HESI PN Pediatrics (PEDS) Actual Exam
2026/2027: Certified Questions with Verified
Answers – Practical Nursing Pediatric
Review – Graded A+
SECTION 1: GROWTH & DEVELOPMENTAL CONSIDERATIONS (Questions
1-10)
Q1
A nurse is assessing a 4-month-old infant during a well-child visit. Which developmental
milestone would the nurse expect to observe?
A. The infant transfers toys from hand to hand
B. The infant rolls from front to back and back to front
C. The infant sits unsupported with a straight back
D. The infant crawls using alternating hand and knee movements
Correct Answer: B
Rationale: By 4 months, infants typically roll from front to back (usually achieved by 2-3
months) and are beginning to roll back to front (achieved by 4-5 months). Transferring
toys hand-to-hand (A) occurs around 6-7 months. Sitting unsupported (C) develops at
6-8 months. Crawling (D) emerges between 7-10 months. The Denver II Developmental
,Screening Test identifies rolling as a 4-month gross motor milestone. Early identification
of developmental delays allows for timely intervention services.
(Cognitive Level: Recall)
Q2
According to Erikson's psychosocial development theory, which statement best
describes the developmental crisis for a toddler (1-3 years)?
A. Trust vs. Mistrust, requiring consistent caregiving to develop hope
B. Autonomy vs. Shame and Doubt, requiring opportunities for independence
C. Initiative vs. Guilt, requiring support for purposeful activity and leadership
D. Industry vs. Inferiority, requiring recognition for accomplishments
Correct Answer: B
Rationale: Toddlers (1-3 years) navigate Autonomy vs. Shame and Doubt. Successful
resolution requires caregivers to allow safe independence (toilet training, feeding self,
exploring environment) while providing consistent boundaries. Trust vs. Mistrust (A) is
the infant crisis (0-1 year). Initiative vs. Guilt (C) applies to preschoolers (3-6 years) who
explore their environment. Industry vs. Inferiority (D) describes school-age children
(6-12 years) developing competence through school and activities. Understanding these
stages helps nurses provide developmentally appropriate care and guidance.
(Cognitive Level: Application)
Q3
,A nurse is planning play activities for hospitalized children. Which activity is most
appropriate for a 7-year-old child based on Piaget's cognitive development theory?
A. Playing peek-a-boo with a blanket
B. Engaging in parallel play with blocks alongside another child
C. Playing a board game with established rules and cooperative strategies
D. Engaging in imaginative pretend play with dolls or action figures
Correct Answer: C
Rationale: According to Piaget, 7-year-olds are in the concrete operational stage (7-11
years), characterized by logical thinking, understanding conservation, and following
rules. Board games with structured rules align with this developmental level. Peek-a-boo
(A) is appropriate for infants (sensorimotor stage). Parallel play (B) is typical of toddlers
(18 months-3 years) in the preoperational stage. Imaginative play (D) peaks in early
preoperational stage (2-7 years) but becomes more complex and rule-oriented as
children approach concrete operations. School-age children benefit from activities that
reinforce their developing logical reasoning and sense of fairness.
(Cognitive Level: Application)
Q4
A nurse is teaching parents about introducing solid foods to their 6-month-old infant.
Which instruction is MOST appropriate?
A. Begin with mixed grain cereals followed by pureed meats
B. Introduce one new food every 2-3 days while observing for allergic reactions
, C. Add honey to cereals to improve palatability and encourage acceptance
D. Start with cow's milk mixed with rice cereal for added protein
Correct Answer: B
Rationale: The American Academy of Pediatrics recommends introducing
single-ingredient foods, waiting 2-3 days between new foods to identify potential
allergens. Iron-fortified single-grain cereals (not mixed grains initially) are typically first
foods, followed by vegetables, fruits, and then meats. Honey (C) is contraindicated
before 12 months due to botulism risk. Cow's milk (D) should not replace breast milk or
formula before 12 months and is not used to mix cereals. This "3-day wait rule" helps
parents identify food sensitivities while ensuring nutritional adequacy during this critical
growth period.
(Cognitive Level: Application)
Q5
During a pediatric assessment, the nurse notes that a 2-year-old child engages in
"parallel play" with another toddler in the waiting room. The parent expresses concern
that the child "doesn't share or play together." Which response by the nurse is MOST
appropriate?
