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2025 HESI RN Pediatrics Exam – 50
Verified Questions with 100% Correct
Answers & Pediatric Nursing
Rationales | A+ Graded
Question Bank
Growth and Development
1. A nurse is assessing a 4-year-old child. Which developmental milestone is expected?
A. Ties shoelaces independently
B. Draws a person with three body parts
C. Reads simple sentences
D. Performs basic multiplication
Rationale : A 4-year-old can draw a person with three body parts (e.g., head, body,
legs), reflecting fine motor and cognitive development. Tying shoelaces (5–6 years),
reading (6–7 years), and multiplication (school-age) are not expected at this age.
(Hockenberry’s Wong’s Essentials of Pediatric Nursing)
2. A 6-month-old infant is brought to the clinic. Which reflex should the nurse expect to be
present?
A. Moro reflex
B. Palmar grasp reflex
C. Stepping reflex
D. Rooting reflex
Rationale : The palmar grasp reflex persists until about 6 months. The Moro,
stepping, and rooting reflexes typically disappear by 3–4 months. (Hockenberry’s Wong’s
Essentials of Pediatric Nursing)
3. A parent reports that their 2-year-old uses two-word phrases. Is this developmentally
appropriate?
A. No, the child should use full sentences
B. Yes, this is expected for a 2-year-old
C. No, the child should only use single words
D. Yes, but the child should also read words
, 2
Rationale : Two-word phrases (e.g., “want milk”) are expected at 2 years,
indicating language development. Full sentences emerge at 3–4 years, single words at 1
year, and reading is not expected. (Hockenberry’s Wong’s Essentials of Pediatric
Nursing)
4. A 10-year-old child is in which stage of Piaget’s cognitive development?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Rationale : The concrete operational stage (7–11 years) involves logical thinking
about concrete events. Sensorimotor (0–2 years), preoperational (2–7 years), and formal
operational (12+ years) are incorrect for a 10-year-old. (Hockenberry’s Wong’s
Essentials of Pediatric Nursing)
5. A nurse is counseling parents of a 12-month-old. What is an expected gross motor skill?
A. Running
B. Walking independently
C. Climbing stairs
D. Jumping with both feet
Rationale : A 12-month-old typically walks independently. Running, climbing
stairs, and jumping emerge at 18–24 months. (Hockenberry’s Wong’s Essentials of
Pediatric Nursing)
Respiratory Disorders
6. A 5-year-old with asthma presents with wheezing and dyspnea. What is the priority
nursing action?
A. Administer oxygen at 6 L/min
B. Administer albuterol via nebulizer
C. Start IV fluids
D. Obtain a chest X-ray
Rationale : Albuterol, a beta-2 agonist, is the first-line treatment for acute asthma
exacerbation, relieving bronchospasm. Oxygen may follow, but albuterol is the priority.
IV fluids and X-rays are secondary. (Hockenberry’s Wong’s Essentials of Pediatric
Nursing)
7. A nurse is caring for a child with cystic fibrosis. Which intervention promotes airway
clearance?
A. Restrict fluid intake
B. Perform chest physiotherapy
, 3
C. Administer antihistamines
D. Encourage bed rest
Rationale : Chest physiotherapy mobilizes mucus in cystic fibrosis, improving
airway clearance. Fluid restriction worsens mucus viscosity, antihistamines dry
secretions, and bed rest does not promote clearance. (Hockenberry’s Wong’s Essentials of
Pediatric Nursing)
8. Clinical Scenario: A 3-year-old with epiglottitis presents with drooling and stridor. What
is the nurse’s priority action?
A. Administer oral antibiotics
B. Maintain a patent airway
C. Encourage oral fluids
D. Perform a throat culture
Rationale : Epiglottitis is a medical emergency due to airway obstruction risk.
Maintaining a patent airway (e.g., preparing for intubation) is the priority. Oral
interventions or cultures can worsen obstruction. (Hockenberry’s Wong’s Essentials of
Pediatric Nursing)
9. A child with bronchiolitis is prescribed oxygen. Which delivery method is most
appropriate for a 6-month-old?
