HESI PEDIATRICS Questions with Answers and
Rationales
SECTION I: GROWTH & DEVELOPMENT
1. A nurse is assessing a 6-month-old infant. Which finding should the nurse expect?
A. Birth weight doubled
B. Birth weight tripled
C. Able to sit alone steadily
D. Pincer grasp present
Correct Answer: A
Rationale: Birth weight doubles by 5–6 months and triples by 12 months. Sitting steadily
occurs at 8–9 months, and pincer grasp at 9–10 months. These milestones reflect standard
infant gross- and fine-motor progression.
2. Which developmental task is most characteristic of a 2-year-old?
A. Cooperative play
B. Parallel play
C. Imaginary friend
D. Sharing toys willingly
Correct Answer: B
Rationale: Toddlers engage in parallel play (playing alongside, not with, others). Cooperative
play begins around 4–5 years, imaginary friends around 3–5 years, and true sharing is not
expected until preschool/school age.
3. A nurse is teaching parents about stranger anxiety. At what age does this typically peak?
A. 2–3 months
B. 6–8 months
C. 18–24 months
D. 3–4 years
, Correct Answer: B
Rationale: Stranger anxiety typically emerges around 6 months and peaks at 6–8 months,
resolving gradually by 2 years. It reflects normal cognitive development and attachment.
4. A 4-year-old is admitted to the hospital. Which behavior should the nurse expect related to
hospitalization?
A. Fear of body mutilation
B. Separation anxiety as the primary stressor
C. Belief that illness is punishment for bad behavior
D. Concern about loss of independence
Correct Answer: C
Rationale: Preschoolers (3–5 years) use magical thinking and may believe
illness/hospitalization is punishment for misbehavior. Separation anxiety is most prominent in
toddlers (1–3 years), fear of body mutilation in school-age children, and loss of independence in
adolescents.
5. Which reflex should disappear by 4–6 months of age?
A. Moro reflex
B. Babinski reflex
C. Tonic neck reflex
D. Gag reflex
Correct Answer: A
Rationale: The Moro (startle) reflex disappears by 3–4 months (some sources say up to 6
months). The Babinski reflex may persist until 1–2 years, and the gag reflex remains lifelong.
6. A nurse observes a 9-month-old pull to standing and cruise along furniture. This is:
A. Delayed development
B. Expected development
C. Advanced development
D. Evidence of cerebral palsy
, Correct Answer: B
Rationale: Pulling to stand and cruising are expected at 9–10 months. Independent walking
typically occurs at 12–15 months. These are normal gross-motor milestones.
7. The nurse should anticipate which fine-motor skill in a 12-month-old?
A. Stacking 6 blocks
B. Scribbling with a crayon
C. Using a pincer grasp to pick up a raisin
D. Drawing a circle
Correct Answer: C
Rationale: Pincer grasp (thumb–index finger) develops at 9–10 months and is well
established by 12 months. Stacking 6 blocks and scribbling occur around 18–24 months;
drawing a circle around 3 years.
8. According to Erikson, the developmental task of the adolescent is:
A. Trust vs. mistrust
B. Industry vs. inferiority
C. Identity vs. role confusion
D. Intimacy vs. isolation
Correct Answer: C
Rationale: Adolescence (12–18 years) centers on identity vs. role confusion. Trust vs.
mistrust is infancy, industry vs. inferiority is school age, and intimacy vs. isolation is young
adulthood.
9. A parent reports her 3-year-old uses "baby talk" and has tantrums when frustrated. The
nurse should:
A. Refer for speech therapy immediately
B. Reassure the parent that this is normal for the age
C. Recommend discipline for regression
D. Assess for autism spectrum disorder
, Correct Answer: B
Rationale: Tantrums and occasional regression are normal in toddlers/preschoolers as they
develop language and self-regulation. Reassurance and anticipatory guidance are appropriate;
referrals are not indicated without red flags.
10. A nurse is assessing a 5-year-old's language development. Which should the nurse expect?
A. 2–3 word sentences
B. 3–4 word sentences
C. Fluent speech with correct grammar most of the time
D. Use of only nouns
Correct Answer: C
Rationale: By 5 years, speech should be largely intelligible with mostly correct grammar and
a vocabulary of ~2,000+ words. Two- to three-word sentences are typical at 2 years, and simple
sentences at 3 years.
11. Which activity is most appropriate for a hospitalized 7-year-old?
A. Mobiles and rattles
B. Board games and crafts
C. Peek-a-boo
D. Quiet reading alone only
Correct Answer: B
Rationale: School-age children (6–12 years) are in Erikson's industry vs. inferiority stage and
enjoy structured, goal-oriented activities like board games and crafts. Mobiles/rattles are for
infants; peek-a-boo for toddlers.
