1
HESI RN Pediatrics Exit Exam
2025/2026 – 55 Actual Questions with
Verified Answers and Expert
Rationales | A+ Graded
Pediatric Growth and Development
1. A nurse is assessing a 2-year-old child during a well-child visit. Which developmental
milestone should the nurse expect the child to achieve?
a. Rides a tricycle independently
b. Ties shoelaces without assistance
c. Speaks in 2- to 3-word sentences
d. Recognizes letters of the alphabet
Rationale: By age 2, children typically speak in 2- to 3-word sentences as part of
language development. Riding a tricycle is expected around age 3, tying shoelaces around
age 5, and recognizing letters is typical for a 4- to 5-year-old.
2. A parent asks the nurse when their child’s birth length is expected to double. What is the
nurse’s best response?
a. By 2 years
b. By 4 years
c. By 6 years
d. By 8 years
Rationale: A child’s birth length typically doubles by age 4 years, a key growth
milestone.
3. The nurse observes a 6-month-old infant during a physical exam. Which finding requires
further evaluation?
a. Turns head to locate sound
b. Plays peek-a-boo
c. Demonstrates startle reflex
d. Has doubled birth weight
Rationale: The startle (Moro) reflex should disappear by 3–4 months. Its presence at 6
months warrants further evaluation for neurological concerns. Other options are age-
appropriate milestones.
4. A 4-year-old child is observed during a clinic visit. Which activity is most age-
appropriate?
a. Solving simple math problems
b. Using scissors to cut shapes
c. Writing full sentences
d. Playing competitive sports
Rationale: At age 4, children can use scissors to cut simple shapes, reflecting fine motor
skill development. Other options are more typical of older children.
, 2
5. A nurse is counseling parents of a 10-year-old girl about puberty. When should the
parents expect her growth spurt to begin?
a. Age 8
b. Age 10
c. Age 12
d. Age 14
Rationale: Girls typically experience a growth spurt starting around age 10, earlier than
boys, who begin around age 12.
6. A 3-year-old child refuses to share toys during a playgroup. How should the nurse
interpret this behavior?
a. Sign of developmental delay
b. Normal toddler behavior
c. Indication of social anxiety
d. Need for behavioral therapy
Rationale: Refusing to share is typical egocentric behavior in toddlers, reflecting normal
psychosocial development per Erikson’s autonomy vs. shame and doubt stage.
7. A nurse assesses a 5-year-old child. Which finding indicates a need for further
developmental evaluation?
a. Draws a stick figure
b. Cannot hop on one foot
c. Names primary colors
d. Engages in cooperative play
Rationale: By age 5, children should be able to hop on one foot. Inability to do so may
indicate a motor delay, requiring further assessment.
8. A parent reports that their 18-month-old child throws a ball underhand but not overhand.
What is the nurse’s best response?
a. Refer the child for physical therapy
b. Explain this is age-appropriate
c. Suggest a neurological evaluation
d. Recommend fine motor exercises
Rationale: Throwing a ball overhand typically develops by 18 months, but underhand
throwing is still age-appropriate for this stage.
9. A nurse is teaching parents about adolescent development. Which behavior is common
during this stage?
a. Consistent obedience to family rules
b. Rebellion against family values
c. Preference for solitary play
d. Lack of identity formation
Rationale: Adolescence is marked by identity vs. role confusion (Erikson), often leading
to rebellion as teens establish their identity.
10. A 12-month-old infant is assessed for growth. What is the expected weight milestone?
a. Doubled birth weight
b. Tripled birth weight
c. Quadrupled birth weight
d. No significant change
HESI RN Pediatrics Exit Exam
2025/2026 – 55 Actual Questions with
Verified Answers and Expert
Rationales | A+ Graded
Pediatric Growth and Development
1. A nurse is assessing a 2-year-old child during a well-child visit. Which developmental
milestone should the nurse expect the child to achieve?
a. Rides a tricycle independently
b. Ties shoelaces without assistance
c. Speaks in 2- to 3-word sentences
d. Recognizes letters of the alphabet
Rationale: By age 2, children typically speak in 2- to 3-word sentences as part of
language development. Riding a tricycle is expected around age 3, tying shoelaces around
age 5, and recognizing letters is typical for a 4- to 5-year-old.
2. A parent asks the nurse when their child’s birth length is expected to double. What is the
nurse’s best response?
a. By 2 years
b. By 4 years
c. By 6 years
d. By 8 years
Rationale: A child’s birth length typically doubles by age 4 years, a key growth
milestone.
3. The nurse observes a 6-month-old infant during a physical exam. Which finding requires
further evaluation?
a. Turns head to locate sound
b. Plays peek-a-boo
c. Demonstrates startle reflex
d. Has doubled birth weight
Rationale: The startle (Moro) reflex should disappear by 3–4 months. Its presence at 6
months warrants further evaluation for neurological concerns. Other options are age-
appropriate milestones.
4. A 4-year-old child is observed during a clinic visit. Which activity is most age-
appropriate?
a. Solving simple math problems
b. Using scissors to cut shapes
c. Writing full sentences
d. Playing competitive sports
Rationale: At age 4, children can use scissors to cut simple shapes, reflecting fine motor
skill development. Other options are more typical of older children.
, 2
5. A nurse is counseling parents of a 10-year-old girl about puberty. When should the
parents expect her growth spurt to begin?
a. Age 8
b. Age 10
c. Age 12
d. Age 14
Rationale: Girls typically experience a growth spurt starting around age 10, earlier than
boys, who begin around age 12.
6. A 3-year-old child refuses to share toys during a playgroup. How should the nurse
interpret this behavior?
a. Sign of developmental delay
b. Normal toddler behavior
c. Indication of social anxiety
d. Need for behavioral therapy
Rationale: Refusing to share is typical egocentric behavior in toddlers, reflecting normal
psychosocial development per Erikson’s autonomy vs. shame and doubt stage.
7. A nurse assesses a 5-year-old child. Which finding indicates a need for further
developmental evaluation?
a. Draws a stick figure
b. Cannot hop on one foot
c. Names primary colors
d. Engages in cooperative play
Rationale: By age 5, children should be able to hop on one foot. Inability to do so may
indicate a motor delay, requiring further assessment.
8. A parent reports that their 18-month-old child throws a ball underhand but not overhand.
What is the nurse’s best response?
a. Refer the child for physical therapy
b. Explain this is age-appropriate
c. Suggest a neurological evaluation
d. Recommend fine motor exercises
Rationale: Throwing a ball overhand typically develops by 18 months, but underhand
throwing is still age-appropriate for this stage.
9. A nurse is teaching parents about adolescent development. Which behavior is common
during this stage?
a. Consistent obedience to family rules
b. Rebellion against family values
c. Preference for solitary play
d. Lack of identity formation
Rationale: Adolescence is marked by identity vs. role confusion (Erikson), often leading
to rebellion as teens establish their identity.
10. A 12-month-old infant is assessed for growth. What is the expected weight milestone?
a. Doubled birth weight
b. Tripled birth weight
c. Quadrupled birth weight
d. No significant change
