HESI Pediatric Nursing Examination
2026/2027
75 Questions | NGN-Aligned | Verified Solutions
HESI/Elsevier Pediatric Competency Assessment
Study Set with Evidence-Based Rationales
100% Verified Answers | Graded A+ Prep
Domains: Growth & Development | Assessment | Family-Centered Care
Acute Conditions | Chronic Conditions | Pharmacology | Immunizations
Emergency & Critical Care | Abuse Recognition | Legal/Ethical | NGN Clinical Judgment
,Abstract
This document presents a comprehensive HESI Pediatric Nursing Examination practice assessment
consisting of 75 questions aligned with Elsevier Health Education Systems' pediatric competency
standards and the NCSBN Clinical Judgment Measurement Model (CJMM). Content spans eleven core
domains: growth and development milestones across pediatric age groups, pediatric assessment
techniques with age-adapted vital signs and pain scales, family-centered care principles, management of
common acute pediatric conditions, chronic disease management, weight-based pharmacology,
CDC/ACIP immunization protocols, pediatric emergency and critical care, child abuse recognition and
mandated reporting, legal/ethical responsibilities, and scenario-based clinical judgment items
incorporating NGN item types. All items include verified correct answers and evidence-based rationales
derived from standard pediatric nursing references including Hockenberry & Wilson's Wong's Nursing
Care of Infants and Children, AAP Bright Futures Guidelines, CDC immunization schedules, and NCSBN
test plan frameworks. This resource is designed as a study preparation tool for pre-licensure nursing
students and should be used in conjunction with institutional HESI remediation resources.
Keywords: HESI Pediatric Nursing, NCLEX-RN Pediatric, Growth and Development, Pediatric
Pharmacology, Immunization Schedules, Family-Centered Care, NGN Clinical Judgment, Child Abuse
Recognition, Pediatric Emergency Care, CJMM Framework
,GROWTH & DEVELOPMENT MILESTONES
1. 1. A nurse is assessing a 4-month-old infant during a well-child visit. Which
developmental milestone should the infant have achieved by this age?
A. Holds head steady when sitting with support
B. Rolls from back to front unassisted
C. Walks independently
D. Uses two-word phrases
The 4-month-old infant should demonstrate head control—holding the head steady and erect when
supported in a sitting position. This reflects progressive cervical and upper trunk muscle strengthening
that begins with head lag resolution by 2 months. Rolling from back to front typically emerges at 5–6
months, walking independently by 12 months, and two-word phrases by approximately 24 months
according to the Denver II and AAP developmental milestones.
2. 2. A parent of a 2-year-old toddler asks the nurse about expected language development.
Which response by the nurse is most accurate?
A. The toddler should be able to speak in complete sentences of 5–6 words
B. The toddler should have a vocabulary of approximately 50–300 words and begin
combining two-word phrases
C. The toddler should be able to read simple words
D. Language development is not significant until preschool age
By age 2, toddlers typically have a vocabulary of approximately 50–300 words and begin combining
two-word phrases (telegraphic speech) such as 'more milk' or 'mommy go.' This represents a significant
language explosion period between 18–24 months. Complete 5–6 word sentences are expected by age 4–
5. Reading simple words typically emerges around age 5–6. Language development follows a
predictable trajectory and is a critical developmental assessment at well-child visits.
3. 3. According to Erikson's psychosocial development theory, which stage is most relevant
for a hospitalized preschool-aged child (3–5 years)?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Erikson's initiative vs. guilt stage (3–5 years) describes the preschooler's need to initiate activities, make
decisions, and exert control over their environment. Hospitalization disrupts this by imposing routines
and restrictions, potentially leading to feelings of guilt if the child perceives illness as punishment for
misbehavior. Nurses can support initiative by offering limited choices (which color cup, which arm for
, BP), allowing play activities, and explaining procedures in simple terms. Trust vs. mistrust (infancy),
autonomy vs. shame (toddler), and industry vs. inferiority (school-age) are the other relevant stages.
