2026 UPDATED QUESTIONS DOWNLOAD
HESI RN PEDS ACTUAL EXAM 2025/2026 – 350
MASTER Q&A | COVERS: GROWTH & DEVELOPMENT,
CARDIAC (TET SPELLS), RESPIRATORY
(EPIGLOTTITIS), GI (PYLORIC STENOSIS), RENAL,
HEMATOLOGY & ERIKSON/PIAGET STAGES
1. A 10-month-old infant is being treated for heart failure. Which clinical
manifestation should the nurse expect to observe?
A) Increased urinary output
B) Sweating across the forehead while feeding
C) Bradycardia at rest
D) Cyanosis of the hands and feet
Answer: B) Sweating across the forehead while feeding
Rationale: Infants with heart failure exert significant energy to feed, leading to
sympathetic nervous system activation and diaphoresis, particularly on the scalp and
forehead.
2. A toddler is admitted for a cleft palate repair. Which intervention should the
nurse include in the postoperative plan of care?
A) Use a metal spoon for feedings
B) Place the child in a prone position
C) Apply bilateral elbow restraints
D) Encourage the use of a pacifier for comfort
Answer: C) Apply bilateral elbow restraints
Rationale: Elbow restraints (often called "no-no's") prevent the toddler from placing
fingers or objects in the mouth, which could disrupt the surgical suture line.
3. The nurse is caring for a 6-month-old infant. Which heart rate should be
reported to the healthcare provider immediately?
A) 100 BPM
B) 120 BPM
C) 140 BPM
D) 60 BPM
Answer: D) 60 BPM
,2026 UPDATED QUESTIONS DOWNLOAD
Rationale: The normal resting heart rate for a 6-month-old is 80–150 BPM. A rate of 60
BPM is critically low and indicates severe bradycardia, often a precursor to cardiac
arrest in infants.
4. A mother asks the nurse when she should start introducing solid foods to her
infant. What is the best response?
A) 3 months
B) 4 months
C) 6 months
D) 9 months
Answer: C) 6 months
Rationale: The American Academy of Pediatrics recommends exclusive
breastfeeding/formula for the first 6 months to allow for gastrointestinal maturity and the
disappearance of the tongue-extrusion reflex.
5. Which developmental milestone should the nurse expect a 12-month-old child
to have achieved?
A) Running easily
B) Climbing stairs
C) Walking while holding onto furniture
D) Jumping with both feet
Answer: C) Walking while holding onto furniture
Rationale: By 12 months, most infants can "cruise" (walk while holding furniture).
Running and jumping are later toddler/preschool milestones.
6. A child is admitted with suspected Epiglottitis. Which action is
contraindicated?
A) Preparing for intubation
B) Using a tongue blade to visualize the throat
C) Administering humidified oxygen
D) Keeping the child in an upright position
Answer: B) Using a tongue blade to visualize the throat
Rationale: Visualizing the throat with a tongue blade can trigger a laryngospasm,
leading to immediate and total airway obstruction.
7. A 2-year-old child is hospitalized. According to Erikson, what is the primary
developmental task for this age group?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
,2026 UPDATED QUESTIONS DOWNLOAD
D) Industry vs. Inferiority
Answer: B) Autonomy vs. Shame and Doubt
Rationale: Toddlers (ages 1–3) are focused on developing a sense of personal control
and independence.
8. The nurse is teaching a parent about Digoxin administration for a child with a
heart defect. Which instruction is correct?
A) Mix the medication with a small amount of juice
B) Give a second dose if the child vomits immediately
C) Hold the dose if the heart rate is below the specified parameter
D) Give the medication only when the child appears tired
Answer: C) Hold the dose if the heart rate is below the specified parameter
Rationale: Digoxin toxicity can cause bradycardia. Parents must take an apical pulse for
one full minute and hold the dose if the rate is below a set limit (usually 90–110 for
infants).
9. What is the first priority when a child is brought to the school clinic with a
small laceration sustained on the playground?
A) Apply a sterile dressing
B) Wash the wound with mild soap and water
C) Apply an antibiotic ointment
D) Notify the parents
Answer: B) Wash the wound with mild soap and water
Rationale: The immediate priority for any skin tear or laceration is to minimize the risk of
infection by removing dirt and debris.
10. A child with Cystic Fibrosis is receiving Pancreatic Enzymes. How should the
nurse instruct the parents to administer them?