A. "This is concerning at age 2 and may indicate autism spectrum disorder"
B. "Parallel play is expected at this age; cooperative play develops around age 4-5"
C. "Your child is showing signs of social anxiety that should be evaluated"
D. "This behavior suggests your child is not yet ready for preschool enrollment"
2026/2027: Certified Questions with Verified
Answers – Practical Nursing Pediatric
Review – Graded A+
SECTION 1: GROWTH & DEVELOPMENTAL CONSIDERATIONS (Questions
1-10)
Q1
A nurse is assessing a 4-month-old infant during a well-child visit. Which developmental
milestone would the nurse expect to observe?
A. The infant transfers toys from hand to hand
B. The infant rolls from front to back and back to front
C. The infant sits unsupported with a straight back
D. The infant crawls using alternating hand and knee movements
Correct Answer: B
Rationale: By 4 months, infants typically roll from front to back (usually achieved by 2-3
months) and are beginning to roll back to front (achieved by 4-5 months). Transferring
toys hand-to-hand (A) occurs around 6-7 months. Sitting unsupported (C) develops at
6-8 months. Crawling (D) emerges between 7-10 months. The Denver II Developmental
,Screening Test identifies rolling as a 4-month gross motor milestone. Early identification
of developmental delays allows for timely intervention services.
(Cognitive Level: Recall)
Q2
According to Erikson's psychosocial development theory, which statement best
describes the developmental crisis for a toddler (1-3 years)?
A. Trust vs. Mistrust, requiring consistent caregiving to develop hope
B. Autonomy vs. Shame and Doubt, requiring opportunities for independence
C. Initiative vs. Guilt, requiring support for purposeful activity and leadership
D. Industry vs. Inferiority, requiring recognition for accomplishments
Correct Answer: B
Rationale: Toddlers (1-3 years) navigate Autonomy vs. Shame and Doubt. Successful
resolution requires caregivers to allow safe independence (toilet training, feeding self,
exploring environment) while providing consistent boundaries. Trust vs. Mistrust (A) is
the infant crisis (0-1 year). Initiative vs. Guilt (C) applies to preschoolers (3-6 years) who
explore their environment. Industry vs. Inferiority (D) describes school-age children
(6-12 years) developing competence through school and activities. Understanding these
stages helps nurses provide developmentally appropriate care and guidance.
(Cognitive Level: Application)
Q3
,A nurse is planning play activities for hospitalized children. Which activity is most
appropriate for a 7-year-old child based on Piaget's cognitive development theory?
A. Playing peek-a-boo with a blanket
B. Engaging in parallel play with blocks alongside another child
C. Playing a board game with established rules and cooperative strategies
D. Engaging in imaginative pretend play with dolls or action figures
Correct Answer: C
Rationale: According to Piaget, 7-year-olds are in the concrete operational stage (7-11
years), characterized by logical thinking, understanding conservation, and following
rules. Board games with structured rules align with this developmental level. Peek-a-boo
(A) is appropriate for infants (sensorimotor stage). Parallel play (B) is typical of toddlers
(18 months-3 years) in the preoperational stage. Imaginative play (D) peaks in early
preoperational stage (2-7 years) but becomes more complex and rule-oriented as
children approach concrete operations. School-age children benefit from activities that
reinforce their developing logical reasoning and sense of fairness.
(Cognitive Level: Application)
Q4
A nurse is teaching parents about introducing solid foods to their 6-month-old infant.
Which instruction is MOST appropriate?
A. Begin with mixed grain cereals followed by pureed meats
B. Introduce one new food every 2-3 days while observing for allergic reactions
, C. Add honey to cereals to improve palatability and encourage acceptance
D. Start with cow's milk mixed with rice cereal for added protein
Correct Answer: B
Rationale: The American Academy of Pediatrics recommends introducing
single-ingredient foods, waiting 2-3 days between new foods to identify potential
allergens. Iron-fortified single-grain cereals (not mixed grains initially) are typically first
foods, followed by vegetables, fruits, and then meats. Honey (C) is contraindicated
before 12 months due to botulism risk. Cow's milk (D) should not replace breast milk or
formula before 12 months and is not used to mix cereals. This "3-day wait rule" helps
parents identify food sensitivities while ensuring nutritional adequacy during this critical
growth period.
(Cognitive Level: Application)
Q5
During a pediatric assessment, the nurse notes that a 2-year-old child engages in
"parallel play" with another toddler in the waiting room. The parent expresses concern
that the child "doesn't share or play together." Which response by the nurse is MOST
appropriate?
A. "This is concerning at age 2 and may indicate autism spectrum disorder"
B. "Parallel play is expected at this age; cooperative play develops around age 4-5"
C. "Your child is showing signs of social anxiety that should be evaluated"
D. "This behavior suggests your child is not yet ready for preschool enrollment"
