EVOLVE HESI PEDIATRICS EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Growth and Development
Pediatric Assessment and Health Promotion
Respiratory Disorders
Cardiovascular Disorders
Gastrointestinal and Genitourinary Disorders
Neurological and Musculoskeletal Disorders
Hematologic and Oncologic Disorders
Pediatric Pharmacology and Medication Safety
Fluid, Electrolyte, and Nutritional Balance
Pediatric Emergencies and Critical Care
Introduction
This comprehensive study guide prepares nursing students for the Evolve HESI Pediatrics specialty
examination. The test assesses knowledge of growth and development, pediatric pathophysiology,
family-centered care, and clinical decision-making. It includes multiple-choice and scenario-
based questions that mirror real-world nursing practice, emphasizing prioritization, safety, and
evidence-based interventions. Candidates must apply critical thinking to manage common and
complex pediatric conditions across diverse healthcare settings.
SECTION ONE: QUESTIONS 1–150
1. A nurse is providing anticipatory guidance to the parents of a 4-month-old infant. Which
developmental milestone should the nurse discuss?
A. The infant will be able to sit without support.
🟢 B. The infant will be able to roll from back to front.
,C. The infant will be able to walk independently.
D. The infant will be able to speak in sentences.
🔴 RATIONALE: Rolling over typically occurs between 4–6 months. Sitting without support
occurs around 7–8 months. Walking independently occurs around 12–15 months. Speaking in
sentences occurs around 2–3 years.
2. The nurse is assessing a 12-month-old infant. Which finding indicates normal growth and
development?
A. The infant weighs approximately double their birth weight.
🟢 B. The infant weighs approximately triple their birth weight.
C. The infant weighs approximately quadruple their birth weight.
D. The infant weighs approximately five times their birth weight.
🔴 RATIONALE: By 12 months, an infant's weight typically triples from birth weight. It doubles
at about 4–6 months and quadruples by 2 years.
3. The nurse is assessing a 2-year-old toddler. Which behavior is expected for this age group
according to Erikson's theory?
A. The child is developing a sense of trust.
🟢 B. The child is developing a sense of autonomy.
C. The child is developing a sense of initiative.
D. The child is developing a sense of industry.
🔴 RATIONALE: Erikson's stage for toddlers (1–3 years) is autonomy vs. shame and doubt. Trust
vs. mistrust is for infants (0–1 year). Initiative vs. guilt is for preschoolers (3–5 years). Industry vs.
inferiority is for school-age children (6–12 years).
4. A 2-year-old child's mother expresses concern that her child is not speaking in complete
sentences. What is the nurse's best response?
A. "Your child should be evaluated for a speech delay immediately."
🟢 B. "At 2 years of age, children typically use 2–3 word phrases."
C. "Most 2-year-olds speak in complete sentences."
D. "This is a sign of cognitive impairment."
,🔴 RATIONALE: At 24 months, children typically have a vocabulary of about 50 words and
begin combining words into simple 2–3 word phrases. Complete sentences are not expected
until 3 years of age.
5. At what age does an infant typically develop a social smile?
A. 1 month
🟢 B. 2 months
C. 4 months
D. 6 months
🔴 RATIONALE: A social smile typically develops around 2 months of age.
6. A nurse is assessing a 4-month-old infant during a well-child visit. Which of the following
developmental milestones should the nurse expect the infant to have achieved? (Select all
that apply)
🟢 A. Rolls from back to side
B. Sits without support
🟢 C. Follows objects with eyes
🟢 D. Babbles consonant sounds
🟢 E. Holds head steady when upright
🔴 RATIONALE: By 4 months of age, infants typically roll from back to side, follow objects with
their eyes, babble consonant sounds, and hold their head steady when upright. Sitting without
support is a 6–8 month milestone.
7. A nurse is providing anticipatory guidance to the parents of a 2-year-old child. Which of
the following developmental characteristics should the nurse include in the teaching?
