HESI Pediatrics Exam Practice
2026/2027
100 Essential Questions, Answers & Rationales
1. A 2-year-old child is admitted with a suspected diagnosis of
intussusception. Which clinical finding should the nurse expect?
A. Steatorrhea | B. Projectile vomiting | C. Currant jelly-like stools | D. Ribbon-
like stools
Correct Answer: C
Rationale: Currant jelly-like stools (stools containing blood and mucus) are a hallmark
sign of intussusception. Ribbon-like stools indicate Hirschsprung's disease.
2. Which assessment finding in a 4-month-old infant would require
immediate notification of the healthcare provider?
A. Inability to sit without support | B. Bulging fontanel when crying | C.
Depressed anterior fontanel | D. Presence of the Babinski reflex
Correct Answer: C
Rationale: A depressed (sunken) fontanel is a sign of moderate to severe dehydration
in an infant. A bulging fontanel is normal during crying, and sitting without support is
not expected until 6 months.
3. The nurse is caring for an infant with Tetralogy of Fallot who begins to
have a 'tet spell.' What is the priority nursing action?
A. Administer 100% oxygen via mask | B. Place the infant in a knee-chest
position | C. Administer IV morphine sulfate | D. Prepare for immediate
intubation
Correct Answer: B
Rationale: The knee-chest position increases systemic vascular resistance, which helps
shunt blood into the pulmonary artery and improves oxygenation during a
hypercyanotic (tet) spell.
,4. Which developmental milestone is typically achieved by a 12-month-old
infant?
A. Using a spoon effectively | B. Standing alone and taking a few steps | C.
Saying sentences of 4-5 words | D. Jumping in place
Correct Answer: B
Rationale: By 12 months, most infants can stand alone and take their first steps.
Spoon usage and jumping are toddler milestones (18-24 months).
5. A school-aged child with Glomerulonephritis is admitted. Which vital sign
is most important for the nurse to monitor?
A. Temperature | B. Heart rate | C. Respiratory rate | D. Blood pressure
Correct Answer: D
Rationale: Hypertension is a major complication of acute glomerulonephritis due to
fluid retention and decreased glomerular filtration.
6. The nurse is providing discharge teaching to the parents of a child with
Celiac disease. Which food choice is appropriate?
A. Rye bread sandwich | B. Barley soup | C. Rice cakes with peanut butter | D.
Whole wheat crackers
Correct Answer: C
Rationale: Celiac disease requires a gluten-free diet. Barley, Rye, Oats (often
contaminated), and Wheat (BROW) must be avoided. Rice is safe.
7. An 8-year-old child is hospitalized with Vaso-occlusive Sickle Cell Crisis.
What is the priority nursing intervention?
A. Administering cold compresses to painful joints | B. Restricting oral fluid
intake | C. Administering IV fluids and pain medication | D. Encouraging
vigorous physical activity
Correct Answer: C
Rationale: Hydration (IV fluids) is critical to reduce blood viscosity and prevent further
sickling, while aggressive pain management is needed for the intense pain of a crisis.
, 8. A child is diagnosed with Epiglottitis. Which action should the nurse
avoid?
A. Monitoring pulse oximetry | B. Placing the child in a tripod position | C.
Visualizing the throat with a tongue blade | D. Providing humidified oxygen
Correct Answer: C
Rationale: Visualizing the throat or using a tongue blade can trigger laryngospasm
and complete airway obstruction in a child with epiglottitis.
9. Which safety instruction should the nurse include for the parents of a 9-
month-old infant?
A. Teach the child to swim | B. Cut grapes into small pieces | C. Use a forward-
facing car seat | D. Keep small objects and choking hazards out of reach
Correct Answer: D
Rationale: Infants at 9 months use the pincer grasp to pick up small objects,
increasing choking risks. Rear-facing car seats are required until at least age 2.
10. A child with Type 1 Diabetes is shaky, sweaty, and pale. What is the
nurse's first action?
A. Check the child's blood glucose level | B. Administer a dose of regular insulin
| C. Call the healthcare provider | 0. Give the child 4 oz of orange juice
Correct Answer: A
Rationale: While the child shows signs of hypoglycemia, the very first action (if
equipment is available) is to verify blood glucose. If not immediately available, treat for
hypoglycemia first.
11. Pediatrics Q11: Rheumatic Fever cause?
A. Group A Strep infection | B. Viral flu | C. Monitor vitals | D. Provide emotional
support
Correct Answer: A
Rationale: Occurs after untreated strep throat.
12. Pediatrics Q12: Hypyloplasia (Hip Dysplasia) sign?
A. Asymmetric gluteal folds | B. Unequal pupil size | C. Monitor vitals | D.
Provide emotional support
Correct Answer: A
Rationale: Ortolani and Barlow maneuvers also check for hip clicks.