4. 4. A 9-month-old infant is observed pulling to a standing position and crawling. The
nurse documents this as consistent with which developmental pattern?
A. Proximodistal development
B. Cephalocaudal development
C. Mass-to-specific (differentiation) development
D. Simple-to-complex integration
Pulling to stand and crawling represent cephalocaudal development—motor development proceeds
from head to toe (cephalocaudal) and from center to periphery (proximodistal). The infant gains head
and neck control first, then trunk control, followed by use of arms and legs. Sitting precedes standing,
and standing precedes walking. This developmental direction guides anticipatory guidance for parents
regarding expected motor milestones and safety considerations such as fall prevention as mobility
increases.
5. 5. A nurse assesses a 12-month-old infant. Which behavior indicates the need for further
developmental evaluation?
A. Uses pincer grasp to pick up small objects
B. Transfers objects from one hand to the other
C. Does not yet speak any recognizable words
D. Shows stranger anxiety when approached by unfamiliar people
By 12 months, an infant should speak 1–2 recognizable words in addition to babbling. Absence of any
words by 12 months warrants further developmental evaluation and possible referral for speech and
language assessment. Pincer grasp (9–10 months), transferring objects (6–7 months), and stranger
anxiety (8–12 months) are all expected developmental findings at this age. Early identification of speech
delays enables timely intervention, which is associated with improved outcomes.
6. 6. A school-age child (7 years old) is recovering from a tonsillectomy. Which Erikson
stage should the nurse consider when planning care?
A. Initiative vs. Guilt
B. Industry vs. Inferiority
C. Identity vs. Role Confusion
D. Autonomy vs. Shame and Doubt
Industry vs. inferiority (6–12 years) is Erikson's stage for school-age children. Children in this stage
need to feel competent and productive, particularly in academic and social domains. Hospitalization
2026/2027
75 Questions | NGN-Aligned | Verified Solutions
HESI/Elsevier Pediatric Competency Assessment
Study Set with Evidence-Based Rationales
100% Verified Answers | Graded A+ Prep
Domains: Growth & Development | Assessment | Family-Centered Care
Acute Conditions | Chronic Conditions | Pharmacology | Immunizations
Emergency & Critical Care | Abuse Recognition | Legal/Ethical | NGN Clinical Judgment
,Abstract
This document presents a comprehensive HESI Pediatric Nursing Examination practice assessment
consisting of 75 questions aligned with Elsevier Health Education Systems' pediatric competency
standards and the NCSBN Clinical Judgment Measurement Model (CJMM). Content spans eleven core
domains: growth and development milestones across pediatric age groups, pediatric assessment
techniques with age-adapted vital signs and pain scales, family-centered care principles, management of
common acute pediatric conditions, chronic disease management, weight-based pharmacology,
CDC/ACIP immunization protocols, pediatric emergency and critical care, child abuse recognition and
mandated reporting, legal/ethical responsibilities, and scenario-based clinical judgment items
incorporating NGN item types. All items include verified correct answers and evidence-based rationales
derived from standard pediatric nursing references including Hockenberry & Wilson's Wong's Nursing
Care of Infants and Children, AAP Bright Futures Guidelines, CDC immunization schedules, and NCSBN
test plan frameworks. This resource is designed as a study preparation tool for pre-licensure nursing
students and should be used in conjunction with institutional HESI remediation resources.
Keywords: HESI Pediatric Nursing, NCLEX-RN Pediatric, Growth and Development, Pediatric
Pharmacology, Immunization Schedules, Family-Centered Care, NGN Clinical Judgment, Child Abuse
Recognition, Pediatric Emergency Care, CJMM Framework
,GROWTH & DEVELOPMENT MILESTONES
1. 1. A nurse is assessing a 4-month-old infant during a well-child visit. Which
developmental milestone should the infant have achieved by this age?
