HESI PEDS (PEDIATRICS) PRACTICE EXAM 2026/2027 UPDATED VERSION | VERIFIED NU… EXAM
P R O F E S S I O N A L P R A C T I C E M AT E R I A L S
HESI Peds (Pediatrics) Practice
Exam 2026/2027 Updated
Version | Verified Nursing
Questions & Detailed
Rationales
Verified Answers Exam Ready With Rationales 55 Questions
DOCUMENT OVERVIEW
This document offers a comprehensive review of pediatrics, covering topics such as spica cast care, pyloric stenosis, dehydration
assessment, developmental milestones, cystic fibrosis management, social interaction facilitation, temper tantrum management,
inguinal hernia assessment, and toilet training. It provides 55 practice questions with their correct answers and detailed
rationales, enabling students to study and understand key pediatric nursing concepts for exam preparation.
E XA M Q U EST I O N S
Q1 QUESTION 1 OF 55
A 3-year-old child sustained injuries requiring a spica cast. To promote play and engagement while adhering to activity
restrictions, the pediatric nurse should select which of the following toys?
A) A handheld electronic game with complex controls.
B) A stuffed animal that requires vigorous squeezing.
Page 1
,C) A finger puppet activity set.
D) A doll with elaborate clothing requiring fine motor manipulation.
CORRECT ANSWER
C) A finger puppet activity set.
RATIONALE
Finger puppets provide interactive play that can be managed within the confines of a spica cast, promoting engagement without
risking cast damage or requiring excessive movement. Other toys demand fine motor skills or physical exertion that is
contraindicated.
Q2 QUESTION 2 OF 55
An infant diagnosed with pyloric stenosis is exhibiting projectile vomiting. The nurse anticipates which of the following
acid-base and electrolyte imbalances as a direct consequence of this condition? (Select all that apply.)
A) Hypokalemia
B) Metabolic acidosis
C) Respiratory alkalosis
D) Hyponatremia
E) Metabolic alkalosis
F) Respiratory acidosis
CORRECT ANSWER
A) Hypokalemia
E) Metabolic alkalosis
RATIONALE
Projectile vomiting leads to significant loss of gastric acid (HCl) and fluid, resulting in hypokalemia and metabolic alkalosis due to
the loss of hydrogen ions and the kidneys' compensatory retention of bicarbonate.
Q3 QUESTION 3 OF 55
A 4-month-old infant admitted for severe diarrhea presents with a reduced level of consciousness and decreased urine
output over the past 12 hours. The nurse notes the infant's skin remains "tented" for several seconds after being gently
pinched on the abdomen. Which additional findings would the nurse anticipate as indicative of early to moderate
dehydration in this infant?
A) Capillary refill time of 4 seconds.
B) Increased heart rate.
C) Warm, moist oral mucous membranes.
Page 2
, D) Decreased respiratory rate.
E) Blood pressure of 70/40 mmHg.
CORRECT ANSWER
A) Capillary refill time of 4 seconds.
B) Increased heart rate.
E) Blood pressure of 70/40 mmHg.
RATIONALE
Prolonged capillary refill, tachycardia, and hypotension are classic signs of intravascular volume depletion and compensatory
mechanisms in early to moderate dehydration, indicating the need for prompt fluid resuscitation. Dry mucous membranes and
decreased skin turgor are also signs, but the question asks for additional findings with the provided context.
Q4 QUESTION 4 OF 55
An on-call pediatric nurse is assessing a 10-month-old infant during a routine check-up. The mother reports that the
infant recently began crying when she leaves the room but stops crying when she returns. The nurse observes the infant
reaching for a toy that was previously hidden under a cloth. Which of the following actions by the nurse are indicated to
assess and support the infant's current developmental stage? (Select all that apply.)
A) Acknowledge the infant's distress upon the mother's departure and offer a comfort item.
B) Encourage the mother to immediately retrieve the infant if crying occurs to prevent escalation.
C) Demonstrate to the infant that the hidden toy is still present, even when out of sight.
D) Gently explain to the mother that the infant's crying is a sign of developing attachment.
E) Ask the mother to bring the infant's favorite stuffed animal to the next appointment for comfort.
CORRECT ANSWER
A) Acknowledge the infant's distress upon the mother's departure and offer a comfort item.
C) Demonstrate to the infant that the hidden toy is still present, even when out of sight.
D) Gently explain to the mother that the infant's crying is a sign of developing attachment.
RATIONALE
Crying upon separation indicates developing object permanence and attachment, while finding the hidden toy shows mastery.
Acknowledging distress and offering comfort, reinforcing the toy's presence, and educating the mother are appropriate nursing
actions.
Q5 QUESTION 5 OF 55
The nurse is reviewing developmental milestones in a 5-month-old infant receiving thyroid hormone replacement for
congenital hypothyroidism. Which observed behavior by the infant would indicate the therapeutic goal of euthyroidism
has been achieved?