A) Give them once daily in the morning
B) Give them with every meal and snack
C) Administer only if the child has a fatty stool
D) Dissolve the beads in a glass of warm milk
Answer: B) Give them with every meal and snack
Rationale: Supplemental enzymes must be present in the duodenum whenever food is
ingested to ensure nutrient absorption in CF patients.
11. A 4-year-old child is being prepped for surgery. Which approach by the nurse
best supports the child's Piagetian stage of development?
A) Provide a detailed scientific explanation
B) Allow the child to play with a stethoscope and medical mask
, 2026 UPDATED QUESTIONS DOWNLOAD
C) Show the child a video of the actual surgery
D) Tell the child there is nothing to worry about
Answer: B) Allow the child to play with a stethoscope and medical mask
Rationale: Preschoolers are in the preoperational stage; they learn best through play
and "magical thinking."
12. A 3-year-old is diagnosed with Intussusception. Which clinical finding is most
characteristic of this condition?
A) Ribbon-like stools
B) Currant jelly-like stools
C) Projectile vomiting
D) Olive-shaped mass in the RUQ
Answer: B) Currant jelly-like stools
Rationale: Intussusception causes intestinal obstruction and ischemia, leading to the
passage of blood and mucus that resembles currant jelly.
13. Which assessment finding in an infant suggests Pyloric Stenosis?
A) Chronic diarrhea
B) Projectile vomiting after feedings
C) Abdominal distention and flatulence
D) Visible peristaltic waves from right to left
Answer: B) Projectile vomiting after feedings
Rationale: Hypertrophic pyloric stenosis obstructs the outlet of the stomach, leading to
non-bilious projectile vomiting, typically between 3 and 6 weeks of age.
14. A nurse is evaluating a school-aged child with Glomerulonephritis. Which
finding indicates the condition is improving?
A) Increased blood pressure
B) Increased urinary output
C) Presence of periorbital edema
D) Dark, tea-colored urine
Answer: B) Increased urinary output
Rationale: As the inflammation in the glomeruli subsides, the kidneys begin to filter
effectively again, resulting in diuresis and a decrease in edema.
15. A child is admitted in Sickle Cell Crisis. What is the primary nursing
intervention?
A) Administering iron supplements
B) Providing vigorous intravenous hydration
C) Applying cold compresses to painful joints
HESI RN PEDS ACTUAL EXAM 2025/2026 – 350
MASTER Q&A | COVERS: GROWTH & DEVELOPMENT,
CARDIAC (TET SPELLS), RESPIRATORY
(EPIGLOTTITIS), GI (PYLORIC STENOSIS), RENAL,
HEMATOLOGY & ERIKSON/PIAGET STAGES
1. A 10-month-old infant is being treated for heart failure. Which clinical
manifestation should the nurse expect to observe?
A) Increased urinary output
B) Sweating across the forehead while feeding
C) Bradycardia at rest
D) Cyanosis of the hands and feet
Answer: B) Sweating across the forehead while feeding
Rationale: Infants with heart failure exert significant energy to feed, leading to
sympathetic nervous system activation and diaphoresis, particularly on the scalp and
forehead.
2. A toddler is admitted for a cleft palate repair. Which intervention should the
nurse include in the postoperative plan of care?
A) Use a metal spoon for feedings
B) Place the child in a prone position
C) Apply bilateral elbow restraints
D) Encourage the use of a pacifier for comfort
Answer: C) Apply bilateral elbow restraints
Rationale: Elbow restraints (often called "no-no's") prevent the toddler from placing
fingers or objects in the mouth, which could disrupt the surgical suture line.
3. The nurse is caring for a 6-month-old infant. Which heart rate should be
reported to the healthcare provider immediately?
A) 100 BPM
B) 120 BPM
C) 140 BPM
D) 60 BPM
Answer: D) 60 BPM
,2026 UPDATED QUESTIONS DOWNLOAD
Rationale: The normal resting heart rate for a 6-month-old is 80–150 BPM. A rate of 60
BPM is critically low and indicates severe bradycardia, often a precursor to cardiac
arrest in infants.
4. A mother asks the nurse when she should start introducing solid foods to her
infant. What is the best response?
A) 3 months
B) 4 months
C) 6 months
D) 9 months
Answer: C) 6 months
Rationale: The American Academy of Pediatrics recommends exclusive
breastfeeding/formula for the first 6 months to allow for gastrointestinal maturity and the
disappearance of the tongue-extrusion reflex.
5. Which developmental milestone should the nurse expect a 12-month-old child
to have achieved?
