HESI RN Pediatrics Exit Exam 2025 –
Verified Questions and Correct
Answers with Expert Rationales
Pediatric Nursing Questions (1–80)
1. A nurse is assessing a 6-month-old infant during a well-child visit. Which
developmental milestone is expected?
a. Walking independently
b. Sitting without support
c. Using two-word phrases
d. Drinking from a straw
Correct Answer: b. Sitting without support
Rationale: By 6 months, infants typically sit without support. Walking occurs around 12
months, two-word phrases around 24 months, and drinking from a straw around 12–18
months.
2. A parent reports their 3-year-old has a fever and sore throat. Which finding
suggests streptococcal pharyngitis?
a. Barking cough
b. White patches on tonsils
c. Inspiratory stridor
d. Wheezing on expiration
Correct Answer: b. White patches on tonsils
Rationale: White patches on tonsils are a hallmark of streptococcal pharyngitis, often
with fever and sore throat. Barking cough and stridor suggest croup, and wheezing is
associated with asthma.
3. A child with type 1 diabetes presents with polyuria and lethargy. Which finding
confirms diabetic ketoacidosis (DKA)?
a. Blood glucose 180 mg/dL
b. Serum pH 7.25
c. Serum potassium 3.8 mEq/L
d. Bicarbonate 20 mEq/L
Correct Answer: b. Serum pH 7.25
Rationale: DKA is characterized by metabolic acidosis (pH <7.35) due to ketone
accumulation. Blood glucose is typically >250 mg/dL, potassium may be elevated
initially, and bicarbonate is low (<18 mEq/L).
4. A nurse is teaching parents about preventing sudden infant death syndrome (SIDS).
Which instruction is most critical?
a. Place the infant prone for sleep
b. Use a firm mattress and avoid soft bedding
, c. Keep the room temperature at 78°F
d. Allow co-sleeping with parents
Correct Answer: b. Use a firm mattress and avoid soft bedding
Rationale: A firm mattress and no soft bedding reduce SIDS risk by preventing
suffocation. Prone positioning and co-sleeping increase risk, and room temperature
should be 68–72°F.
5. A child with asthma is prescribed albuterol via metered-dose inhaler. Which
statement by the parent indicates understanding?
a. “This medication prevents asthma attacks.”
b. “I’ll give it every 6 hours daily.”
c. “This medication relieves acute wheezing.”
d. “I should shake the inhaler after each puff.”
Correct Answer: c. This medication relieves acute wheezing.
Rationale: Albuterol, a short-acting beta-agonist, relieves acute asthma symptoms like
wheezing. It is used as needed, not preventatively, and the inhaler is shaken before use,
not after puffs.
6. A nurse is assessing a 12-month-old with suspected dehydration. Which finding is
most concerning?
a. Heart rate 130 bpm
b. Sunken fontanelles
c. Dry mucous membranes
d. Urine output 2 mL/kg/hr
Correct Answer: b. Sunken fontanelles
Rationale: Sunken fontanelles in a 12-month-old indicate severe dehydration, as the
anterior fontanelle is still open. Tachycardia and dry mucous membranes are concerning
but less specific, and urine output of 2 mL/kg/hr is normal.
7. A child with epilepsy is prescribed valproic acid. Which side effect should the nurse
monitor for?
a. Weight loss
b. Hepatotoxicity
c. Hypoglycemia
d. Hypertension
Correct Answer: b. Hepatotoxicity
Rationale: Valproic acid can cause hepatotoxicity, requiring liver function monitoring.
Weight gain, not loss, is common, and hypoglycemia or hypertension are not typical side
effects.
8. A nurse is preparing to administer vaccines to a 2-month-old. Which vaccine is
typically given at this age?
a. Measles, mumps, rubella (MMR)
b. Diphtheria, tetanus, pertussis (DTaP)
c. Varicella
d. Hepatitis A
Correct Answer: b. Diphtheria, tetanus, pertussis (DTaP)
Rationale: DTaP is administered at 2, 4, 6, and 15–18 months to prevent diphtheria,
tetanus, and pertussis. MMR and varicella are given at 12–15 months, and hepatitis A at
12–23 months.