A. The child can ride a tricycle.
🟢 B. The child has a vocabulary of approximately 50 words.
C. The child can hop on one foot.
D. The child can draw a circle.
🔴 RATIONALE: A 2-year-old typically has a vocabulary of approximately 50 words and uses 2–
3 word phrases. Riding a tricycle is a 3-year milestone.
, 8. A 3-year-old boy is brought to the emergency room because he swallowed an entire
bottle of children's vitamin pills. Which intervention should the nurse implement first?
A. Insert N/G tube for gastric lavage.
🟢 B. Determine the child's pulse and respirations.
C. Assess the child's level of consciousness.
D. Administer an IV D5/0.25 NS as prescribed.
🔴 RATIONALE: The most important principle in dealing with a poisoning is to treat the child
first, not the poison. Initiate immediate life support measures with assessment of vital signs, in
particular, respirations.
9. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which
approach by the nurse is most helpful in establishing communication?
🟢 A. Engage the child through drawing pictures.
B. Suggest that the parent read a book to the child.
C. Provide paper and pencil for the child to keep a diary.
D. Ask the parent if the child is always uncommunicative.
🔴 RATIONALE: Drawing pictures is a valuable form of non-verbal communication. As the
nurse and child look at the drawings, a verbal story can be told that projects the child's
thinking.
10. A 2-year-old toddler is admitted with croup and presents with a barking cough,
inspiratory stridor, and mild retractions. The nurse notes that the child becomes more
agitated when upset. Which is the most appropriate nursing action to support airway
patency while minimizing distress?
A. Insert a nasopharyngeal airway
B. Perform frequent oral suctioning
🟢 C. Keep the child calm and avoid unnecessary stimulation
D. Place the child in a supine position
🔴 RATIONALE: In children with croup, agitation increases oxygen demand and can worsen
airway obstruction due to laryngeal edema. The priority is to maintain a calm environment and
avoid any interventions that could provoke crying or distress.
ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Growth and Development
Pediatric Assessment and Health Promotion
Respiratory Disorders
Cardiovascular Disorders
Gastrointestinal and Genitourinary Disorders
Neurological and Musculoskeletal Disorders
Hematologic and Oncologic Disorders
Pediatric Pharmacology and Medication Safety
Fluid, Electrolyte, and Nutritional Balance
Pediatric Emergencies and Critical Care
Introduction
This comprehensive study guide prepares nursing students for the Evolve HESI Pediatrics specialty
examination. The test assesses knowledge of growth and development, pediatric pathophysiology,
family-centered care, and clinical decision-making. It includes multiple-choice and scenario-
based questions that mirror real-world nursing practice, emphasizing prioritization, safety, and
evidence-based interventions. Candidates must apply critical thinking to manage common and
complex pediatric conditions across diverse healthcare settings.
SECTION ONE: QUESTIONS 1–150
1. A nurse is providing anticipatory guidance to the parents of a 4-month-old infant. Which
developmental milestone should the nurse discuss?
A. The infant will be able to sit without support.
🟢 B. The infant will be able to roll from back to front.
,C. The infant will be able to walk independently.
D. The infant will be able to speak in sentences.
🔴 RATIONALE: Rolling over typically occurs between 4–6 months. Sitting without support
occurs around 7–8 months. Walking independently occurs around 12–15 months. Speaking in
sentences occurs around 2–3 years.
2. The nurse is assessing a 12-month-old infant. Which finding indicates normal growth and
development?
A. The infant weighs approximately double their birth weight.
🟢 B. The infant weighs approximately triple their birth weight.
C. The infant weighs approximately quadruple their birth weight.
D. The infant weighs approximately five times their birth weight.
🔴 RATIONALE: By 12 months, an infant's weight typically triples from birth weight. It doubles
at about 4–6 months and quadruples by 2 years.
