HESI Pediatrics Exam Prep 2026 | Comprehensive Review of Growth &
Development, Pediatric Disorders, Medication Safety, Family-Centered
Care, Immunizations, Emergency Situations, and Clinical Judgment | HESI-
Style Practice Questions with Verified Answers, NCLEX-Aligned
Rationales, Real-World Pediatric Scenarios, and Complete Study Guide to
Ace the HESI Pediatric Nursing Exam
Question 1:
A 5-year-old child is brought to the clinic for a routine check-up. The nurse notices that
the child is significantly underweight for their age. What is the priority nursing
intervention?
• A) Recommend a high-calorie diet
• B) Obtain a dietary history
• C) Refer to a nutritionist
• D) Schedule a follow-up appointment
Correct Option: B) Obtain a dietary history
Rationale:
Obtaining a dietary history is crucial to identify potential dietary deficiencies, eating
behaviors, or family circumstances contributing to the child's underweight status.
Understanding the child's current intake helps in tailoring interventions effectively.
Question 2:
Which of the following is the most common cause of dehydration in pediatric patients?
• A) Excessive sweating
• B) Vomiting and diarrhea
• C) Inadequate fluid intake
• D) Fever
Correct Option: C) Inadequate fluid intake
Rationale:
While vomiting and diarrhea are significant contributors to dehydration, inadequate
fluid intake is the most prevalent cause, especially in infants and young children who
may have limited access to fluids or are unable to communicate their thirst.
Question 3:
A nurse is assessing a 3-month-old infant. What is an expected developmental
milestone for this age group?
, • A) Sitting without assistance
• B) Coos and babbles
• C) Walking
• D) Imitating gestures
Correct Option: B) Coos and babbles
Rationale:
At 3 months, infants typically begin cooing and babbling as part of their verbal
development. This is a critical milestone in communication skills as they engage more
with caregivers.
Question 4:
An 8-year-old is diagnosed with asthma. Which statement by the parent indicates a
need for further education?
• A) "I should let my child play outdoors when the air quality is poor."
• B) "We will ensure my child has a rescue inhaler handy at all times."
• C) "I will monitor my child for signs of an asthma attack."
• D) "We will keep track of any potential triggers for his asthma."
Correct Option: A) "I should let my child play outdoors when the air quality is poor."
Rationale:
This statement indicates a lack of understanding regarding asthma management.
Children with asthma should avoid outdoor activities during poor air quality to minimize
the risk of exacerbation.
Question 5:
A nurse is caring for a 2-year-old child. Which of the following approaches should the
nurse use to assess the child?
• A) Use play to facilitate the examination
• B) Explain the procedure step by step
• C) Conduct the examination quickly to minimize stress
• D) Involve the parents in every step
Correct Option: A) Use play to facilitate the examination
,Rationale:
Using play is an effective pediatric nursing strategy as it helps reduce anxiety and allows
the child to engage actively during the assessment, making it less intimidating.
Question 6:
A nurse is educating parents about the signs of dehydration in infants. Which of the
following indicates severe dehydration?
• A) Decreased urine output
• B) Dry mucous membranes
• C) Sunken fontanel
• D) Increased thirst
Correct Option: C) Sunken fontanel
Rationale:
A sunken fontanel is a classic sign of severe dehydration in infants, indicating a
significant loss of fluid volume. Other signs can also be present but are less specific.
Question 7:
When assessing a 10-year-old child with suspected appendicitis, which symptom is
considered classic?
• A) Diarrhea
• B) Fever
• C) Right lower quadrant pain
• D) Nausea without vomiting
Correct Option: C) Right lower quadrant pain
Rationale:
Classic symptoms of appendicitis include pain in the right lower quadrant, often
starting around the umbilicus before localizing.
Question 8:
The nurse is discussing growth and development with a parent of a 1-year-old. What
should the nurse emphasize as a typical milestone for this age?
• A) Jumping in place
• B) Using simple words
• C) Skipping
, • D) Riding a tricycle
Correct Option: B) Using simple words
Rationale:
By age one, children typically begin to use simple words, marking a significant
milestone in language development.
Question 9:
Which of the following behaviors is typical for a 4-year-old child?
• A) Engaging in imaginative play
• B) Reading simple books independently
• C) Demonstrating mature social skills
• D) Performing complex puzzles
Correct Option: A) Engaging in imaginative play
Rationale:
Imaginative play is a hallmark of development at this age, reflecting cognitive and
emotional growth.
Question 10:
A nurse notices that a child has gained a significant amount of weight rapidly. What is
the most appropriate initial nursing action?
• A) Refer to a dietitian
• B) Educate the family on healthy eating
• C) Assess for underlying health issues
• D) Schedule a follow-up appointment
Correct Option: C) Assess for underlying health issues
Rationale:
Rapid weight gain may indicate medical concerns such as hormonal imbalances or
metabolic issues, making assessment the priority.
Question 11:
A pediatric patient is prescribed an antibiotic. Which statement by the parent indicates
a need for further teaching?