, 9. A child with sickle cell anemia is in a vaso-occlusive crisis. Which intervention is the
priority?
a. Administer oxygen
b. Provide pain relief
c. Apply cold compresses
d. Restrict fluid intake
Correct Answer: b. Provide pain relief
Rationale: Pain is the hallmark of a vaso-occlusive crisis, making pain relief the priority.
Oxygen is used for hypoxia, cold compresses may worsen vasoconstriction, and fluids are
encouraged.
10. A parent asks how to manage their child’s fever at home. Which recommendation is
appropriate?
a. Use aspirin to reduce fever
b. Administer ibuprofen as prescribed
c. Apply cold compresses to the chest
d. Give acetaminophen every 2 hours
Correct Answer: b. Administer ibuprofen as prescribed
Rationale: Ibuprofen is safe and effective for fever when dosed correctly. Aspirin is
contraindicated due to Reye’s syndrome risk, cold compresses are less effective, and
acetaminophen dosing is every 4–6 hours.
11. A nurse is assessing a 4-year-old with suspected meningitis. Which finding requires
immediate action?
a. Fever of 102°F
b. Altered level of consciousness
c. Photophobia
d. Nuchal rigidity
Correct Answer: b. Altered level of consciousness
Rationale: Altered consciousness suggests neurological deterioration in meningitis,
requiring urgent intervention. Fever, photophobia, and nuchal rigidity are expected but
less immediately life-threatening.
12. A child with cystic fibrosis is prescribed pancreatic enzymes. When should the nurse
instruct the parent to administer them?
a. One hour after meals
b. With meals or snacks
c. At bedtime
d. Every 4 hours
Correct Answer: b. With meals or snacks
Rationale: Pancreatic enzymes aid digestion in cystic fibrosis and are taken with meals
or snacks for effectiveness. Other timings are incorrect.
13. A nurse is caring for a newborn with jaundice. Which intervention is most
appropriate?
a. Increase formula feedings
b. Initiate phototherapy
c. Administer vitamin K
d. Apply a warm compress
Correct Answer: b. Initiate phototherapy
Verified Questions and Correct
Answers with Expert Rationales
Pediatric Nursing Questions (1–80)
1. A nurse is assessing a 6-month-old infant during a well-child visit. Which
developmental milestone is expected?
a. Walking independently
b. Sitting without support
c. Using two-word phrases
d. Drinking from a straw
Correct Answer: b. Sitting without support
Rationale: By 6 months, infants typically sit without support. Walking occurs around 12
months, two-word phrases around 24 months, and drinking from a straw around 12–18
months.
2. A parent reports their 3-year-old has a fever and sore throat. Which finding
suggests streptococcal pharyngitis?
a. Barking cough
b. White patches on tonsils
c. Inspiratory stridor
d. Wheezing on expiration
Correct Answer: b. White patches on tonsils
Rationale: White patches on tonsils are a hallmark of streptococcal pharyngitis, often
with fever and sore throat. Barking cough and stridor suggest croup, and wheezing is
associated with asthma.
3. A child with type 1 diabetes presents with polyuria and lethargy. Which finding
confirms diabetic ketoacidosis (DKA)?
a. Blood glucose 180 mg/dL
b. Serum pH 7.25
c. Serum potassium 3.8 mEq/L
d. Bicarbonate 20 mEq/L
Correct Answer: b. Serum pH 7.25
Rationale: DKA is characterized by metabolic acidosis (pH <7.35) due to ketone
accumulation. Blood glucose is typically >250 mg/dL, potassium may be elevated
initially, and bicarbonate is low (<18 mEq/L).
4. A nurse is teaching parents about preventing sudden infant death syndrome (SIDS).
Which instruction is most critical?
a. Place the infant prone for sleep
b. Use a firm mattress and avoid soft bedding
, c. Keep the room temperature at 78°F
d. Allow co-sleeping with parents
Correct Answer: b. Use a firm mattress and avoid soft bedding
Rationale: A firm mattress and no soft bedding reduce SIDS risk by preventing
suffocation. Prone positioning and co-sleeping increase risk, and room temperature
should be 68–72°F.
