HESI RN Pediatrics Exam (2026 Edition) – 150 Next
Generation NCLEX (NGN) Style Questions with
Detailed Rationales
Summary of Questions by Domain
Domain Question Range
Growth & Development 1–25
Pediatric Assessment 26–45
Neonatal & Newborn 46–60
Respiratory Disorders 61–75
Cardiovascular Disorders 76–85
Gastrointestinal Disorders 86–100
Neurological Disorders 101–110
Infectious Diseases 111–120
Hematologic/Oncologic 121–130
Endocrine/Metabolic 131–140
Musculoskeletal & Renal 141–145
Psychosocial & Child Abuse 146–150
1|Page
,Domain 1: Growth & Development (Questions 1–25)
Question 1
A 4-month-old infant is brought to the clinic for a well-child visit. The parent asks
what developmental milestones to expect by 6 months of age. Which milestone
should the nurse include?
A. Sitting without support
B. Rolling from back to abdomen
C. Walking independently
D. Using a pincer grasp
Correct Answer: B. Rolling from back to abdomen
Rationale: By 6 months, most infants can roll from back to abdomen and
abdomen to back. Sitting without support occurs around 8 months. Walking
independently occurs around 12 months. Pincer grasp develops around 9-10
months.
Question 2
A 2-year-old child is having a temper tantrum in the clinic waiting room. The
parent asks the nurse for advice. Which response by the nurse is MOST
appropriate?
A. "Spank the child to stop the behavior immediately"
B. "Ignore the tantrum and do not give in to the child's demands"
C. "Offer the child a candy to stop crying"
D. "Send the child to time-out for 30 minutes"
Correct Answer: B. "Ignore the tantrum and do not give in to the child's
demands"
Rationale: Temper tantrums are normal in toddlers. The best approach is to
ignore the behavior (as long as the child is safe) and not reinforce it with
attention. Spanking is never recommended. Offering candy rewards negative
behavior. Time-out duration should be 1 minute per year of age (2 minutes
maximum).
2|Page
,Question 3
A school nurse is teaching a group of parents about normal adolescent
development. Which statement by a parent indicates a need for further teaching?
A. "My 14-year-old daughter is very concerned about her body image."
B. "My 16-year-old son wants to spend more time with his friends than family."
C. "My 13-year-old daughter has started her period and is now fully grown."
D. "My 17-year-old son is thinking about his future career plans."
Correct Answer: C. "My 13-year-old daughter has started her period and is now
fully grown."
Rationale: Menarche occurs during puberty, but girls continue to grow for about
2 years after menarche (typically reaching final height by age 16-17). The other
statements are normal adolescent behaviors.
Question 4
The nurse is assessing a 9-month-old infant. Which finding would be MOST
concerning?
A. The infant can sit unsupported
B. The infant has a head circumference larger than chest circumference
C. The infant cannot pull to standing
D. The infant does not say "mama" or "dada" specifically
Correct Answer: D. The infant does not say "mama" or "dada" specifically
Rationale: By 9-10 months, infants should use "mama" or "dada" specifically.
Sitting unsupported occurs by 8 months. Head circumference is larger than chest
circumference until about 12 months. Pulling to standing occurs around 9-10
months; not doing so at 9 months is not yet concerning.
Question 5
The nurse is providing anticipatory guidance to parents of a 12-month-old. Which
safety measure is MOST important to discuss?
A. Using a rear-facing car seat
3|Page
, B. Installing childproof locks on cabinets
C. Keeping poisonous plants out of reach
D. Ensuring the water heater temperature is below 120°F (49°C)
Correct Answer: All are important, but the priority for a 12-month-old who is
becoming mobile is B. Installing childproof locks on cabinets (poisoning
prevention) and D. Water heater temperature (burn prevention). However, the
single best answer is D as burns are a leading cause of injury at this age when
toddlers can reach faucets.
Rationale: At 12 months, toddlers can walk and explore. Scald burns from hot
water are a major risk; water heater temperature should be set at or below 120°F
(49°C). All options are important, but water heater safety is often overlooked.
Question 6 (SATA)
The nurse is assessing a 7-year-old child. Which developmental tasks are expected
for this age? Select all that apply.
A. Developing a sense of industry
B. Understanding conservation of mass
C. Engaging in parallel play
D. Developing secondary sex characteristics
E. Forming friendships based on trust
Correct Answer: A, B, E
Rationale: School-age children (6-12 years) develop a sense of industry (Erikson),
understand conservation (Piaget), and form friendships based on trust. Parallel
play is typical for toddlers (2-3 years). Secondary sex characteristics develop in
adolescence (10+ years).
Question 7
A mother asks the nurse when she should introduce solid foods to her 4-month-
old infant. Which response is MOST appropriate?