3. The nurse is assessing a 2-year-old toddler. Which behavior is expected for this age group
according to Erikson's theory?
A. The child is developing a sense of trust.
🟢 B. The child is developing a sense of autonomy.
C. The child is developing a sense of initiative.
D. The child is developing a sense of industry.
🔴 RATIONALE: Erikson's stage for toddlers (1–3 years) is autonomy vs. shame and doubt. Trust
vs. mistrust is for infants (0–1 year). Initiative vs. guilt is for preschoolers (3–5 years). Industry vs.
inferiority is for school-age children (6–12 years).
4. A 2-year-old child's mother expresses concern that her child is not speaking in complete
sentences. What is the nurse's best response?
A. "Your child should be evaluated for a speech delay immediately."
🟢 B. "At 2 years of age, children typically use 2–3 word phrases."
C. "Most 2-year-olds speak in complete sentences."
D. "This is a sign of cognitive impairment."
,🔴 RATIONALE: At 24 months, children typically have a vocabulary of about 50 words and
begin combining words into simple 2–3 word phrases. Complete sentences are not expected
until 3 years of age.
5. At what age does an infant typically develop a social smile?
A. 1 month
🟢 B. 2 months
C. 4 months
D. 6 months
🔴 RATIONALE: A social smile typically develops around 2 months of age.
6. A nurse is assessing a 4-month-old infant during a well-child visit. Which of the following
developmental milestones should the nurse expect the infant to have achieved? (Select all
that apply)
🟢 A. Rolls from back to side
B. Sits without support
🟢 C. Follows objects with eyes
🟢 D. Babbles consonant sounds
🟢 E. Holds head steady when upright
🔴 RATIONALE: By 4 months of age, infants typically roll from back to side, follow objects with
their eyes, babble consonant sounds, and hold their head steady when upright. Sitting without
support is a 6–8 month milestone.
7. A nurse is providing anticipatory guidance to the parents of a 2-year-old child. Which of
the following developmental characteristics should the nurse include in the teaching?
A. The child can ride a tricycle.
🟢 B. The child has a vocabulary of approximately 50 words.
C. The child can hop on one foot.
D. The child can draw a circle.
🔴 RATIONALE: A 2-year-old typically has a vocabulary of approximately 50 words and uses 2–
3 word phrases. Riding a tricycle is a 3-year milestone.
, 8. A 3-year-old boy is brought to the emergency room because he swallowed an entire
bottle of children's vitamin pills. Which intervention should the nurse implement first?
A. Insert N/G tube for gastric lavage.
🟢 B. Determine the child's pulse and respirations.
C. Assess the child's level of consciousness.
D. Administer an IV D5/0.25 NS as prescribed.
🔴 RATIONALE: The most important principle in dealing with a poisoning is to treat the child
first, not the poison. Initiate immediate life support measures with assessment of vital signs, in
particular, respirations.
9. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which
approach by the nurse is most helpful in establishing communication?
🟢 A. Engage the child through drawing pictures.
B. Suggest that the parent read a book to the child.
C. Provide paper and pencil for the child to keep a diary.
D. Ask the parent if the child is always uncommunicative.
🔴 RATIONALE: Drawing pictures is a valuable form of non-verbal communication. As the
nurse and child look at the drawings, a verbal story can be told that projects the child's
thinking.
10. A 2-year-old toddler is admitted with croup and presents with a barking cough,
inspiratory stridor, and mild retractions. The nurse notes that the child becomes more
agitated when upset. Which is the most appropriate nursing action to support airway
patency while minimizing distress?
A. Insert a nasopharyngeal airway
B. Perform frequent oral suctioning
🟢 C. Keep the child calm and avoid unnecessary stimulation
D. Place the child in a supine position
🔴 RATIONALE: In children with croup, agitation increases oxygen demand and can worsen
airway obstruction due to laryngeal edema. The priority is to maintain a calm environment and
avoid any interventions that could provoke crying or distress.
