1
HESI Pediatric Exit Exam 2025 | 250 Actual NCLEX-Style Questions
with Verified Answers & Rationales | Graded A+
1. A 2-year-old is brought to the clinic for a routine checkup. The nurse observes that the child
can walk alone but cannot jump with both feet. What should the nurse do next?
A. Refer the child to a physical therapist
B. Document this as a normal developmental milestone
C. Request an immediate neurological evaluation
D. Assess for signs of cerebral palsy
Correct Answer: B
Rationale: By age 2, walking independently is expected, but jumping with both feet may not yet
be developed. This falls within normal limits for this developmental stage.
2. A child with croup presents with inspiratory stridor and a barking cough. What is the priority
nursing intervention?
A. Administer oral antibiotics
B. Encourage oral fluids
, 2
C. Provide humidified oxygen
D. Lay the child flat for rest
Correct Answer: C
Rationale: Humidified oxygen helps reduce airway inflammation and stridor in croup.
Antibiotics are not typically used unless there’s a bacterial infection.
3. A 4-month-old is brought in for DTaP immunization. Which reaction should the nurse report to
the provider immediately?
A. Mild fever and fussiness
B. Soreness at the injection site
C. Persistent inconsolable crying for over 3 hours
D. Decreased appetite
Correct Answer: C
Rationale: Persistent inconsolable crying can indicate a serious adverse reaction and should be
evaluated promptly.
4. A school-age child with asthma uses albuterol frequently. The nurse should be most concerned
about which finding?
A. Increased appetite
B. Hand tremors and tachycardia
C. Decreased peak flow readings
D. Daytime drowsiness
, 3
Correct Answer: C
Rationale: Decreased peak flow indicates worsening airway obstruction and potential loss of
asthma control.
5. A nurse is caring for a 10-month-old with iron-deficiency anemia. Which feeding practice
likely contributed to the condition?
A. Breastfeeding exclusively for 4 months
B. Introduction of solid foods at 6 months
C. Drinking cow’s milk as a primary milk source
D. Giving vitamin C-rich juices with meals
Correct Answer: C
Rationale: Cow’s milk can cause occult GI bleeding and is a poor source of iron, especially if
given before 12 months.
6. A 6-year-old with acute glomerulonephritis is on restricted fluid intake. Which sign indicates
fluid overload?
A. Decreased blood pressure
B. Facial edema
C. Hypothermia
D. Increased urine output
, 4
Correct Answer: B
Rationale: Facial or periorbital edema is a hallmark of fluid retention and glomerulonephritis in
children.
7. The nurse is caring for a child with suspected meningitis. What is the priority action?
A. Administer acetaminophen
B. Place the child in isolation
C. Provide IV fluids
D. Assess Glasgow Coma Scale
Correct Answer: B
Rationale: Meningitis can be contagious; placing the child in droplet precautions is essential
until a diagnosis is confirmed.
8. A 3-year-old child is diagnosed with lead poisoning. Which lab finding supports this
diagnosis?
A. Hematocrit of 42%
B. Blood lead level of 15 mcg/dL
C. Platelet count of 200,000/mm³
D. Sodium of 138 mEq/L
Correct Answer: B
Rationale: A blood lead level above 5 mcg/dL is considered elevated; 15 mcg/dL confirms lead
poisoning.
HESI Pediatric Exit Exam 2025 | 250 Actual NCLEX-Style Questions
with Verified Answers & Rationales | Graded A+
1. A 2-year-old is brought to the clinic for a routine checkup. The nurse observes that the child
can walk alone but cannot jump with both feet. What should the nurse do next?
A. Refer the child to a physical therapist
B. Document this as a normal developmental milestone
C. Request an immediate neurological evaluation
D. Assess for signs of cerebral palsy
Correct Answer: B
Rationale: By age 2, walking independently is expected, but jumping with both feet may not yet
be developed. This falls within normal limits for this developmental stage.
2. A child with croup presents with inspiratory stridor and a barking cough. What is the priority
nursing intervention?
A. Administer oral antibiotics
B. Encourage oral fluids
, 2
C. Provide humidified oxygen
D. Lay the child flat for rest
Correct Answer: C
Rationale: Humidified oxygen helps reduce airway inflammation and stridor in croup.
Antibiotics are not typically used unless there’s a bacterial infection.
3. A 4-month-old is brought in for DTaP immunization. Which reaction should the nurse report to
the provider immediately?
A. Mild fever and fussiness
B. Soreness at the injection site
C. Persistent inconsolable crying for over 3 hours
D. Decreased appetite
Correct Answer: C
Rationale: Persistent inconsolable crying can indicate a serious adverse reaction and should be
evaluated promptly.
4. A school-age child with asthma uses albuterol frequently. The nurse should be most concerned
about which finding?
A. Increased appetite
B. Hand tremors and tachycardia
C. Decreased peak flow readings
D. Daytime drowsiness
, 3
Correct Answer: C
Rationale: Decreased peak flow indicates worsening airway obstruction and potential loss of
asthma control.
5. A nurse is caring for a 10-month-old with iron-deficiency anemia. Which feeding practice
likely contributed to the condition?
A. Breastfeeding exclusively for 4 months
B. Introduction of solid foods at 6 months
C. Drinking cow’s milk as a primary milk source
D. Giving vitamin C-rich juices with meals
Correct Answer: C
Rationale: Cow’s milk can cause occult GI bleeding and is a poor source of iron, especially if
given before 12 months.
6. A 6-year-old with acute glomerulonephritis is on restricted fluid intake. Which sign indicates
fluid overload?
A. Decreased blood pressure
B. Facial edema
C. Hypothermia
D. Increased urine output
, 4
Correct Answer: B
Rationale: Facial or periorbital edema is a hallmark of fluid retention and glomerulonephritis in
children.
7. The nurse is caring for a child with suspected meningitis. What is the priority action?
A. Administer acetaminophen
B. Place the child in isolation
C. Provide IV fluids
D. Assess Glasgow Coma Scale
Correct Answer: B
Rationale: Meningitis can be contagious; placing the child in droplet precautions is essential
until a diagnosis is confirmed.
8. A 3-year-old child is diagnosed with lead poisoning. Which lab finding supports this
diagnosis?
A. Hematocrit of 42%
B. Blood lead level of 15 mcg/dL
C. Platelet count of 200,000/mm³
D. Sodium of 138 mEq/L
Correct Answer: B
Rationale: A blood lead level above 5 mcg/dL is considered elevated; 15 mcg/dL confirms lead
poisoning.