A. Holds head steady when sitting with support
B. Rolls from back to front unassisted
C. Walks independently
D. Uses two-word phrases
The 4-month-old infant should demonstrate head control—holding the head steady and erect when
supported in a sitting position. This reflects progressive cervical and upper trunk muscle strengthening
that begins with head lag resolution by 2 months. Rolling from back to front typically emerges at 5–6
months, walking independently by 12 months, and two-word phrases by approximately 24 months
according to the Denver II and AAP developmental milestones.
2. 2. A parent of a 2-year-old toddler asks the nurse about expected language development.
Which response by the nurse is most accurate?
A. The toddler should be able to speak in complete sentences of 5–6 words
B. The toddler should have a vocabulary of approximately 50–300 words and begin
combining two-word phrases
C. The toddler should be able to read simple words
D. Language development is not significant until preschool age
By age 2, toddlers typically have a vocabulary of approximately 50–300 words and begin combining
two-word phrases (telegraphic speech) such as 'more milk' or 'mommy go.' This represents a significant
language explosion period between 18–24 months. Complete 5–6 word sentences are expected by age 4–
5. Reading simple words typically emerges around age 5–6. Language development follows a
predictable trajectory and is a critical developmental assessment at well-child visits.
3. 3. According to Erikson's psychosocial development theory, which stage is most relevant
for a hospitalized preschool-aged child (3–5 years)?
A. Trust vs. Mistrust
B. Autonomy vs. Shame and Doubt
C. Initiative vs. Guilt
D. Industry vs. Inferiority
Erikson's initiative vs. guilt stage (3–5 years) describes the preschooler's need to initiate activities, make
decisions, and exert control over their environment. Hospitalization disrupts this by imposing routines
and restrictions, potentially leading to feelings of guilt if the child perceives illness as punishment for
misbehavior. Nurses can support initiative by offering limited choices (which color cup, which arm for
, BP), allowing play activities, and explaining procedures in simple terms. Trust vs. mistrust (infancy),
autonomy vs. shame (toddler), and industry vs. inferiority (school-age) are the other relevant stages.
4. 4. A 9-month-old infant is observed pulling to a standing position and crawling. The
nurse documents this as consistent with which developmental pattern?
A. Proximodistal development
B. Cephalocaudal development
C. Mass-to-specific (differentiation) development
D. Simple-to-complex integration
Pulling to stand and crawling represent cephalocaudal development—motor development proceeds
from head to toe (cephalocaudal) and from center to periphery (proximodistal). The infant gains head
and neck control first, then trunk control, followed by use of arms and legs. Sitting precedes standing,
and standing precedes walking. This developmental direction guides anticipatory guidance for parents
regarding expected motor milestones and safety considerations such as fall prevention as mobility
increases.
5. 5. A nurse assesses a 12-month-old infant. Which behavior indicates the need for further
developmental evaluation?
A. Uses pincer grasp to pick up small objects
B. Transfers objects from one hand to the other
C. Does not yet speak any recognizable words
D. Shows stranger anxiety when approached by unfamiliar people
By 12 months, an infant should speak 1–2 recognizable words in addition to babbling. Absence of any
words by 12 months warrants further developmental evaluation and possible referral for speech and
language assessment. Pincer grasp (9–10 months), transferring objects (6–7 months), and stranger
anxiety (8–12 months) are all expected developmental findings at this age. Early identification of speech
delays enables timely intervention, which is associated with improved outcomes.
6. 6. A school-age child (7 years old) is recovering from a tonsillectomy. Which Erikson
stage should the nurse consider when planning care?
A. Initiative vs. Guilt
B. Industry vs. Inferiority
C. Identity vs. Role Confusion
D. Autonomy vs. Shame and Doubt
Industry vs. inferiority (6–12 years) is Erikson's stage for school-age children. Children in this stage
need to feel competent and productive, particularly in academic and social domains. Hospitalization
