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HESI Growth & Development
Exam Bank: Pediatric Milestones,
Delays & Nursing Assessment
Q&A
Table of Contents
Subtopic 1: Newborn to 2 Months – Physical, Neurological, and Reflex
Development...................................................................................................3
Subtopic 2: 2 to 6 Months – Emerging Motor Skills, Communication, and
Cognitive Development.................................................................................11
Subtopic 3: 6 to 9 Months – Advanced Social Interaction, Gross Motor
Changes, and Object Permanence.................................................................19
Subtopic 4: 9 to 12 Months – Independence, Mobility, and Communication
Expansion......................................................................................................28
Subtopic 5: Preschool Developmental Progress (3–5 Years)...........................36
Subtopic 6: Nutrition, Feeding Patterns & Growth Monitoring (Questions 101–
120)...............................................................................................................44
Subtopic 7: Social, Emotional, and Behavioral Development (Q121–140).....51
Subtopic 8: Growth Monitoring and Early Detection in Special Populations
(Q141–160)....................................................................................................60
Subtopic 9: Delays in Milestone Attainment, Screening and Referrals (Q161–
180)...............................................................................................................68
Subtopic 10: Integrated Case-Based Growth & Development Questions
(Q181–200)....................................................................................................77
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Subtopic 1: Newborn to 2 Months – Physical,
Neurological, and Reflex Development
Question 1:
Which primitive reflex is expected to be present in a newborn and typically
disappears by 2 months of age?
A. Babinski reflex
B. Moro reflex
C. Landau reflex
D. Parachute reflex
Correct Answer: B. Moro reflex
Rationale: The Moro (startle) reflex is present at birth and typically
disappears by 2 months. The Babinski may persist up to 1 year, while Landau
and Parachute reflexes emerge later in infancy.
Question 2:
A 6-week-old infant does not respond to loud noises. What is the most
appropriate next nursing action?
A. Encourage frequent tummy time
B. Document as a normal finding
C. Refer for hearing evaluation
D. Schedule next routine check-up
Correct Answer: C. Refer for hearing evaluation
Rationale: By this age, infants should startle or react to loud sounds. Lack of
response may indicate hearing impairment and warrants further evaluation.
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Question 3:
At what age is it expected for a newborn to regain birth weight?
A. 1 week
B. 10 days
C. 2 weeks
D. 1 month
Correct Answer: C. 2 weeks
Rationale: It is normal for infants to lose up to 10% of their birth weight in
the first few days, but they should regain it by 10 to 14 days of life.
Question 4:
Which physical finding in a 1-month-old would be considered a
developmental red flag?
A. Has some head lag when pulled to sit
B. Absent rooting reflex
C. Brings hands to mouth
D. Eyes briefly follow faces
Correct Answer: B. Absent rooting reflex
Rationale: The rooting reflex is present at birth and assists with
breastfeeding. Its absence may indicate a neurologic concern.
Question 5:
Which gross motor milestone is expected in a healthy 2-month-old?
A. Rolls from front to back
B. Lifts head when prone
C. Sits with support
HESI Growth & Development
Exam Bank: Pediatric Milestones,
Delays & Nursing Assessment
Q&A
Table of Contents
Subtopic 1: Newborn to 2 Months – Physical, Neurological, and Reflex
Development...................................................................................................3
Subtopic 2: 2 to 6 Months – Emerging Motor Skills, Communication, and
Cognitive Development.................................................................................11
Subtopic 3: 6 to 9 Months – Advanced Social Interaction, Gross Motor
Changes, and Object Permanence.................................................................19
Subtopic 4: 9 to 12 Months – Independence, Mobility, and Communication
Expansion......................................................................................................28
Subtopic 5: Preschool Developmental Progress (3–5 Years)...........................36
Subtopic 6: Nutrition, Feeding Patterns & Growth Monitoring (Questions 101–
120)...............................................................................................................44
Subtopic 7: Social, Emotional, and Behavioral Development (Q121–140).....51
Subtopic 8: Growth Monitoring and Early Detection in Special Populations
(Q141–160)....................................................................................................60
Subtopic 9: Delays in Milestone Attainment, Screening and Referrals (Q161–
180)...............................................................................................................68
Subtopic 10: Integrated Case-Based Growth & Development Questions
(Q181–200)....................................................................................................77
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Subtopic 1: Newborn to 2 Months – Physical,
Neurological, and Reflex Development
Question 1:
Which primitive reflex is expected to be present in a newborn and typically
disappears by 2 months of age?
A. Babinski reflex
B. Moro reflex
C. Landau reflex
D. Parachute reflex
Correct Answer: B. Moro reflex
Rationale: The Moro (startle) reflex is present at birth and typically
disappears by 2 months. The Babinski may persist up to 1 year, while Landau
and Parachute reflexes emerge later in infancy.
Question 2:
A 6-week-old infant does not respond to loud noises. What is the most
appropriate next nursing action?
A. Encourage frequent tummy time
B. Document as a normal finding
C. Refer for hearing evaluation
D. Schedule next routine check-up
Correct Answer: C. Refer for hearing evaluation
Rationale: By this age, infants should startle or react to loud sounds. Lack of
response may indicate hearing impairment and warrants further evaluation.
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Question 3:
At what age is it expected for a newborn to regain birth weight?
A. 1 week
B. 10 days
C. 2 weeks
D. 1 month
Correct Answer: C. 2 weeks
Rationale: It is normal for infants to lose up to 10% of their birth weight in
the first few days, but they should regain it by 10 to 14 days of life.
Question 4:
Which physical finding in a 1-month-old would be considered a
developmental red flag?
A. Has some head lag when pulled to sit
B. Absent rooting reflex
C. Brings hands to mouth
D. Eyes briefly follow faces
Correct Answer: B. Absent rooting reflex
Rationale: The rooting reflex is present at birth and assists with
breastfeeding. Its absence may indicate a neurologic concern.
Question 5:
Which gross motor milestone is expected in a healthy 2-month-old?
A. Rolls from front to back
B. Lifts head when prone
C. Sits with support
