document the findings as normal variations for this age group.
B. Advise the parent to re-evaluate the child's skills in 3 months.
C. Refer the infant to a pediatric specialist for developmental delay.
D. Teach the parent exercises to improve the infant's fine motor skills.
🟢 C. Refer the infant to a pediatric specialist for developmental delay.
🔴 RATIONALE: Infants typically sit unsupported by 8 months and transfer objects between hands by 7
months. Lacking these milestones at 10 months suggests a developmental delay that requires immediate
professional evaluation, rather than a wait-and-see approach.
Question 3
,The nurse is caring for a 6-year-old child post-tonsillectomy. Which sign should the nurse recognize as
an early indicator of postoperative hemorrhage?
A. Frequent, repetitive swallowing
B. An elevated axillary temperature of 38°C
C. Complaints of a mild sore throat
D. Decreased blood pressure
🟢 A. Frequent, repetitive swallowing
🔴 RATIONALE: Continuous trickling of blood down the back of the pharynx triggers the swallowing
reflex, making frequent swallowing an early sign of bleeding. Hypotension is a late sign of shock. Mild
throat pain and low-grade fever are expected findings postoperatively.
Question 4
A nurse is preparing to administer an intramuscular injection to a 14-month-old toddler. Which muscle
site is the most appropriate for this patient?
A. Dorsogluteal muscle
B. Deltoid muscle
C. Ventrogluteal muscle
D. Vastus lateralis muscle
🟢 D. Vastus lateralis muscle
🔴 RATIONALE: The vastus lateralis is the preferred site for intramuscular injections in infants and
toddlers because it is the largest and most developed muscle mass in this age group, free of major
nerves and blood vessels.
Question 5
A 12-year-old child diagnosed with Type 1 Diabetes Mellitus is learning about self-management. The
child asks why insulin must be injected rather than taken as a pill. Which explanation should the nurse
provide?
A. Oral insulin causes severe mucosal irritation in the stomach.
B. Digestive enzymes in the gastrointestinal tract destroy insulin before it can be absorbed.
, C. Oral medications cannot be absorbed quickly enough during a hyperglycemic crisis.
D. Insulin pills are too large for children of this age to swallow safely.
🟢 B. Digestive enzymes in the gastrointestinal tract destroy insulin before it can be absorbed.
🔴 RATIONALE: Insulin is a protein hormone. If taken orally, it is broken down and inactivated by
proteolytic enzymes in the gastrointestinal tract before it can enter the bloodstream. Therefore, it must be
administered parenterally.
Question 6
A 2-month-old infant is admitted with suspected pertussis. Which type of isolation precautions must the
nurse implement immediately?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Standard precautions only
🟢 B. Droplet precautions
🔴 RATIONALE: Pertussis (whooping cough) is transmitted via large respiratory droplets generated
during coughing or sneezing. Droplet precautions must be maintained until the patient has received
effective antibiotic therapy for at least 5 days.
Question 7
The nurse is reviewing the laboratory results of an 8-year-old child receiving chemotherapy for leukemia.
The platelet count is 22,000/mm³. Which intervention should the nurse include in the plan of care?
A. Encourage frequent ambulation in the hallway.
B. Use a soft-bristled toothbrush for oral care.
C. Monitor oral temperature every 2 hours.
D. Administer intramuscular analgesics for pain relief.
🟢 B. Use a soft-bristled toothbrush for oral care.
PASS ON YOUR FIRST ATTEMPT AND AVOID RESITS | BASED ON HESI COMPREHENSIVE
REVIEW FOR THE NCLEX-RN EXAMINATION 7TH EDITION BY HES QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
*Core Domains
Pediatric Growth and Development
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Psychosocial Integrity
Safe and Effective Care Environment
Management of Care
Legal and Ethical Responsibilities in Pediatric Nursing
Introduction
This comprehensive assessment tool is designed to evaluate and reinforce critical pediatric nursing
knowledge required for success on the HESI RN Exit Examination and the NCLEX-RN. It assesses
clinical judgment, pharmacological safety, and the synthesis of foundational growth and development
theories. Featuring a blend of standard multiple-choice and complex, scenario-based items, this
document mimics high-stakes testing environments. An intense focus is placed on real-world clinical
application, prioritization, and ethical decision-making across diverse pediatric healthcare settings. By
engaging with these rigorous items, candidates will refine their critical thinking skills, bridge theoretical
gaps, and solidify the competence necessary to achieve passing scores and practice safely as entry-
level registered nurses.*
,Section One: Questions 1–100
Question 1
A 4-year-old child is admitted to the pediatric unit with a diagnosis of acute epiglottitis. Which nursing
intervention is the highest priority?