2026/2027
100 Essential Questions, Answers & Rationales
1. A 2-year-old child is admitted with a suspected diagnosis of
intussusception. Which clinical finding should the nurse expect?
A. Steatorrhea | B. Projectile vomiting | C. Currant jelly-like stools | D. Ribbon-
like stools
Correct Answer: C
Rationale: Currant jelly-like stools (stools containing blood and mucus) are a hallmark
sign of intussusception. Ribbon-like stools indicate Hirschsprung's disease.
2. Which assessment finding in a 4-month-old infant would require
immediate notification of the healthcare provider?
A. Inability to sit without support | B. Bulging fontanel when crying | C.
Depressed anterior fontanel | D. Presence of the Babinski reflex
Correct Answer: C
Rationale: A depressed (sunken) fontanel is a sign of moderate to severe dehydration
in an infant. A bulging fontanel is normal during crying, and sitting without support is
not expected until 6 months.
3. The nurse is caring for an infant with Tetralogy of Fallot who begins to
have a 'tet spell.' What is the priority nursing action?
A. Administer 100% oxygen via mask | B. Place the infant in a knee-chest
position | C. Administer IV morphine sulfate | D. Prepare for immediate
intubation
Correct Answer: B
Rationale: The knee-chest position increases systemic vascular resistance, which helps
shunt blood into the pulmonary artery and improves oxygenation during a
hypercyanotic (tet) spell.
,4. Which developmental milestone is typically achieved by a 12-month-old
infant?
A. Using a spoon effectively | B. Standing alone and taking a few steps | C.
Saying sentences of 4-5 words | D. Jumping in place
Correct Answer: B
Rationale: By 12 months, most infants can stand alone and take their first steps.
Spoon usage and jumping are toddler milestones (18-24 months).
5. A school-aged child with Glomerulonephritis is admitted. Which vital sign
is most important for the nurse to monitor?
A. Temperature | B. Heart rate | C. Respiratory rate | D. Blood pressure
Correct Answer: D
Rationale: Hypertension is a major complication of acute glomerulonephritis due to
fluid retention and decreased glomerular filtration.
6. The nurse is providing discharge teaching to the parents of a child with
Celiac disease. Which food choice is appropriate?
A. Rye bread sandwich | B. Barley soup | C. Rice cakes with peanut butter | D.
Whole wheat crackers
Correct Answer: C
Rationale: Celiac disease requires a gluten-free diet. Barley, Rye, Oats (often
contaminated), and Wheat (BROW) must be avoided. Rice is safe.
7. An 8-year-old child is hospitalized with Vaso-occlusive Sickle Cell Crisis.
What is the priority nursing intervention?
A. Administering cold compresses to painful joints | B. Restricting oral fluid
intake | C. Administering IV fluids and pain medication | D. Encouraging
vigorous physical activity
Correct Answer: C
Rationale: Hydration (IV fluids) is critical to reduce blood viscosity and prevent further
sickling, while aggressive pain management is needed for the intense pain of a crisis.
, 8. A child is diagnosed with Epiglottitis. Which action should the nurse
avoid?
A. Monitoring pulse oximetry | B. Placing the child in a tripod position | C.
Visualizing the throat with a tongue blade | D. Providing humidified oxygen
Correct Answer: C
Rationale: Visualizing the throat or using a tongue blade can trigger laryngospasm
and complete airway obstruction in a child with epiglottitis.
9. Which safety instruction should the nurse include for the parents of a 9-
month-old infant?
A. Teach the child to swim | B. Cut grapes into small pieces | C. Use a forward-
facing car seat | D. Keep small objects and choking hazards out of reach
Correct Answer: D
Rationale: Infants at 9 months use the pincer grasp to pick up small objects,
increasing choking risks. Rear-facing car seats are required until at least age 2.
10. A child with Type 1 Diabetes is shaky, sweaty, and pale. What is the
nurse's first action?
A. Check the child's blood glucose level | B. Administer a dose of regular insulin
| C. Call the healthcare provider | 0. Give the child 4 oz of orange juice
Correct Answer: A
Rationale: While the child shows signs of hypoglycemia, the very first action (if
equipment is available) is to verify blood glucose. If not immediately available, treat for
hypoglycemia first.
11. Pediatrics Q11: Rheumatic Fever cause?
A. Group A Strep infection | B. Viral flu | C. Monitor vitals | D. Provide emotional
support
Correct Answer: A
Rationale: Occurs after untreated strep throat.
12. Pediatrics Q12: Hypyloplasia (Hip Dysplasia) sign?
A. Asymmetric gluteal folds | B. Unequal pupil size | C. Monitor vitals | D.
Provide emotional support
Correct Answer: A
Rationale: Ortolani and Barlow maneuvers also check for hip clicks.
