HESI Pediatric Practice Exam (2025/2026 Syllabus)
Growth and Development (Infant to Adolescent)
1. According to Piaget, what is the expected cognitive stage of a 7-year-old child?
ANSWER: ✓ Concrete Operational Stage. In this stage, children develop logical thought
about concrete events, understand conservation, and can classify objects. They move
beyond the egocentrism of the preoperational stage.
2. A nurse is assessing a 6-month-old infant. Which fine motor skill is expected at
this age?
ANSWER: ✓ Transferring a toy from one hand to the other. This demonstrates the
development of coordination and intentional grasp, a key milestone around 5-7 months.
3. What is the primary psychosocial conflict of a toddler according to Erikson's
stages?
ANSWER: ✓ Autonomy vs. Shame and Doubt. Toddlers (1-3 years) are learning to
exercise their will and make choices. Successful resolution leads to a sense of self-
control and confidence.
4. A 4-year-old child is admitted to the pediatric unit. Which communication
technique is most effective for this age group?
ANSWER: ✓ Use short, simple sentences and engage in therapeutic play. Four-year-olds
are in the preoperational stage and learn best through play and concrete explanations.
5. The parent of a 3-month-old is concerned because the infant is not yet rolling
over. What is the nurse's best response?
ANSWER: ✓ "Motor development varies, but let's discuss your infant's other milestones.
Most infants begin rolling from prone to supine around 4-6 months." This response
educates the parent while acknowledging the normal range of development.
6. What is the leading cause of death in adolescents?
ANSWER: ✓ Unintentional injuries (including motor vehicle accidents). This highlights
the importance of patient education on safety, risk-taking behaviors, and substance use.
7. According to Kohlberg, what is the stage of moral development for a school-
aged child?
ANSWER: ✓ Conventional Level, specifically the "Good Boy/Nice Girl" orientation.
Children at this age make decisions based on pleasing others and maintaining social
order.
, 8. A 2-year-old is scheduled for a minor procedure. What is the most significant
stressor for a child of this age during hospitalization?
ANSWER: ✓ Separation from parents. Toddlers have a strong attachment to their
primary caregivers and fear abandonment.
9. Which immunization is contraindicated in a child with a severe anaphylactic
allergy to eggs?
ANSWER: ✓ Influenza vaccine, as it is cultivated in egg embryos. (Note: Some newer
formulations may be egg-free, but this remains a key consideration requiring provider
consultation).
10. What is the recommended sleeping position for a healthy, full-term infant to
reduce the risk of SIDS?
ANSWER: ✓ On their back, on a firm sleep surface with no loose bedding or soft toys.
Health Promotion and Safety
11. A mother asks when she should introduce solid foods to her infant. What is the
nurse's best response?
ANSWER: ✓ Around 6 months of age, when the infant can hold their head up, sit with
support, and has lost the extrusion reflex.
12. What is the most appropriate toy to recommend for a 9-month-old infant?
ANSWER: ✓ A large, brightly colored stacking ring or a soft, textured ball. These toys
encourage fine motor skills, object permanence, and sensory exploration.
13. During a well-child visit, the nurse discusses dental health. When should a child
first visit the dentist?
ANSWER: ✓ Within 6 months of the first tooth erupting, or by 12 months of age.
14. The parent of a newborn asks about car seat safety. What is the correct
instruction?
ANSWER: ✓ Use a rear-facing car seat in the back seat of the vehicle until the child
reaches the maximum height or weight limit allowed by the car seat's manufacturer.
15. A nurse is providing education on poison prevention to the parents of a
toddler. What is the most important instruction?
ANSWER: ✓ Keep all poisonous substances, including medications and cleaning
products, in locked cabinets out of sight and reach.
Growth and Development (Infant to Adolescent)
1. According to Piaget, what is the expected cognitive stage of a 7-year-old child?
ANSWER: ✓ Concrete Operational Stage. In this stage, children develop logical thought
about concrete events, understand conservation, and can classify objects. They move
beyond the egocentrism of the preoperational stage.
2. A nurse is assessing a 6-month-old infant. Which fine motor skill is expected at
this age?
ANSWER: ✓ Transferring a toy from one hand to the other. This demonstrates the
development of coordination and intentional grasp, a key milestone around 5-7 months.
3. What is the primary psychosocial conflict of a toddler according to Erikson's
stages?
ANSWER: ✓ Autonomy vs. Shame and Doubt. Toddlers (1-3 years) are learning to
exercise their will and make choices. Successful resolution leads to a sense of self-
control and confidence.
4. A 4-year-old child is admitted to the pediatric unit. Which communication
technique is most effective for this age group?
ANSWER: ✓ Use short, simple sentences and engage in therapeutic play. Four-year-olds
are in the preoperational stage and learn best through play and concrete explanations.
5. The parent of a 3-month-old is concerned because the infant is not yet rolling
over. What is the nurse's best response?
ANSWER: ✓ "Motor development varies, but let's discuss your infant's other milestones.
Most infants begin rolling from prone to supine around 4-6 months." This response
educates the parent while acknowledging the normal range of development.
6. What is the leading cause of death in adolescents?
ANSWER: ✓ Unintentional injuries (including motor vehicle accidents). This highlights
the importance of patient education on safety, risk-taking behaviors, and substance use.
7. According to Kohlberg, what is the stage of moral development for a school-
aged child?
ANSWER: ✓ Conventional Level, specifically the "Good Boy/Nice Girl" orientation.
Children at this age make decisions based on pleasing others and maintaining social
order.
, 8. A 2-year-old is scheduled for a minor procedure. What is the most significant
stressor for a child of this age during hospitalization?
ANSWER: ✓ Separation from parents. Toddlers have a strong attachment to their
primary caregivers and fear abandonment.
9. Which immunization is contraindicated in a child with a severe anaphylactic
allergy to eggs?
ANSWER: ✓ Influenza vaccine, as it is cultivated in egg embryos. (Note: Some newer
formulations may be egg-free, but this remains a key consideration requiring provider
consultation).
10. What is the recommended sleeping position for a healthy, full-term infant to
reduce the risk of SIDS?
ANSWER: ✓ On their back, on a firm sleep surface with no loose bedding or soft toys.
Health Promotion and Safety
11. A mother asks when she should introduce solid foods to her infant. What is the
nurse's best response?
ANSWER: ✓ Around 6 months of age, when the infant can hold their head up, sit with
support, and has lost the extrusion reflex.
12. What is the most appropriate toy to recommend for a 9-month-old infant?
ANSWER: ✓ A large, brightly colored stacking ring or a soft, textured ball. These toys
encourage fine motor skills, object permanence, and sensory exploration.
13. During a well-child visit, the nurse discusses dental health. When should a child
first visit the dentist?
ANSWER: ✓ Within 6 months of the first tooth erupting, or by 12 months of age.
14. The parent of a newborn asks about car seat safety. What is the correct
instruction?
ANSWER: ✓ Use a rear-facing car seat in the back seat of the vehicle until the child
reaches the maximum height or weight limit allowed by the car seat's manufacturer.
15. A nurse is providing education on poison prevention to the parents of a
toddler. What is the most important instruction?
ANSWER: ✓ Keep all poisonous substances, including medications and cleaning
products, in locked cabinets out of sight and reach.