12. A nurse is assessing an infant's fontanels. The anterior fontanel typically closes by:
A. 2 months
B. 6 months
C. 12–18 months
D. 24 months
Rationales
SECTION I: GROWTH & DEVELOPMENT
1. A nurse is assessing a 6-month-old infant. Which finding should the nurse expect?
A. Birth weight doubled
B. Birth weight tripled
C. Able to sit alone steadily
D. Pincer grasp present
Correct Answer: A
Rationale: Birth weight doubles by 5–6 months and triples by 12 months. Sitting steadily
occurs at 8–9 months, and pincer grasp at 9–10 months. These milestones reflect standard
infant gross- and fine-motor progression.
2. Which developmental task is most characteristic of a 2-year-old?
A. Cooperative play
B. Parallel play
C. Imaginary friend
D. Sharing toys willingly
Correct Answer: B
Rationale: Toddlers engage in parallel play (playing alongside, not with, others). Cooperative
play begins around 4–5 years, imaginary friends around 3–5 years, and true sharing is not
expected until preschool/school age.
3. A nurse is teaching parents about stranger anxiety. At what age does this typically peak?
A. 2–3 months
B. 6–8 months
C. 18–24 months
D. 3–4 years
, Correct Answer: B
Rationale: Stranger anxiety typically emerges around 6 months and peaks at 6–8 months,
resolving gradually by 2 years. It reflects normal cognitive development and attachment.
4. A 4-year-old is admitted to the hospital. Which behavior should the nurse expect related to
hospitalization?
A. Fear of body mutilation
B. Separation anxiety as the primary stressor
C. Belief that illness is punishment for bad behavior
D. Concern about loss of independence
Correct Answer: C
Rationale: Preschoolers (3–5 years) use magical thinking and may believe
illness/hospitalization is punishment for misbehavior. Separation anxiety is most prominent in
toddlers (1–3 years), fear of body mutilation in school-age children, and loss of independence in
adolescents.
5. Which reflex should disappear by 4–6 months of age?
A. Moro reflex
B. Babinski reflex
C. Tonic neck reflex
D. Gag reflex
Correct Answer: A
Rationale: The Moro (startle) reflex disappears by 3–4 months (some sources say up to 6
months). The Babinski reflex may persist until 1–2 years, and the gag reflex remains lifelong.
6. A nurse observes a 9-month-old pull to standing and cruise along furniture. This is:
A. Delayed development
B. Expected development
C. Advanced development
D. Evidence of cerebral palsy
, Correct Answer: B
Rationale: Pulling to stand and cruising are expected at 9–10 months. Independent walking
typically occurs at 12–15 months. These are normal gross-motor milestones.
7. The nurse should anticipate which fine-motor skill in a 12-month-old?
A. Stacking 6 blocks
B. Scribbling with a crayon
C. Using a pincer grasp to pick up a raisin
D. Drawing a circle
Correct Answer: C
Rationale: Pincer grasp (thumb–index finger) develops at 9–10 months and is well
established by 12 months. Stacking 6 blocks and scribbling occur around 18–24 months;
drawing a circle around 3 years.
8. According to Erikson, the developmental task of the adolescent is:
A. Trust vs. mistrust
B. Industry vs. inferiority
C. Identity vs. role confusion
D. Intimacy vs. isolation
Correct Answer: C
Rationale: Adolescence (12–18 years) centers on identity vs. role confusion. Trust vs.
mistrust is infancy, industry vs. inferiority is school age, and intimacy vs. isolation is young
adulthood.
9. A parent reports her 3-year-old uses "baby talk" and has tantrums when frustrated. The
nurse should:
A. Refer for speech therapy immediately
B. Reassure the parent that this is normal for the age
C. Recommend discipline for regression
D. Assess for autism spectrum disorder
, Correct Answer: B
Rationale: Tantrums and occasional regression are normal in toddlers/preschoolers as they
develop language and self-regulation. Reassurance and anticipatory guidance are appropriate;
referrals are not indicated without red flags.
10. A nurse is assessing a 5-year-old's language development. Which should the nurse expect?
A. 2–3 word sentences
B. 3–4 word sentences
C. Fluent speech with correct grammar most of the time
D. Use of only nouns
Correct Answer: C
Rationale: By 5 years, speech should be largely intelligible with mostly correct grammar and
a vocabulary of ~2,000+ words. Two- to three-word sentences are typical at 2 years, and simple
sentences at 3 years.
11. Which activity is most appropriate for a hospitalized 7-year-old?
A. Mobiles and rattles
B. Board games and crafts
C. Peek-a-boo
D. Quiet reading alone only
Correct Answer: B
Rationale: School-age children (6–12 years) are in Erikson's industry vs. inferiority stage and
enjoy structured, goal-oriented activities like board games and crafts. Mobiles/rattles are for
infants; peek-a-boo for toddlers.
12. A nurse is assessing an infant's fontanels. The anterior fontanel typically closes by:
A. 2 months
B. 6 months
C. 12–18 months
D. 24 months
