PEDIATRIC HESI EXAM 2026/2027
,EVOLVE HESI Pediatrics Exam 2026/2027
Complete Study Guide with Answers and Rationales
SECTION 1: GROWTH AND DEVELOPMENT
Question 1
A nurse is assessing a 4-month-old infant during a well-child visit. Which finding would require further
evaluation?
A) The infant has not doubled their birth weight
B) The infant does not roll from back to front
C) The infant does not have a social smile
D) The infant does not sit without support
Answer: C
Rationale: Social smile typically develops by 2 months of age. Absence at 4 months warrants further
developmental evaluation. Doubling of birth weight occurs by 4-6 months, rolling from back to front by
5-6 months, and sitting without support by 6-8 months.
Question 2
The nurse is teaching parents about age-appropriate activities for their 18-month-old toddler. Which toy
would be most appropriate?
A) A 500-piece puzzle
B) Push-pull toys
C) Board games with simple rules
D) Craft supplies with small beads
Answer: B
Rationale: Push-pull toys are ideal for toddlers as they support gross motor development and encourage
walking. Small pieces pose choking hazards, and complex games are developmentally inappropriate.
,Question 3
A nurse is caring for a hospitalized 8-year-old child. According to Erikson's stages of development, this
child is in which stage?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Answer: D
Rationale: School-age children (6-12 years) are in the Industry vs. Inferiority stage, where they develop
competence through achievements in school and social activities.
Question 4
When assessing an adolescent, which behavior would indicate the adolescent is progressing normally
through Erikson's Identity vs. Role Confusion stage?
A) Dependence on parents for all decisions
B) Experimentation with different clothing styles and peer groups
C) Regression to earlier childhood behaviors
D) Complete isolation from peers
Answer: B
Rationale: Adolescents normally experiment with different roles, appearances, and peer groups as they
develop their identity. This is a healthy part of identity formation.
Question 5
A parent asks when their child should receive the first dose of the MMR vaccine. What is the nurse's
best response?
, A) "At birth, before leaving the hospital"
B) "At 2 months of age"
C) "At 12 to 15 months of age"
D) "At 4 to 6 years of age"
Answer: C
Rationale: The first MMR (measles, mumps, rubella) vaccine is given at 12-15 months, with the second
dose at 4-6 years.
SECTION 2: RESPIRATORY DISORDERS
Question 6
A 2-year-old child is admitted with acute laryngotracheobronchitis (croup). Which intervention should
the nurse implement first?
A) Administer prescribed antibiotics
B) Place the child in a cool mist tent
C) Assess the child's respiratory status
D) Obtain a throat culture
Answer: C
Rationale: Assessment is the first step in the nursing process. The nurse must first assess respiratory
status to determine the severity of airway obstruction before implementing interventions.
Question 7
A child with epiglottitis is admitted to the pediatric unit. Which action should the nurse avoid?
A) Allowing the child to sit upright
B) Examining the child's throat with a tongue depressor
C) Keeping emergency intubation equipment nearby
D) Administering humidified oxygen
,EVOLVE HESI Pediatrics Exam 2026/2027
Complete Study Guide with Answers and Rationales
SECTION 1: GROWTH AND DEVELOPMENT
Question 1
A nurse is assessing a 4-month-old infant during a well-child visit. Which finding would require further
evaluation?
A) The infant has not doubled their birth weight
B) The infant does not roll from back to front
C) The infant does not have a social smile
D) The infant does not sit without support
Answer: C
Rationale: Social smile typically develops by 2 months of age. Absence at 4 months warrants further
developmental evaluation. Doubling of birth weight occurs by 4-6 months, rolling from back to front by
5-6 months, and sitting without support by 6-8 months.
Question 2
The nurse is teaching parents about age-appropriate activities for their 18-month-old toddler. Which toy
would be most appropriate?
A) A 500-piece puzzle
B) Push-pull toys
C) Board games with simple rules
D) Craft supplies with small beads
Answer: B
Rationale: Push-pull toys are ideal for toddlers as they support gross motor development and encourage
walking. Small pieces pose choking hazards, and complex games are developmentally inappropriate.
,Question 3
A nurse is caring for a hospitalized 8-year-old child. According to Erikson's stages of development, this
child is in which stage?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Answer: D
Rationale: School-age children (6-12 years) are in the Industry vs. Inferiority stage, where they develop
competence through achievements in school and social activities.
Question 4
When assessing an adolescent, which behavior would indicate the adolescent is progressing normally
through Erikson's Identity vs. Role Confusion stage?
A) Dependence on parents for all decisions
B) Experimentation with different clothing styles and peer groups
C) Regression to earlier childhood behaviors
D) Complete isolation from peers
Answer: B
Rationale: Adolescents normally experiment with different roles, appearances, and peer groups as they
develop their identity. This is a healthy part of identity formation.
Question 5
A parent asks when their child should receive the first dose of the MMR vaccine. What is the nurse's
best response?
, A) "At birth, before leaving the hospital"
B) "At 2 months of age"
C) "At 12 to 15 months of age"
D) "At 4 to 6 years of age"
Answer: C
Rationale: The first MMR (measles, mumps, rubella) vaccine is given at 12-15 months, with the second
dose at 4-6 years.
SECTION 2: RESPIRATORY DISORDERS
Question 6
A 2-year-old child is admitted with acute laryngotracheobronchitis (croup). Which intervention should
the nurse implement first?
A) Administer prescribed antibiotics
B) Place the child in a cool mist tent
C) Assess the child's respiratory status
D) Obtain a throat culture
Answer: C
Rationale: Assessment is the first step in the nursing process. The nurse must first assess respiratory
status to determine the severity of airway obstruction before implementing interventions.
Question 7
A child with epiglottitis is admitted to the pediatric unit. Which action should the nurse avoid?
A) Allowing the child to sit upright
B) Examining the child's throat with a tongue depressor
C) Keeping emergency intubation equipment nearby
D) Administering humidified oxygen