A. Nasal cannula
B. Oxygen hood
C. Face mask
D. Non-rebreather mask
Rationale : An oxygen hood is ideal for infants, providing high humidity and
oxygen without irritation. Nasal cannulas and masks are less tolerated, and non-
rebreathers are for older children. (ATI Pediatric Nursing)
10. A nurse is teaching parents about croup management. Which instruction is correct?
A. Administer cough suppressants
B. Use cool mist humidification
C. Encourage hot liquids
D. Restrict fluids
Rationale : Cool mist humidification reduces airway swelling in croup. Cough
suppressants are contraindicated, hot liquids may worsen symptoms, and fluid restriction
is unnecessary. (Hockenberry’s Wong’s Essentials of Pediatric Nursing)
Cardiac Conditions
11. A nurse is caring for a child with tetralogy of Fallot. What is a hallmark symptom?
A. Bradycardia
, 4
B. Cyanosis
C. Hypertension
D. Edema
Rationale : Tetralogy of Fallot causes right-to-left shunting, leading to cyanosis.
Bradycardia, hypertension, and edema are not typical. (Hockenberry’s Wong’s Essentials
of Pediatric Nursing)
12. A child with Kawasaki disease is prescribed aspirin. What is the therapeutic goal?
A. Pain relief
B. Prevent thrombus formation
C. Reduce fever only
D. Improve oxygenation
Rationale : Aspirin in Kawasaki disease prevents thrombus formation in coronary
arteries during the acute phase. Pain relief and fever reduction are secondary, and it does
not affect oxygenation. (Hockenberry’s Wong’s Essentials of Pediatric Nursing)
13. Clinical Scenario: A 2-year-old with heart failure is prescribed digoxin. What should the
nurse check first?
A. Blood pressure
B. Apical pulse
C. Respiratory rate
D. Temperature
Rationale : Digoxin can cause bradycardia, so checking the apical pulse (holding if
<90 bpm in infants) is the priority to prevent toxicity. Other vital signs are secondary.
(Hockenberry’s Wong’s Essentials of Pediatric Nursing)
14. A child with a ventricular septal defect (VSD) is at risk for which complication?
A. Seizures
B. Heart failure
C. Asthma
D. Renal failure
Rationale : VSD causes increased pulmonary blood flow, leading to heart failure.
Seizures, asthma, and renal failure are not directly related. (Hockenberry’s Wong’s
Essentials of Pediatric Nursing)
15. A nurse is teaching parents about post-operative care for a child with coarctation of the
aorta repair. What should they monitor?
A. Blood glucose
B. Lower extremity pulses
C. Respiratory rate
D. Temperature
2025 HESI RN Pediatrics Exam – 50
Verified Questions with 100% Correct
Answers & Pediatric Nursing
Rationales | A+ Graded
Question Bank
Growth and Development
1. A nurse is assessing a 4-year-old child. Which developmental milestone is expected?
A. Ties shoelaces independently
B. Draws a person with three body parts
C. Reads simple sentences
D. Performs basic multiplication
Rationale : A 4-year-old can draw a person with three body parts (e.g., head, body,
legs), reflecting fine motor and cognitive development. Tying shoelaces (5–6 years),
reading (6–7 years), and multiplication (school-age) are not expected at this age.
(Hockenberry’s Wong’s Essentials of Pediatric Nursing)
2. A 6-month-old infant is brought to the clinic. Which reflex should the nurse expect to be
present?
A. Moro reflex
B. Palmar grasp reflex
C. Stepping reflex
D. Rooting reflex
Rationale : The palmar grasp reflex persists until about 6 months. The Moro,
stepping, and rooting reflexes typically disappear by 3–4 months. (Hockenberry’s Wong’s
Essentials of Pediatric Nursing)
3. A parent reports that their 2-year-old uses two-word phrases. Is this developmentally
appropriate?
A. No, the child should use full sentences
B. Yes, this is expected for a 2-year-old
C. No, the child should only use single words
D. Yes, but the child should also read words
, 2
Rationale : Two-word phrases (e.g., “want milk”) are expected at 2 years,
indicating language development. Full sentences emerge at 3–4 years, single words at 1
year, and reading is not expected. (Hockenberry’s Wong’s Essentials of Pediatric
Nursing)
4. A 10-year-old child is in which stage of Piaget’s cognitive development?
A. Sensorimotor
B. Preoperational
C. Concrete operational
D. Formal operational
Rationale : The concrete operational stage (7–11 years) involves logical thinking
about concrete events. Sensorimotor (0–2 years), preoperational (2–7 years), and formal
operational (12+ years) are incorrect for a 10-year-old. (Hockenberry’s Wong’s
Essentials of Pediatric Nursing)
5. A nurse is counseling parents of a 12-month-old. What is an expected gross motor skill?
A. Running
B. Walking independently
C. Climbing stairs
D. Jumping with both feet
Rationale : A 12-month-old typically walks independently. Running, climbing
stairs, and jumping emerge at 18–24 months. (Hockenberry’s Wong’s Essentials of
Pediatric Nursing)
Respiratory Disorders
6. A 5-year-old with asthma presents with wheezing and dyspnea. What is the priority
nursing action?
