HESI RN Pediatric Nursing Exam 2026 | 200
Questions with Detailed Rationales | Latest Edition
| Pass Guaranteed Study Guide
HESI RN Pediatric Nursing Practice Exam (200 Questions)
Instructions: Choose the best answer for each question. The correct answer and rationale
are provided immediately after each question.
Growth and Development
1. A nurse is assessing a 6-month-old infant. Which developmental finding is most
appropriate for this age?
A. Walking independently
B. Sitting with support and beginning to roll in both directions
C. Riding a tricycle
D. Speaking in complete sentences
Answer: B
Rationale: By approximately 6 months, many infants can roll in both directions and sit with
,support or begin sitting independently. Development varies, so assessment should consider
the overall developmental pattern.
2. According to Erikson, the primary psychosocial task for a toddler aged 1-3 years is
which of the following?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Answer: B
Rationale: Erikson's stages of psychosocial development identify the toddler's primary task
as developing a sense of personal control and independence. Success leads to autonomy,
while failure results in feelings of shame and doubt about their abilities.
3. A 4-year-old child is being assessed. Which developmental milestone would the
nurse expect this child to have achieved?
A) Tying shoelaces
B) Riding a tricycle
C) Using a spoon
D) Writing their first name
Answer: B
Rationale: A preschool-aged child (3-4 years) typically develops the coordination to ride a
tricycle. Tying shoelaces and writing their first name are skills expected of an older child,
around 5-6 years.
4. At 6 months of age, which fine motor skill should an infant have developed?
A) Pincer grasp
B) Transferring objects from one hand to the other
,C) Building a tower of two cubes
D) Holding a pencil
Answer: B
Rationale: At six months, a major fine motor milestone is the ability to transfer objects from
one hand to the other. The pincer grasp, a more refined skill, typically does not develop until
around 9-10 months.
5. The nurse is providing anticipatory guidance to parents of an 8-year-old child.
Which suggestion best supports the child's developmental task according to
Erikson?
A) Allow the child to make choices about meals and activities
B) Provide unlimited screen time to reduce anxiety
C) Have parents stay with the child at all times during hospitalization
D) Restrict all choices to prevent the child from becoming overwhelmed
Answer: A
Rationale: School-age children are in Erikson's "Industry vs. Inferiority" stage and need
opportunities to develop competence and accomplishment. Allowing them to make choices
fosters a sense of autonomy and self-esteem.
6. The nurse is assessing a 6-month-old infant during a well-child visit. Which finding
should the nurse report to the healthcare provider?
A. Positive Babinski reflex
B. Presence of a Moro reflex
C. Inability to hold head up without support
D. Heart rate of 130 beats per minute
Answer: C
Rationale: By 4 months of age, an infant should have good head control. Inability to hold the
head up at 6 months indicates delayed motor development and should be reported. The
, Babinski reflex is normal until 1 year, the Moro reflex disappears by 4 months but may be
present in some infants slightly longer, and a heart rate of 130 is normal for this age.
7. The mother of a 2-month-old infant is concerned because the infant's anterior
fontanel is still open. What is the nurse's best response?
A. "This is a normal finding and is expected to close between 12-18 months of age."
B. "This indicates hydrocephalus and requires immediate surgical intervention."
C. "The fontanel should have closed by 2 months; I will inform the pediatrician."
D. "This is a sign of dehydration and we need to start IV fluids."
Answer: A
Rationale: The anterior fontanel is diamond-shaped and normally closes between 12-18
months of age. The posterior fontanel closes by 2-3 months. An open anterior fontanel at 2
months is an expected finding. Why Others Are Wrong: Option B is incorrect because an
open anterior fontanel at 2 months does not indicate hydrocephalus. Option C is wrong
because the anterior fontanel should not be closed by 2 months. Option D is incorrect
because a bulging or sunken fontanel, not simply an open one, indicates dehydration or
increased intracranial pressure.
8. A nurse is assessing a 4-year-old child. Which behavior best reflects the child's
expected psychosocial stage per Erikson?
A. The child cries when the parent leaves the room.
B. The child insists on choosing their own clothes and dressing independently.
C. The child repeatedly lines up toy cars in a precise row.
D. The child becomes upset when a puzzle piece doesn't fit.
Answer: B
Rationale: Preschoolers (ages 3-5) are in Erikson's Initiative vs. Guilt stage. They assert
control over their environment through independent choices and actions. Insisting on
choosing clothes and dressing independently demonstrates this developmental task. Why
Questions with Detailed Rationales | Latest Edition
| Pass Guaranteed Study Guide
HESI RN Pediatric Nursing Practice Exam (200 Questions)
Instructions: Choose the best answer for each question. The correct answer and rationale
are provided immediately after each question.