• A) "I will finish all the medication even if my child feels better."
Development, Pediatric Disorders, Medication Safety, Family-Centered
Care, Immunizations, Emergency Situations, and Clinical Judgment | HESI-
Style Practice Questions with Verified Answers, NCLEX-Aligned
Rationales, Real-World Pediatric Scenarios, and Complete Study Guide to
Ace the HESI Pediatric Nursing Exam
Question 1:
A 5-year-old child is brought to the clinic for a routine check-up. The nurse notices that
the child is significantly underweight for their age. What is the priority nursing
intervention?
• A) Recommend a high-calorie diet
• B) Obtain a dietary history
• C) Refer to a nutritionist
• D) Schedule a follow-up appointment
Correct Option: B) Obtain a dietary history
Rationale:
Obtaining a dietary history is crucial to identify potential dietary deficiencies, eating
behaviors, or family circumstances contributing to the child's underweight status.
Understanding the child's current intake helps in tailoring interventions effectively.
Question 2:
Which of the following is the most common cause of dehydration in pediatric patients?
• A) Excessive sweating
• B) Vomiting and diarrhea
• C) Inadequate fluid intake
• D) Fever
Correct Option: C) Inadequate fluid intake
Rationale:
While vomiting and diarrhea are significant contributors to dehydration, inadequate
fluid intake is the most prevalent cause, especially in infants and young children who
may have limited access to fluids or are unable to communicate their thirst.
Question 3:
A nurse is assessing a 3-month-old infant. What is an expected developmental
milestone for this age group?
, • A) Sitting without assistance
• B) Coos and babbles
• C) Walking
• D) Imitating gestures
Correct Option: B) Coos and babbles
Rationale:
At 3 months, infants typically begin cooing and babbling as part of their verbal
development. This is a critical milestone in communication skills as they engage more
with caregivers.
Question 4:
An 8-year-old is diagnosed with asthma. Which statement by the parent indicates a
need for further education?
• A) "I should let my child play outdoors when the air quality is poor."
• B) "We will ensure my child has a rescue inhaler handy at all times."
• C) "I will monitor my child for signs of an asthma attack."
• D) "We will keep track of any potential triggers for his asthma."
Correct Option: A) "I should let my child play outdoors when the air quality is poor."
Rationale:
This statement indicates a lack of understanding regarding asthma management.
Children with asthma should avoid outdoor activities during poor air quality to minimize
the risk of exacerbation.
Question 5:
A nurse is caring for a 2-year-old child. Which of the following approaches should the
nurse use to assess the child?
• A) Use play to facilitate the examination
• B) Explain the procedure step by step
• C) Conduct the examination quickly to minimize stress
• D) Involve the parents in every step
Correct Option: A) Use play to facilitate the examination
,Rationale:
Using play is an effective pediatric nursing strategy as it helps reduce anxiety and allows
the child to engage actively during the assessment, making it less intimidating.
Question 6:
A nurse is educating parents about the signs of dehydration in infants. Which of the
following indicates severe dehydration?
• A) Decreased urine output
• B) Dry mucous membranes
• C) Sunken fontanel
• D) Increased thirst
Correct Option: C) Sunken fontanel
Rationale:
A sunken fontanel is a classic sign of severe dehydration in infants, indicating a
significant loss of fluid volume. Other signs can also be present but are less specific.
Question 7:
When assessing a 10-year-old child with suspected appendicitis, which symptom is
considered classic?
• A) Diarrhea
• B) Fever
• C) Right lower quadrant pain
• D) Nausea without vomiting
Correct Option: C) Right lower quadrant pain
Rationale:
Classic symptoms of appendicitis include pain in the right lower quadrant, often
starting around the umbilicus before localizing.
Question 8:
The nurse is discussing growth and development with a parent of a 1-year-old. What
should the nurse emphasize as a typical milestone for this age?
• A) Jumping in place
• B) Using simple words
• C) Skipping
, • D) Riding a tricycle
Correct Option: B) Using simple words
Rationale:
By age one, children typically begin to use simple words, marking a significant
milestone in language development.
Question 9:
Which of the following behaviors is typical for a 4-year-old child?
• A) Engaging in imaginative play
• B) Reading simple books independently
• C) Demonstrating mature social skills
• D) Performing complex puzzles
Correct Option: A) Engaging in imaginative play
Rationale:
Imaginative play is a hallmark of development at this age, reflecting cognitive and
emotional growth.
Question 10:
A nurse notices that a child has gained a significant amount of weight rapidly. What is
the most appropriate initial nursing action?
• A) Refer to a dietitian
• B) Educate the family on healthy eating
• C) Assess for underlying health issues
• D) Schedule a follow-up appointment
Correct Option: C) Assess for underlying health issues
Rationale:
Rapid weight gain may indicate medical concerns such as hormonal imbalances or
metabolic issues, making assessment the priority.
Question 11:
A pediatric patient is prescribed an antibiotic. Which statement by the parent indicates
a need for further teaching?
• A) "I will finish all the medication even if my child feels better."
