EVOLVE HESI Pediatrics (PEDS) Practice Exam
2026 | 75 NCLEX-Style Questions, Answers &
Detailed Rationales | Complete Study Guide for
Nursing Students
Overview
Prepare for the HESI Pediatrics (PEDS) exam with this comprehensive 2026 practice
question bundle. Designed for nursing students, this guide includes 75 NCLEX-style questions
covering the full pediatric scope:
Growth and development
Common pediatric illnesses and emergencies
Pediatric medications and safety
Chronic conditions (e.g., asthma, diabetes, cystic fibrosis, sickle cell disease)
Infectious diseases and immunizations
Fluid and electrolyte balance
Cardiac, respiratory, and renal disorders
Each question comes with:
✅ Correct answer
✅ Detailed explanation / rationale
1. A nurse is caring for a 2-year-old admitted with dehydration from
gastroenteritis. Which assessment finding is MOST concerning?
A. Dry mucous membranes
B. Decreased urine output
C. Sunken anterior fontanel
D. Tachycardia
Correct Answer: D. Tachycardia
Explanation: Tachycardia indicates moderate to severe dehydration and possible
hypovolemia, which requires prompt intervention.
,2. A child with croup is experiencing stridor at rest. What is the PRIORITY
nursing action?
A. Encourage oral fluids
B. Prepare for intubation
C. Administer nebulized epinephrine
D. Obtain a throat culture
Correct Answer: C. Administer nebulized epinephrine
Explanation: Stridor at rest signals severe airway obstruction. Nebulized
epinephrine rapidly reduces airway edema.
3. Which finding is expected in an infant with pyloric stenosis?
A. Bilious vomiting
B. Projectile non-bilious vomiting
C. Abdominal distention
D. Diarrhea
Correct Answer: B. Projectile non-bilious vomiting
Explanation: Pyloric stenosis causes forceful vomiting without bile due to gastric
outlet obstruction.
4. The nurse is teaching parents about sickle cell disease. Which statement
indicates correct understanding?
A. “Pain crises are caused by low platelet levels.”
B. “Hydration helps prevent vaso-occlusive episodes.”
C. “Iron supplements are always required.”
D. “The disease resolves during adolescence.”
Correct Answer: B. Hydration helps prevent vaso-occlusive episodes
Explanation: Adequate hydration reduces blood viscosity and prevents sickling.
, 5. Which vaccine is CONTRAINDICATED in an immunocompromised child?
A. IPV
B. Hepatitis B
C. MMR
D. DTaP
Correct Answer: C. MMR
Explanation: MMR is a live vaccine and should not be given to
immunocompromised children.
6. A nurse is assessing a child with suspected epiglottitis. Which finding requires
immediate action?
A. Barking cough
B. Drooling and tripod positioning
C. Low-grade fever
D. Hoarse voice
Correct Answer: B. Drooling and tripod positioning
Explanation: These are classic signs of epiglottitis, a medical emergency requiring
airway protection.
7. Which lab result is MOST concerning in a child with diabetic ketoacidosis
(DKA)?
A. Blood glucose 420 mg/dL
B. Serum potassium 5.8 mEq/L
C. Arterial pH 7.10
D. Positive urine ketones
Correct Answer: C. Arterial pH 7.10
Explanation: Severe metabolic acidosis places the child at risk for cardiac
dysrhythmias and cerebral edema.
2026 | 75 NCLEX-Style Questions, Answers &
Detailed Rationales | Complete Study Guide for
Nursing Students
Overview
Prepare for the HESI Pediatrics (PEDS) exam with this comprehensive 2026 practice
question bundle. Designed for nursing students, this guide includes 75 NCLEX-style questions
covering the full pediatric scope:
Growth and development
Common pediatric illnesses and emergencies
Pediatric medications and safety
Chronic conditions (e.g., asthma, diabetes, cystic fibrosis, sickle cell disease)
Infectious diseases and immunizations
Fluid and electrolyte balance
Cardiac, respiratory, and renal disorders
Each question comes with:
✅ Correct answer
✅ Detailed explanation / rationale
1. A nurse is caring for a 2-year-old admitted with dehydration from
gastroenteritis. Which assessment finding is MOST concerning?
A. Dry mucous membranes
B. Decreased urine output
C. Sunken anterior fontanel
D. Tachycardia
Correct Answer: D. Tachycardia
Explanation: Tachycardia indicates moderate to severe dehydration and possible
hypovolemia, which requires prompt intervention.
,2. A child with croup is experiencing stridor at rest. What is the PRIORITY
nursing action?
A. Encourage oral fluids
B. Prepare for intubation
C. Administer nebulized epinephrine
D. Obtain a throat culture
Correct Answer: C. Administer nebulized epinephrine
Explanation: Stridor at rest signals severe airway obstruction. Nebulized
epinephrine rapidly reduces airway edema.
3. Which finding is expected in an infant with pyloric stenosis?
A. Bilious vomiting
B. Projectile non-bilious vomiting
C. Abdominal distention
D. Diarrhea
Correct Answer: B. Projectile non-bilious vomiting
Explanation: Pyloric stenosis causes forceful vomiting without bile due to gastric
outlet obstruction.
4. The nurse is teaching parents about sickle cell disease. Which statement
indicates correct understanding?
A. “Pain crises are caused by low platelet levels.”
B. “Hydration helps prevent vaso-occlusive episodes.”
C. “Iron supplements are always required.”
D. “The disease resolves during adolescence.”
Correct Answer: B. Hydration helps prevent vaso-occlusive episodes
Explanation: Adequate hydration reduces blood viscosity and prevents sickling.
, 5. Which vaccine is CONTRAINDICATED in an immunocompromised child?
A. IPV
B. Hepatitis B
C. MMR
D. DTaP
Correct Answer: C. MMR
Explanation: MMR is a live vaccine and should not be given to
immunocompromised children.
6. A nurse is assessing a child with suspected epiglottitis. Which finding requires
immediate action?
A. Barking cough
B. Drooling and tripod positioning
C. Low-grade fever
D. Hoarse voice
Correct Answer: B. Drooling and tripod positioning
Explanation: These are classic signs of epiglottitis, a medical emergency requiring
airway protection.
7. Which lab result is MOST concerning in a child with diabetic ketoacidosis
(DKA)?
A. Blood glucose 420 mg/dL
B. Serum potassium 5.8 mEq/L
C. Arterial pH 7.10
D. Positive urine ketones
Correct Answer: C. Arterial pH 7.10
Explanation: Severe metabolic acidosis places the child at risk for cardiac
dysrhythmias and cerebral edema.
