HESI Pediatrics V2 | 2026 Q&A with
Rationale (HESI Peds Exam)
1. A 6-month-old infant is brought to the clinic for a well-baby checkup. Which developmental
milestone should the nurse expect the infant to have achieved?
A. Sitting independently without support
B. Walking while holding onto furniture
C. Using a neat pincer grasp
D. Rolling from back to abdomen
Correct Answer: D
Rationale: By the age of 6 months, an infant is expected to be able to roll from their back to
their abdomen. Sitting independently is usually achieved around 8 months, and the pincer
grasp appears around 9 months. Walking while holding onto furniture, or cruising, typically
occurs around 11 to 12 months.-
2. A child is admitted with suspected epiglottitis. Which nursing intervention is the highest
priority?
A. Prepare for immediate endotracheal intubation
B. Obtain a throat culture immediately
C. Assess the child’s oxygen saturation
,D. Administer an oral antipyretic for fever
Correct Answer: A
Rationale: Epiglottitis is a medical emergency that can lead to rapid airway obstruction.
The nurse should avoid any throat examination, including cultures, as this can trigger a
laryngospasm. Preparing for emergency airway management, such as intubation or
tracheostomy, is the priority to ensure the child remains ventilated.
3. The nurse is assessing a 4-week-old infant with a history of projectile vomiting after
feedings. Which finding should the nurse expect to palpate?
A. A sausage-shaped mass in the upper right quadrant
B. A distended bladder above the symphysis pubis
C. An olive-shaped mass in the epigastrium
D. Rebound tenderness in the lower right quadrant
Correct Answer: C
Rationale: Projectile vomiting in a neonate is a hallmark sign of hypertrophic pyloric
stenosis. An olive-shaped mass in the epigastric area to the right of the midline is typically
palpable in these infants. A sausage-shaped mass is more indicative of intussusception
rather than pyloric stenosis.
4. A child with cystic fibrosis is being prepared for discharge. Which instructions should the
nurse include in the teaching? (Select all that apply)
A. Administer pancreatic enzymes with all meals and snacks
,B. Restrict fat intake to less than 20% of total calories
C. Perform chest physiotherapy twice daily
D. Increase fluid intake to thin secretions
E. Provide a high-calorie, high-protein diet
F. Encourage physical activity as tolerated
Correct Answer: A, C, D, E, F
Rationale: Cystic fibrosis management requires a multi-faceted approach to manage
respiratory and digestive issues. Pancreatic enzymes are essential for nutrient absorption,
and a high-calorie diet is needed due to malabsorption. Airway clearance techniques,
hydration, and exercise help manage thick mucus secretions in the lungs.
5. A 5-year-old is diagnosed with nephrotic syndrome. Which clinical manifestation should
the nurse expect to observe?
A. Gross hematuria and hypertension
B. Massive proteinuria and generalized edema
C. Weight loss and increased urinary output
D. Low serum cholesterol levels
Correct Answer: B
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability to
protein, leading to massive proteinuria. This results in hypoalbuminemia, which causes a
, shift of fluid into the interstitial spaces, manifesting as generalized edema (anasarca).
Hematuria and hypertension are more common in acute glomerulonephritis.
6. A toddler with Tetralogy of Fallot begins to have a hypercyanotic (Tet) spell. Which action
should the nurse take first?
A. Place the child in the knee-chest position
B. Administer 100% oxygen via face mask
C. Administer intravenous morphine sulfate
D. Prepare for emergency surgical repair
Correct Answer: A
Rationale: The knee-chest position is the first intervention because it increases systemic
vascular resistance and decreases the right-to-left shunt. This helps improve pulmonary
blood flow and increases oxygenation. Oxygen and morphine may follow, but the physical
positioning provides the most immediate benefit.
7. A nurse is caring for a child with Kawasaki disease in the acute phase. What is the primary
reason for administering high-dose aspirin?