Growth and Development
1. A nurse is assessing a 6-month-old infant. Which developmental finding is most
appropriate for this age?
A. Walking independently
B. Sitting with support and beginning to roll in both directions
C. Riding a tricycle
D. Speaking in complete sentences
Answer: B
Rationale: By approximately 6 months, many infants can roll in both directions and sit with
,support or begin sitting independently. Development varies, so assessment should consider
the overall developmental pattern.
2. According to Erikson, the primary psychosocial task for a toddler aged 1-3 years is
which of the following?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
D) Industry vs. Inferiority
Answer: B
Rationale: Erikson's stages of psychosocial development identify the toddler's primary task
as developing a sense of personal control and independence. Success leads to autonomy,
while failure results in feelings of shame and doubt about their abilities.
3. A 4-year-old child is being assessed. Which developmental milestone would the
nurse expect this child to have achieved?
A) Tying shoelaces
B) Riding a tricycle
C) Using a spoon
D) Writing their first name
Answer: B
Rationale: A preschool-aged child (3-4 years) typically develops the coordination to ride a
tricycle. Tying shoelaces and writing their first name are skills expected of an older child,
around 5-6 years.
4. At 6 months of age, which fine motor skill should an infant have developed?
A) Pincer grasp
B) Transferring objects from one hand to the other
,C) Building a tower of two cubes
D) Holding a pencil
Answer: B
Rationale: At six months, a major fine motor milestone is the ability to transfer objects from
one hand to the other. The pincer grasp, a more refined skill, typically does not develop until
around 9-10 months.
5. The nurse is providing anticipatory guidance to parents of an 8-year-old child.
Which suggestion best supports the child's developmental task according to
Erikson?
A) Allow the child to make choices about meals and activities
B) Provide unlimited screen time to reduce anxiety
C) Have parents stay with the child at all times during hospitalization
D) Restrict all choices to prevent the child from becoming overwhelmed
Answer: A
Rationale: School-age children are in Erikson's "Industry vs. Inferiority" stage and need
opportunities to develop competence and accomplishment. Allowing them to make choices
fosters a sense of autonomy and self-esteem.
6. The nurse is assessing a 6-month-old infant during a well-child visit. Which finding
should the nurse report to the healthcare provider?
A. Positive Babinski reflex
B. Presence of a Moro reflex
C. Inability to hold head up without support
D. Heart rate of 130 beats per minute
Answer: C
Rationale: By 4 months of age, an infant should have good head control. Inability to hold the
head up at 6 months indicates delayed motor development and should be reported. The
, Babinski reflex is normal until 1 year, the Moro reflex disappears by 4 months but may be
present in some infants slightly longer, and a heart rate of 130 is normal for this age.
7. The mother of a 2-month-old infant is concerned because the infant's anterior
fontanel is still open. What is the nurse's best response?
A. "This is a normal finding and is expected to close between 12-18 months of age."
B. "This indicates hydrocephalus and requires immediate surgical intervention."
C. "The fontanel should have closed by 2 months; I will inform the pediatrician."
D. "This is a sign of dehydration and we need to start IV fluids."
Answer: A
Rationale: The anterior fontanel is diamond-shaped and normally closes between 12-18
months of age. The posterior fontanel closes by 2-3 months. An open anterior fontanel at 2
months is an expected finding. Why Others Are Wrong: Option B is incorrect because an
open anterior fontanel at 2 months does not indicate hydrocephalus. Option C is wrong
because the anterior fontanel should not be closed by 2 months. Option D is incorrect
because a bulging or sunken fontanel, not simply an open one, indicates dehydration or
increased intracranial pressure.
8. A nurse is assessing a 4-year-old child. Which behavior best reflects the child's
expected psychosocial stage per Erikson?
A. The child cries when the parent leaves the room.
B. The child insists on choosing their own clothes and dressing independently.
C. The child repeatedly lines up toy cars in a precise row.
D. The child becomes upset when a puzzle piece doesn't fit.
Answer: B
Rationale: Preschoolers (ages 3-5) are in Erikson's Initiative vs. Guilt stage. They assert
control over their environment through independent choices and actions. Insisting on
choosing clothes and dressing independently demonstrates this developmental task. Why