5. A child with asthma is prescribed albuterol via metered-dose inhaler. Which
statement by the parent indicates understanding?
a. “This medication prevents asthma attacks.”
b. “I’ll give it every 6 hours daily.”
c. “This medication relieves acute wheezing.”
d. “I should shake the inhaler after each puff.”
Correct Answer: c. This medication relieves acute wheezing.
Rationale: Albuterol, a short-acting beta-agonist, relieves acute asthma symptoms like
wheezing. It is used as needed, not preventatively, and the inhaler is shaken before use,
not after puffs.
6. A nurse is assessing a 12-month-old with suspected dehydration. Which finding is
most concerning?
a. Heart rate 130 bpm
b. Sunken fontanelles
c. Dry mucous membranes
d. Urine output 2 mL/kg/hr
Correct Answer: b. Sunken fontanelles
Rationale: Sunken fontanelles in a 12-month-old indicate severe dehydration, as the
anterior fontanelle is still open. Tachycardia and dry mucous membranes are concerning
but less specific, and urine output of 2 mL/kg/hr is normal.
7. A child with epilepsy is prescribed valproic acid. Which side effect should the nurse
monitor for?
a. Weight loss
b. Hepatotoxicity
c. Hypoglycemia
d. Hypertension
Correct Answer: b. Hepatotoxicity
Rationale: Valproic acid can cause hepatotoxicity, requiring liver function monitoring.
Weight gain, not loss, is common, and hypoglycemia or hypertension are not typical side
effects.
8. A nurse is preparing to administer vaccines to a 2-month-old. Which vaccine is
typically given at this age?
a. Measles, mumps, rubella (MMR)
b. Diphtheria, tetanus, pertussis (DTaP)
c. Varicella
d. Hepatitis A
Correct Answer: b. Diphtheria, tetanus, pertussis (DTaP)
Rationale: DTaP is administered at 2, 4, 6, and 15–18 months to prevent diphtheria,
tetanus, and pertussis. MMR and varicella are given at 12–15 months, and hepatitis A at
12–23 months.
, 9. A child with sickle cell anemia is in a vaso-occlusive crisis. Which intervention is the
priority?
a. Administer oxygen
b. Provide pain relief
c. Apply cold compresses
d. Restrict fluid intake
Correct Answer: b. Provide pain relief
Rationale: Pain is the hallmark of a vaso-occlusive crisis, making pain relief the priority.
Oxygen is used for hypoxia, cold compresses may worsen vasoconstriction, and fluids are
encouraged.
10. A parent asks how to manage their child’s fever at home. Which recommendation is
appropriate?
a. Use aspirin to reduce fever
b. Administer ibuprofen as prescribed
c. Apply cold compresses to the chest
d. Give acetaminophen every 2 hours
Correct Answer: b. Administer ibuprofen as prescribed
Rationale: Ibuprofen is safe and effective for fever when dosed correctly. Aspirin is
contraindicated due to Reye’s syndrome risk, cold compresses are less effective, and
acetaminophen dosing is every 4–6 hours.
11. A nurse is assessing a 4-year-old with suspected meningitis. Which finding requires
immediate action?
a. Fever of 102°F
b. Altered level of consciousness
c. Photophobia
d. Nuchal rigidity
Correct Answer: b. Altered level of consciousness
Rationale: Altered consciousness suggests neurological deterioration in meningitis,
requiring urgent intervention. Fever, photophobia, and nuchal rigidity are expected but
less immediately life-threatening.
12. A child with cystic fibrosis is prescribed pancreatic enzymes. When should the nurse
instruct the parent to administer them?
a. One hour after meals
b. With meals or snacks
c. At bedtime
d. Every 4 hours
Correct Answer: b. With meals or snacks
Rationale: Pancreatic enzymes aid digestion in cystic fibrosis and are taken with meals
or snacks for effectiveness. Other timings are incorrect.
13. A nurse is caring for a newborn with jaundice. Which intervention is most
appropriate?
a. Increase formula feedings
b. Initiate phototherapy
c. Administer vitamin K
d. Apply a warm compress
Correct Answer: b. Initiate phototherapy