A. To reduce the risk of Reye syndrome
B. To provide analgesia for joint pain
C. To reduce inflammation and prevent coronary artery aneurysms
D. To lower the high fever associated with the illness
Rationale (HESI Peds Exam)
1. A 6-month-old infant is brought to the clinic for a well-baby checkup. Which developmental
milestone should the nurse expect the infant to have achieved?
A. Sitting independently without support
B. Walking while holding onto furniture
C. Using a neat pincer grasp
D. Rolling from back to abdomen
Correct Answer: D
Rationale: By the age of 6 months, an infant is expected to be able to roll from their back to
their abdomen. Sitting independently is usually achieved around 8 months, and the pincer
grasp appears around 9 months. Walking while holding onto furniture, or cruising, typically
occurs around 11 to 12 months.-
2. A child is admitted with suspected epiglottitis. Which nursing intervention is the highest
priority?
A. Prepare for immediate endotracheal intubation
B. Obtain a throat culture immediately
C. Assess the child’s oxygen saturation
,D. Administer an oral antipyretic for fever
Correct Answer: A
Rationale: Epiglottitis is a medical emergency that can lead to rapid airway obstruction.
The nurse should avoid any throat examination, including cultures, as this can trigger a
laryngospasm. Preparing for emergency airway management, such as intubation or
tracheostomy, is the priority to ensure the child remains ventilated.
3. The nurse is assessing a 4-week-old infant with a history of projectile vomiting after
feedings. Which finding should the nurse expect to palpate?
A. A sausage-shaped mass in the upper right quadrant
B. A distended bladder above the symphysis pubis
C. An olive-shaped mass in the epigastrium
D. Rebound tenderness in the lower right quadrant
Correct Answer: C
Rationale: Projectile vomiting in a neonate is a hallmark sign of hypertrophic pyloric
stenosis. An olive-shaped mass in the epigastric area to the right of the midline is typically
palpable in these infants. A sausage-shaped mass is more indicative of intussusception
rather than pyloric stenosis.
4. A child with cystic fibrosis is being prepared for discharge. Which instructions should the
nurse include in the teaching? (Select all that apply)
A. Administer pancreatic enzymes with all meals and snacks
,B. Restrict fat intake to less than 20% of total calories
C. Perform chest physiotherapy twice daily
D. Increase fluid intake to thin secretions
E. Provide a high-calorie, high-protein diet
F. Encourage physical activity as tolerated
Correct Answer: A, C, D, E, F
Rationale: Cystic fibrosis management requires a multi-faceted approach to manage
respiratory and digestive issues. Pancreatic enzymes are essential for nutrient absorption,
and a high-calorie diet is needed due to malabsorption. Airway clearance techniques,
hydration, and exercise help manage thick mucus secretions in the lungs.
5. A 5-year-old is diagnosed with nephrotic syndrome. Which clinical manifestation should
the nurse expect to observe?
A. Gross hematuria and hypertension
B. Massive proteinuria and generalized edema
C. Weight loss and increased urinary output
D. Low serum cholesterol levels
Correct Answer: B
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability to
protein, leading to massive proteinuria. This results in hypoalbuminemia, which causes a
, shift of fluid into the interstitial spaces, manifesting as generalized edema (anasarca).
Hematuria and hypertension are more common in acute glomerulonephritis.
6. A toddler with Tetralogy of Fallot begins to have a hypercyanotic (Tet) spell. Which action
should the nurse take first?
A. Place the child in the knee-chest position
B. Administer 100% oxygen via face mask
C. Administer intravenous morphine sulfate
D. Prepare for emergency surgical repair
Correct Answer: A
Rationale: The knee-chest position is the first intervention because it increases systemic
vascular resistance and decreases the right-to-left shunt. This helps improve pulmonary
blood flow and increases oxygenation. Oxygen and morphine may follow, but the physical
positioning provides the most immediate benefit.
7. A nurse is caring for a child with Kawasaki disease in the acute phase. What is the primary
reason for administering high-dose aspirin?
A. To reduce the risk of Reye syndrome
B. To provide analgesia for joint pain
C. To reduce inflammation and prevent coronary artery aneurysms
D. To lower the high fever associated with the illness