A. Administer oxygen at 6 L/min
B. Administer albuterol via nebulizer
C. Start IV fluids
D. Obtain a chest X-ray
Rationale : Albuterol, a beta-2 agonist, is the first-line treatment for acute asthma
exacerbation, relieving bronchospasm. Oxygen may follow, but albuterol is the priority.
IV fluids and X-rays are secondary. (Hockenberry’s Wong’s Essentials of Pediatric
Nursing)
7. A nurse is caring for a child with cystic fibrosis. Which intervention promotes airway
clearance?
A. Restrict fluid intake
B. Perform chest physiotherapy
, 3
C. Administer antihistamines
D. Encourage bed rest
Rationale : Chest physiotherapy mobilizes mucus in cystic fibrosis, improving
airway clearance. Fluid restriction worsens mucus viscosity, antihistamines dry
secretions, and bed rest does not promote clearance. (Hockenberry’s Wong’s Essentials of
Pediatric Nursing)
8. Clinical Scenario: A 3-year-old with epiglottitis presents with drooling and stridor. What
is the nurse’s priority action?
A. Administer oral antibiotics
B. Maintain a patent airway
C. Encourage oral fluids
D. Perform a throat culture
Rationale : Epiglottitis is a medical emergency due to airway obstruction risk.
Maintaining a patent airway (e.g., preparing for intubation) is the priority. Oral
interventions or cultures can worsen obstruction. (Hockenberry’s Wong’s Essentials of
Pediatric Nursing)
9. A child with bronchiolitis is prescribed oxygen. Which delivery method is most
appropriate for a 6-month-old?
A. Nasal cannula
B. Oxygen hood
C. Face mask
D. Non-rebreather mask
Rationale : An oxygen hood is ideal for infants, providing high humidity and
oxygen without irritation. Nasal cannulas and masks are less tolerated, and non-
rebreathers are for older children. (ATI Pediatric Nursing)
10. A nurse is teaching parents about croup management. Which instruction is correct?
A. Administer cough suppressants
B. Use cool mist humidification
C. Encourage hot liquids
D. Restrict fluids
Rationale : Cool mist humidification reduces airway swelling in croup. Cough
suppressants are contraindicated, hot liquids may worsen symptoms, and fluid restriction
is unnecessary. (Hockenberry’s Wong’s Essentials of Pediatric Nursing)
Cardiac Conditions
11. A nurse is caring for a child with tetralogy of Fallot. What is a hallmark symptom?
A. Bradycardia
, 4
B. Cyanosis
C. Hypertension
D. Edema
Rationale : Tetralogy of Fallot causes right-to-left shunting, leading to cyanosis.
Bradycardia, hypertension, and edema are not typical. (Hockenberry’s Wong’s Essentials
of Pediatric Nursing)
12. A child with Kawasaki disease is prescribed aspirin. What is the therapeutic goal?
A. Pain relief
B. Prevent thrombus formation
C. Reduce fever only
D. Improve oxygenation
Rationale : Aspirin in Kawasaki disease prevents thrombus formation in coronary
arteries during the acute phase. Pain relief and fever reduction are secondary, and it does
not affect oxygenation. (Hockenberry’s Wong’s Essentials of Pediatric Nursing)
13. Clinical Scenario: A 2-year-old with heart failure is prescribed digoxin. What should the
nurse check first?
A. Blood pressure
B. Apical pulse
C. Respiratory rate
D. Temperature
Rationale : Digoxin can cause bradycardia, so checking the apical pulse (holding if
<90 bpm in infants) is the priority to prevent toxicity. Other vital signs are secondary.
(Hockenberry’s Wong’s Essentials of Pediatric Nursing)
14. A child with a ventricular septal defect (VSD) is at risk for which complication?
A. Seizures
B. Heart failure
C. Asthma
D. Renal failure
Rationale : VSD causes increased pulmonary blood flow, leading to heart failure.
Seizures, asthma, and renal failure are not directly related. (Hockenberry’s Wong’s
Essentials of Pediatric Nursing)
15. A nurse is teaching parents about post-operative care for a child with coarctation of the
aorta repair. What should they monitor?
A. Blood glucose
B. Lower extremity pulses
C. Respiratory rate
D. Temperature
