Pediatrics HESI RN Exit Exam Test
Bank (7th Edition) by Sandra Upchurch
and HESI - Latest 2025/2026 Prep to Pass
Exams on Your First Attempt and Avoid
Resits
1. Afebrile seizures are a common clinical feature of this
syndrome, which is also associated with moderate to severe
intellectual disability and a distinctive facial appearance.
A. Down Syndrome
B. Fragile X Syndrome
C. Turner Syndrome
D. Klinefelter Syndrome
✅ Correct Answer: B. Fragile X Syndrome
Rationale: Fragile X syndrome is the most common inherited
cause of intellectual disability and the most common known
genetic cause of autism. Seizures (often afebrile) occur in
approximately 25% of affected males. The syndrome also presents
with characteristic physical features such as a long and narrow
face, large ears, and macroorchidism (enlarged testicles) after
puberty. This pattern distinguishes it from other genetic
syndromes. Down syndrome (A) is associated with a distinct set
of physical features and intellectual disability but seizures are less
consistently afebrile and the facial features are very
,different. Turner syndrome (C) occurs only in females and is
characterized by short stature and webbed neck, but not typically
with seizures. Klinefelter syndrome (D) is characterized by an
XXY karyotype in males, resulting in tall stature, small testes, and
gynecomastia, without the craniofacial abnormalities described.
2. The nurse is reinforcing teaching about promoting rest and
sleep for a preschooler. Which of the following statements by the
parent indicates an understanding of the teaching?
A. "My child has begun having nightmares, so I will check on
her once or twice a night to make sure she is safe."
B. "My child needs 10 to 13 hours of sleep each night."
C. "To help my child fall asleep faster, I will make sure she
gets a lot of screen time right before bed."
D. "If my child wakes up from a night terror, I will hold her
until she is fully awake."
✅ Correct Answer: B. "My child needs 10 to 13 hours of sleep
each night."
Rationale: Preschoolers require an average of 10 to 13 hours of
sleep per night to support growth, cognitive development, and
emotional regulation, and this range is consistently recommended
by the American Academy of Pediatrics. Option A is partially
correct in that parents should check on children having
nightmares, but the statement does not demonstrate
understanding of behavioral sleep strategies (dark room,
consistent bedtime routine) which are equally important. Option
C is incorrect because excessive screen time, especially blue light
exposure right before bed, suppresses melatonin secretion and
,delays sleep onset, negatively impacting total sleep
duration. Option D is incorrect because attempting to wake or
hold a child during a night terror can prolong the episode or
agitate the child further, as the child is not consciously aware and
will not remember the event; reassurance after the episode is best.
3. Parents ask the nurse about introducing solid foods to their 6-
month-old infant. Which of the following would be the most
appropriate first food?
A. Strained beef
B. Pureed spinach
C. Iron-fortified rice cereal
D. Mashed potatoes
✅ Correct Answer: C. Iron-fortified rice cereal
Rationale: Iron-fortified single-grain cereals like rice or oatmeal
are the standard first solid foods for infants, as they are gentle on
the digestive system, provide essential iron to prevent anemia,
and have a low allergenic potential compared to meats or
vegetables. The American Academy of Pediatrics advises starting
solids around 6 months of age, beginning with iron-rich
foods. Option A (strained beef) is high in protein and may be
harder for an infant's immature gastrointestinal system to digest;
it is typically introduced later, around 8 months. Option B (pureed
spinach) is not recommended as a first food due to its typically
thin consistency and its high nitrate content, which can lead to
methemoglobinemia in young infants. Option D (mashed
potatoes) lacks iron and provides empty calories without
significant nutritional benefit compared to fortified cereals.
, 4. A nurse is conducting a well-child visit for a 15-month-old
toddler. Which of the following developmental milestones is the
nurse most likely to observe?
A. Walking independently and scribbling with a crayon
B. Riding a tricycle and speaking in short sentences
C. Building a tower of 6 cubes and copying a circle
D. Using a spoon without spilling and jumping in place
✅ Correct Answer: A. Walking independently and scribbling
with a crayon
Rationale: By 15 months of age, most toddlers can walk
independently without support and demonstrate emerging fine
motor skills such as scribbling spontaneously with a crayon. These
achievements are consistent with the typical progression of gross
and fine motor development. Option B describes skills more
typical of a 3-year-old preschooler (riding a tricycle, speaking in
3–4 word sentences). Option C describes milestones of a 4-to-5-
year-old child (building a tower of 6 cubes, copying a
circle). Option D describes refined motor and social skills usually
seen around 24 to 30 months (using a spoon without major
spillage, jumping in place).
5. The nurse is planning to administer the MMR vaccine to a child.
Which of the following children would contraindicate receiving
the MMR vaccine?
