1. Growth and Development Milestones (infant through adolescent)
2. Pediatric Assessment and Vital Signs (age-specific norms)
3. Immunizations and Vaccine Contraindications
4. Respiratory Disorders and Airway Emergencies (RSV, croup, epiglottitis, asthma)
5. Fluid and Electrolyte Imbalances / Dehydration
6. Congenital and Chronic Conditions (congenital heart defects, sickle cell, cystic
fibrosis)
7. Pediatric Medication Safety and Weight-Based Dosing
8. Family-Centered Care and Communication by Developmental Stage
9. Safety, Injury Prevention, and Maltreatment Recognition
10. Post-Operative and Emergency Prioritization (ABCs, NGN clinical judgment)
HESI RN Pediatrics V2 NGN
1. A nurse is assessing a 6-month-old infant during a well-child visit and notes that the
anterior fontanelle remains open and soft with no signs of bulging or depression.
Which action should the nurse take next?
A. Notify the healthcare provider immediately for suspected hydrocephalus
B. Document the finding as a normal expected assessment for this age
,C. Assess the infant for signs of severe dehydration and sunken fontanelle
D. Prepare the family for an urgent head ultrasound to evaluate closure
Correct Answer: B
A is incorrect because a bulging fontanelle would suggest increased intracranial
pressure, but the finding described is soft and flat.
B is correct because the anterior fontanelle normally closes between 12 and 18
months of age, making an open soft fontanelle at 6 months an expected normal
finding . 3
C is incorrect because a sunken fontanelle would indicate dehydration, but the stem
describes a soft, normal fontanelle.
D is incorrect because no urgency exists for a normal developmental finding.
2. A nurse is caring for a 4-month-old infant and is reviewing expected developmental
milestones with the parents. Which milestone should the nurse anticipate this infant
has achieved?
A. Sitting without support for extended periods
B. Rolling from abdomen to back
,C. Transferring objects hand to hand
D. Waving bye-bye to familiar caregivers
Correct Answer: B
A is incorrect because independent sitting typically emerges around 6 to 7 months of
age . 4
B is correct because rolling over usually begins between 4 and 5 months of age . 4
C is incorrect because hand-to-hand transfer typically develops around 7 months.
D is incorrect because waving bye-bye is a 9-month milestone.
3. A nurse is teaching a parent about appropriate toy selection for a hospitalized 6-
month-old infant who is awake and playful. Which toy should the nurse recommend as
safest and most developmentally appropriate?
A. Puzzle board with small removable pieces
B. Soft rattle with textured surfaces
C. Coloring book with large crayons
D. Building blocks labeled with numbers
Correct Answer: B
, A is incorrect because small puzzle pieces pose a choking hazard for an infant who
explores objects orally.
B is correct because a soft textured rattle supports grasping, sensory exploration, and
is safe for a 6-month-old’s developmental stage . 3
C is incorrect because crayons and coloring are appropriate for older toddlers and
preschoolers, not infants.
D is incorrect because small blocks are a choking risk at this age.
4. A 2-day-old newborn presents with jaundice involving the face and chest, a total
serum bilirubin of 14 mg/dL, and blood type A positive with a mother who is O positive.
The infant is breastfeeding well. Which nursing action is the priority?
A. Prepare for an emergent exchange transfusion
B. Initiate phototherapy and continue breastfeeding
C. Stop breastfeeding and switch to a lactose-free formula
D. Administer intravenous immunoglobulin immediately without provider order
Correct Answer: B
A is incorrect because exchange transfusion is reserved for severe hyperbilirubinemia
unresponsive to phototherapy or approaching kernicterus thresholds.
2. Pediatric Assessment and Vital Signs (age-specific norms)
3. Immunizations and Vaccine Contraindications
4. Respiratory Disorders and Airway Emergencies (RSV, croup, epiglottitis, asthma)
5. Fluid and Electrolyte Imbalances / Dehydration
6. Congenital and Chronic Conditions (congenital heart defects, sickle cell, cystic
fibrosis)
7. Pediatric Medication Safety and Weight-Based Dosing
8. Family-Centered Care and Communication by Developmental Stage
9. Safety, Injury Prevention, and Maltreatment Recognition
10. Post-Operative and Emergency Prioritization (ABCs, NGN clinical judgment)
HESI RN Pediatrics V2 NGN
1. A nurse is assessing a 6-month-old infant during a well-child visit and notes that the
anterior fontanelle remains open and soft with no signs of bulging or depression.
Which action should the nurse take next?
A. Notify the healthcare provider immediately for suspected hydrocephalus
B. Document the finding as a normal expected assessment for this age
,C. Assess the infant for signs of severe dehydration and sunken fontanelle
D. Prepare the family for an urgent head ultrasound to evaluate closure
Correct Answer: B
A is incorrect because a bulging fontanelle would suggest increased intracranial
pressure, but the finding described is soft and flat.
B is correct because the anterior fontanelle normally closes between 12 and 18
months of age, making an open soft fontanelle at 6 months an expected normal
finding . 3
C is incorrect because a sunken fontanelle would indicate dehydration, but the stem
describes a soft, normal fontanelle.
D is incorrect because no urgency exists for a normal developmental finding.
2. A nurse is caring for a 4-month-old infant and is reviewing expected developmental
milestones with the parents. Which milestone should the nurse anticipate this infant
has achieved?
A. Sitting without support for extended periods
B. Rolling from abdomen to back
,C. Transferring objects hand to hand
D. Waving bye-bye to familiar caregivers
Correct Answer: B
A is incorrect because independent sitting typically emerges around 6 to 7 months of
age . 4
B is correct because rolling over usually begins between 4 and 5 months of age . 4
C is incorrect because hand-to-hand transfer typically develops around 7 months.
D is incorrect because waving bye-bye is a 9-month milestone.
3. A nurse is teaching a parent about appropriate toy selection for a hospitalized 6-
month-old infant who is awake and playful. Which toy should the nurse recommend as
safest and most developmentally appropriate?
A. Puzzle board with small removable pieces
B. Soft rattle with textured surfaces
C. Coloring book with large crayons
D. Building blocks labeled with numbers
Correct Answer: B
, A is incorrect because small puzzle pieces pose a choking hazard for an infant who
explores objects orally.
B is correct because a soft textured rattle supports grasping, sensory exploration, and
is safe for a 6-month-old’s developmental stage . 3
C is incorrect because crayons and coloring are appropriate for older toddlers and
preschoolers, not infants.
D is incorrect because small blocks are a choking risk at this age.
4. A 2-day-old newborn presents with jaundice involving the face and chest, a total
serum bilirubin of 14 mg/dL, and blood type A positive with a mother who is O positive.
The infant is breastfeeding well. Which nursing action is the priority?
A. Prepare for an emergent exchange transfusion
B. Initiate phototherapy and continue breastfeeding
C. Stop breastfeeding and switch to a lactose-free formula
D. Administer intravenous immunoglobulin immediately without provider order
Correct Answer: B
A is incorrect because exchange transfusion is reserved for severe hyperbilirubinemia
unresponsive to phototherapy or approaching kernicterus thresholds.