A) The infant consistently keeps their fists clenched and only opens them briefly when an object is placed in their palm.
Page 3
P R O F E S S I O N A L P R A C T I C E M AT E R I A L S
HESI Peds (Pediatrics) Practice
Exam 2026/2027 Updated
Version | Verified Nursing
Questions & Detailed
Rationales
Verified Answers Exam Ready With Rationales 55 Questions
DOCUMENT OVERVIEW
This document offers a comprehensive review of pediatrics, covering topics such as spica cast care, pyloric stenosis, dehydration
assessment, developmental milestones, cystic fibrosis management, social interaction facilitation, temper tantrum management,
inguinal hernia assessment, and toilet training. It provides 55 practice questions with their correct answers and detailed
rationales, enabling students to study and understand key pediatric nursing concepts for exam preparation.
E XA M Q U EST I O N S
Q1 QUESTION 1 OF 55
A 3-year-old child sustained injuries requiring a spica cast. To promote play and engagement while adhering to activity
restrictions, the pediatric nurse should select which of the following toys?
A) A handheld electronic game with complex controls.
B) A stuffed animal that requires vigorous squeezing.
Page 1
,C) A finger puppet activity set.
D) A doll with elaborate clothing requiring fine motor manipulation.
CORRECT ANSWER
C) A finger puppet activity set.
RATIONALE
Finger puppets provide interactive play that can be managed within the confines of a spica cast, promoting engagement without
risking cast damage or requiring excessive movement. Other toys demand fine motor skills or physical exertion that is
contraindicated.
Q2 QUESTION 2 OF 55
An infant diagnosed with pyloric stenosis is exhibiting projectile vomiting. The nurse anticipates which of the following
acid-base and electrolyte imbalances as a direct consequence of this condition? (Select all that apply.)
A) Hypokalemia
B) Metabolic acidosis
C) Respiratory alkalosis
D) Hyponatremia
E) Metabolic alkalosis
F) Respiratory acidosis
CORRECT ANSWER
A) Hypokalemia
E) Metabolic alkalosis
RATIONALE
Projectile vomiting leads to significant loss of gastric acid (HCl) and fluid, resulting in hypokalemia and metabolic alkalosis due to
the loss of hydrogen ions and the kidneys' compensatory retention of bicarbonate.
Q3 QUESTION 3 OF 55
A 4-month-old infant admitted for severe diarrhea presents with a reduced level of consciousness and decreased urine
output over the past 12 hours. The nurse notes the infant's skin remains "tented" for several seconds after being gently
pinched on the abdomen. Which additional findings would the nurse anticipate as indicative of early to moderate
dehydration in this infant?
A) Capillary refill time of 4 seconds.
B) Increased heart rate.
C) Warm, moist oral mucous membranes.
Page 2
, D) Decreased respiratory rate.
E) Blood pressure of 70/40 mmHg.
CORRECT ANSWER
A) Capillary refill time of 4 seconds.
B) Increased heart rate.
E) Blood pressure of 70/40 mmHg.
RATIONALE
Prolonged capillary refill, tachycardia, and hypotension are classic signs of intravascular volume depletion and compensatory
mechanisms in early to moderate dehydration, indicating the need for prompt fluid resuscitation. Dry mucous membranes and
decreased skin turgor are also signs, but the question asks for additional findings with the provided context.
Q4 QUESTION 4 OF 55
An on-call pediatric nurse is assessing a 10-month-old infant during a routine check-up. The mother reports that the
infant recently began crying when she leaves the room but stops crying when she returns. The nurse observes the infant
reaching for a toy that was previously hidden under a cloth. Which of the following actions by the nurse are indicated to
assess and support the infant's current developmental stage? (Select all that apply.)
A) Acknowledge the infant's distress upon the mother's departure and offer a comfort item.
B) Encourage the mother to immediately retrieve the infant if crying occurs to prevent escalation.
C) Demonstrate to the infant that the hidden toy is still present, even when out of sight.
D) Gently explain to the mother that the infant's crying is a sign of developing attachment.
E) Ask the mother to bring the infant's favorite stuffed animal to the next appointment for comfort.
CORRECT ANSWER
A) Acknowledge the infant's distress upon the mother's departure and offer a comfort item.
C) Demonstrate to the infant that the hidden toy is still present, even when out of sight.
D) Gently explain to the mother that the infant's crying is a sign of developing attachment.
RATIONALE
Crying upon separation indicates developing object permanence and attachment, while finding the hidden toy shows mastery.
Acknowledging distress and offering comfort, reinforcing the toy's presence, and educating the mother are appropriate nursing
actions.
Q5 QUESTION 5 OF 55
The nurse is reviewing developmental milestones in a 5-month-old infant receiving thyroid hormone replacement for
congenital hypothyroidism. Which observed behavior by the infant would indicate the therapeutic goal of euthyroidism
has been achieved?
A) The infant consistently keeps their fists clenched and only opens them briefly when an object is placed in their palm.
Page 3