A. Obtain a throat culture to identify the causative organism.
B. Assess vital signs and prepare intubation equipment at the bedside.
C. Administer an intramuscular dose of antibiotics as prescribed.
D. Place the child in a supine position to facilitate a full physical assessment.
🟢 B. Assess vital signs and prepare intubation equipment at the bedside.
🔴 RATIONALE: Acute epiglottitis is a medical emergency that can progress rapidly to total airway
occlusion. Preparing emergency airway equipment takes precedence over diagnostic tests or
medications. Throat cultures or inspecting the mouth with a tongue blade can cause laryngospasm and
must never be attempted. The child should be allowed to sit upright in a position of comfort.
Question 2
A 10-month-old infant is brought to the clinic for a routine check-up. The nurse notes that the infant
cannot sit unsupported and does not transfer objects from hand to hand. What is the most appropriate
action by the nurse?
A. Document the findings as normal variations for this age group.
B. Advise the parent to re-evaluate the child's skills in 3 months.
C. Refer the infant to a pediatric specialist for developmental delay.
D. Teach the parent exercises to improve the infant's fine motor skills.
🟢 C. Refer the infant to a pediatric specialist for developmental delay.
🔴 RATIONALE: Infants typically sit unsupported by 8 months and transfer objects between hands by 7
months. Lacking these milestones at 10 months suggests a developmental delay that requires immediate
professional evaluation, rather than a wait-and-see approach.
Question 3
,The nurse is caring for a 6-year-old child post-tonsillectomy. Which sign should the nurse recognize as
an early indicator of postoperative hemorrhage?
A. Frequent, repetitive swallowing
B. An elevated axillary temperature of 38°C
C. Complaints of a mild sore throat
D. Decreased blood pressure
🟢 A. Frequent, repetitive swallowing
🔴 RATIONALE: Continuous trickling of blood down the back of the pharynx triggers the swallowing
reflex, making frequent swallowing an early sign of bleeding. Hypotension is a late sign of shock. Mild
throat pain and low-grade fever are expected findings postoperatively.
Question 4
A nurse is preparing to administer an intramuscular injection to a 14-month-old toddler. Which muscle
site is the most appropriate for this patient?
A. Dorsogluteal muscle
B. Deltoid muscle
C. Ventrogluteal muscle
D. Vastus lateralis muscle
🟢 D. Vastus lateralis muscle
🔴 RATIONALE: The vastus lateralis is the preferred site for intramuscular injections in infants and
toddlers because it is the largest and most developed muscle mass in this age group, free of major
nerves and blood vessels.
Question 5
A 12-year-old child diagnosed with Type 1 Diabetes Mellitus is learning about self-management. The
child asks why insulin must be injected rather than taken as a pill. Which explanation should the nurse
provide?
A. Oral insulin causes severe mucosal irritation in the stomach.
B. Digestive enzymes in the gastrointestinal tract destroy insulin before it can be absorbed.
, C. Oral medications cannot be absorbed quickly enough during a hyperglycemic crisis.
D. Insulin pills are too large for children of this age to swallow safely.
🟢 B. Digestive enzymes in the gastrointestinal tract destroy insulin before it can be absorbed.
🔴 RATIONALE: Insulin is a protein hormone. If taken orally, it is broken down and inactivated by
proteolytic enzymes in the gastrointestinal tract before it can enter the bloodstream. Therefore, it must be
administered parenterally.
Question 6
A 2-month-old infant is admitted with suspected pertussis. Which type of isolation precautions must the
nurse implement immediately?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Standard precautions only
🟢 B. Droplet precautions
🔴 RATIONALE: Pertussis (whooping cough) is transmitted via large respiratory droplets generated
during coughing or sneezing. Droplet precautions must be maintained until the patient has received
effective antibiotic therapy for at least 5 days.
Question 7
The nurse is reviewing the laboratory results of an 8-year-old child receiving chemotherapy for leukemia.
The platelet count is 22,000/mm³. Which intervention should the nurse include in the plan of care?
A. Encourage frequent ambulation in the hallway.
B. Use a soft-bristled toothbrush for oral care.
C. Monitor oral temperature every 2 hours.
D. Administer intramuscular analgesics for pain relief.
🟢 B. Use a soft-bristled toothbrush for oral care.