A. An 18-month-old with a mild upper respiratory infection
and low-grade fever (38.0°C)
B. A 4-year-old child with a documented egg allergy
Bank (7th Edition) by Sandra Upchurch
and HESI - Latest 2025/2026 Prep to Pass
Exams on Your First Attempt and Avoid
Resits
1. Afebrile seizures are a common clinical feature of this
syndrome, which is also associated with moderate to severe
intellectual disability and a distinctive facial appearance.
A. Down Syndrome
B. Fragile X Syndrome
C. Turner Syndrome
D. Klinefelter Syndrome
✅ Correct Answer: B. Fragile X Syndrome
Rationale: Fragile X syndrome is the most common inherited
cause of intellectual disability and the most common known
genetic cause of autism. Seizures (often afebrile) occur in
approximately 25% of affected males. The syndrome also presents
with characteristic physical features such as a long and narrow
face, large ears, and macroorchidism (enlarged testicles) after
puberty. This pattern distinguishes it from other genetic
syndromes. Down syndrome (A) is associated with a distinct set
of physical features and intellectual disability but seizures are less
consistently afebrile and the facial features are very
,different. Turner syndrome (C) occurs only in females and is
characterized by short stature and webbed neck, but not typically
with seizures. Klinefelter syndrome (D) is characterized by an
XXY karyotype in males, resulting in tall stature, small testes, and
gynecomastia, without the craniofacial abnormalities described.
2. The nurse is reinforcing teaching about promoting rest and
sleep for a preschooler. Which of the following statements by the
parent indicates an understanding of the teaching?
A. "My child has begun having nightmares, so I will check on
her once or twice a night to make sure she is safe."
B. "My child needs 10 to 13 hours of sleep each night."
C. "To help my child fall asleep faster, I will make sure she
gets a lot of screen time right before bed."
D. "If my child wakes up from a night terror, I will hold her
until she is fully awake."
✅ Correct Answer: B. "My child needs 10 to 13 hours of sleep
each night."
Rationale: Preschoolers require an average of 10 to 13 hours of
sleep per night to support growth, cognitive development, and
emotional regulation, and this range is consistently recommended
by the American Academy of Pediatrics. Option A is partially
correct in that parents should check on children having
nightmares, but the statement does not demonstrate
understanding of behavioral sleep strategies (dark room,
consistent bedtime routine) which are equally important. Option
C is incorrect because excessive screen time, especially blue light
exposure right before bed, suppresses melatonin secretion and
,delays sleep onset, negatively impacting total sleep
duration. Option D is incorrect because attempting to wake or
hold a child during a night terror can prolong the episode or
agitate the child further, as the child is not consciously aware and
will not remember the event; reassurance after the episode is best.
3. Parents ask the nurse about introducing solid foods to their 6-
month-old infant. Which of the following would be the most
appropriate first food?
A. Strained beef
B. Pureed spinach
C. Iron-fortified rice cereal
D. Mashed potatoes
✅ Correct Answer: C. Iron-fortified rice cereal
Rationale: Iron-fortified single-grain cereals like rice or oatmeal
are the standard first solid foods for infants, as they are gentle on
the digestive system, provide essential iron to prevent anemia,
and have a low allergenic potential compared to meats or
vegetables. The American Academy of Pediatrics advises starting
solids around 6 months of age, beginning with iron-rich
foods. Option A (strained beef) is high in protein and may be
harder for an infant's immature gastrointestinal system to digest;
it is typically introduced later, around 8 months. Option B (pureed
spinach) is not recommended as a first food due to its typically
thin consistency and its high nitrate content, which can lead to
methemoglobinemia in young infants. Option D (mashed
potatoes) lacks iron and provides empty calories without
significant nutritional benefit compared to fortified cereals.
, 4. A nurse is conducting a well-child visit for a 15-month-old
toddler. Which of the following developmental milestones is the
nurse most likely to observe?
A. Walking independently and scribbling with a crayon
B. Riding a tricycle and speaking in short sentences
C. Building a tower of 6 cubes and copying a circle
D. Using a spoon without spilling and jumping in place
✅ Correct Answer: A. Walking independently and scribbling
with a crayon
Rationale: By 15 months of age, most toddlers can walk
independently without support and demonstrate emerging fine
motor skills such as scribbling spontaneously with a crayon. These
achievements are consistent with the typical progression of gross
and fine motor development. Option B describes skills more
typical of a 3-year-old preschooler (riding a tricycle, speaking in
3–4 word sentences). Option C describes milestones of a 4-to-5-
year-old child (building a tower of 6 cubes, copying a
circle). Option D describes refined motor and social skills usually
seen around 24 to 30 months (using a spoon without major
spillage, jumping in place).
5. The nurse is planning to administer the MMR vaccine to a child.
Which of the following children would contraindicate receiving
the MMR vaccine?
A. An 18-month-old with a mild upper respiratory infection
and low-grade fever (38.0°C)
B. A 4-year-old child with a documented egg allergy