A. "You can start now with rice cereal mixed with formula or breast milk"
B. "Wait until 6 months of age to introduce solid foods"
4|Page
Generation NCLEX (NGN) Style Questions with
Detailed Rationales
Summary of Questions by Domain
Domain Question Range
Growth & Development 1–25
Pediatric Assessment 26–45
Neonatal & Newborn 46–60
Respiratory Disorders 61–75
Cardiovascular Disorders 76–85
Gastrointestinal Disorders 86–100
Neurological Disorders 101–110
Infectious Diseases 111–120
Hematologic/Oncologic 121–130
Endocrine/Metabolic 131–140
Musculoskeletal & Renal 141–145
Psychosocial & Child Abuse 146–150
1|Page
,Domain 1: Growth & Development (Questions 1–25)
Question 1
A 4-month-old infant is brought to the clinic for a well-child visit. The parent asks
what developmental milestones to expect by 6 months of age. Which milestone
should the nurse include?
A. Sitting without support
B. Rolling from back to abdomen
C. Walking independently
D. Using a pincer grasp
Correct Answer: B. Rolling from back to abdomen
Rationale: By 6 months, most infants can roll from back to abdomen and
abdomen to back. Sitting without support occurs around 8 months. Walking
independently occurs around 12 months. Pincer grasp develops around 9-10
months.
Question 2
A 2-year-old child is having a temper tantrum in the clinic waiting room. The
parent asks the nurse for advice. Which response by the nurse is MOST
appropriate?
A. "Spank the child to stop the behavior immediately"
B. "Ignore the tantrum and do not give in to the child's demands"
C. "Offer the child a candy to stop crying"
D. "Send the child to time-out for 30 minutes"
Correct Answer: B. "Ignore the tantrum and do not give in to the child's
demands"
Rationale: Temper tantrums are normal in toddlers. The best approach is to
ignore the behavior (as long as the child is safe) and not reinforce it with
attention. Spanking is never recommended. Offering candy rewards negative
behavior. Time-out duration should be 1 minute per year of age (2 minutes
maximum).
2|Page
,Question 3
A school nurse is teaching a group of parents about normal adolescent
development. Which statement by a parent indicates a need for further teaching?
A. "My 14-year-old daughter is very concerned about her body image."
B. "My 16-year-old son wants to spend more time with his friends than family."
C. "My 13-year-old daughter has started her period and is now fully grown."
D. "My 17-year-old son is thinking about his future career plans."
Correct Answer: C. "My 13-year-old daughter has started her period and is now
fully grown."
Rationale: Menarche occurs during puberty, but girls continue to grow for about
2 years after menarche (typically reaching final height by age 16-17). The other
statements are normal adolescent behaviors.
Question 4
The nurse is assessing a 9-month-old infant. Which finding would be MOST
concerning?
A. The infant can sit unsupported
B. The infant has a head circumference larger than chest circumference
C. The infant cannot pull to standing
D. The infant does not say "mama" or "dada" specifically
Correct Answer: D. The infant does not say "mama" or "dada" specifically
Rationale: By 9-10 months, infants should use "mama" or "dada" specifically.
Sitting unsupported occurs by 8 months. Head circumference is larger than chest
circumference until about 12 months. Pulling to standing occurs around 9-10
months; not doing so at 9 months is not yet concerning.
Question 5
The nurse is providing anticipatory guidance to parents of a 12-month-old. Which
safety measure is MOST important to discuss?
A. Using a rear-facing car seat
3|Page
, B. Installing childproof locks on cabinets
C. Keeping poisonous plants out of reach
D. Ensuring the water heater temperature is below 120°F (49°C)
Correct Answer: All are important, but the priority for a 12-month-old who is
becoming mobile is B. Installing childproof locks on cabinets (poisoning
prevention) and D. Water heater temperature (burn prevention). However, the
single best answer is D as burns are a leading cause of injury at this age when
toddlers can reach faucets.
Rationale: At 12 months, toddlers can walk and explore. Scald burns from hot
water are a major risk; water heater temperature should be set at or below 120°F
(49°C). All options are important, but water heater safety is often overlooked.
Question 6 (SATA)
The nurse is assessing a 7-year-old child. Which developmental tasks are expected
for this age? Select all that apply.
A. Developing a sense of industry
B. Understanding conservation of mass
C. Engaging in parallel play
D. Developing secondary sex characteristics
E. Forming friendships based on trust
Correct Answer: A, B, E
Rationale: School-age children (6-12 years) develop a sense of industry (Erikson),
understand conservation (Piaget), and form friendships based on trust. Parallel
play is typical for toddlers (2-3 years). Secondary sex characteristics develop in
adolescence (10+ years).
Question 7
A mother asks the nurse when she should introduce solid foods to her 4-month-
old infant. Which response is MOST appropriate?
A. "You can start now with rice cereal mixed with formula or breast milk"
B. "Wait until 6 months of age to introduce solid foods"
4|Page