A) Running easily
B) Climbing stairs
C) Walking while holding onto furniture
D) Jumping with both feet
Answer: C) Walking while holding onto furniture
Rationale: By 12 months, most infants can "cruise" (walk while holding furniture).
Running and jumping are later toddler/preschool milestones.
6. A child is admitted with suspected Epiglottitis. Which action is
contraindicated?
A) Preparing for intubation
B) Using a tongue blade to visualize the throat
C) Administering humidified oxygen
D) Keeping the child in an upright position
Answer: B) Using a tongue blade to visualize the throat
Rationale: Visualizing the throat with a tongue blade can trigger a laryngospasm,
leading to immediate and total airway obstruction.
7. A 2-year-old child is hospitalized. According to Erikson, what is the primary
developmental task for this age group?
A) Trust vs. Mistrust
B) Autonomy vs. Shame and Doubt
C) Initiative vs. Guilt
,2026 UPDATED QUESTIONS DOWNLOAD
D) Industry vs. Inferiority
Answer: B) Autonomy vs. Shame and Doubt
Rationale: Toddlers (ages 1–3) are focused on developing a sense of personal control
and independence.
8. The nurse is teaching a parent about Digoxin administration for a child with a
heart defect. Which instruction is correct?
A) Mix the medication with a small amount of juice
B) Give a second dose if the child vomits immediately
C) Hold the dose if the heart rate is below the specified parameter
D) Give the medication only when the child appears tired
Answer: C) Hold the dose if the heart rate is below the specified parameter
Rationale: Digoxin toxicity can cause bradycardia. Parents must take an apical pulse for
one full minute and hold the dose if the rate is below a set limit (usually 90–110 for
infants).
9. What is the first priority when a child is brought to the school clinic with a
small laceration sustained on the playground?
A) Apply a sterile dressing
B) Wash the wound with mild soap and water
C) Apply an antibiotic ointment
D) Notify the parents
Answer: B) Wash the wound with mild soap and water
Rationale: The immediate priority for any skin tear or laceration is to minimize the risk of
infection by removing dirt and debris.
10. A child with Cystic Fibrosis is receiving Pancreatic Enzymes. How should the
nurse instruct the parents to administer them?
A) Give them once daily in the morning
B) Give them with every meal and snack
C) Administer only if the child has a fatty stool
D) Dissolve the beads in a glass of warm milk
Answer: B) Give them with every meal and snack
Rationale: Supplemental enzymes must be present in the duodenum whenever food is
ingested to ensure nutrient absorption in CF patients.
11. A 4-year-old child is being prepped for surgery. Which approach by the nurse
best supports the child's Piagetian stage of development?
A) Provide a detailed scientific explanation
B) Allow the child to play with a stethoscope and medical mask
, 2026 UPDATED QUESTIONS DOWNLOAD
C) Show the child a video of the actual surgery
D) Tell the child there is nothing to worry about
Answer: B) Allow the child to play with a stethoscope and medical mask
Rationale: Preschoolers are in the preoperational stage; they learn best through play
and "magical thinking."
12. A 3-year-old is diagnosed with Intussusception. Which clinical finding is most
characteristic of this condition?
A) Ribbon-like stools
B) Currant jelly-like stools
C) Projectile vomiting
D) Olive-shaped mass in the RUQ
Answer: B) Currant jelly-like stools
Rationale: Intussusception causes intestinal obstruction and ischemia, leading to the
passage of blood and mucus that resembles currant jelly.
13. Which assessment finding in an infant suggests Pyloric Stenosis?
A) Chronic diarrhea
B) Projectile vomiting after feedings
C) Abdominal distention and flatulence
D) Visible peristaltic waves from right to left
Answer: B) Projectile vomiting after feedings
Rationale: Hypertrophic pyloric stenosis obstructs the outlet of the stomach, leading to
non-bilious projectile vomiting, typically between 3 and 6 weeks of age.
14. A nurse is evaluating a school-aged child with Glomerulonephritis. Which
finding indicates the condition is improving?
A) Increased blood pressure
B) Increased urinary output
C) Presence of periorbital edema
D) Dark, tea-colored urine
Answer: B) Increased urinary output
Rationale: As the inflammation in the glomeruli subsides, the kidneys begin to filter
effectively again, resulting in diuresis and a decrease in edema.
15. A child is admitted in Sickle Cell Crisis. What is the primary nursing
intervention?
A) Administering iron supplements
B) Providing vigorous intravenous hydration
C) Applying cold compresses to painful joints
