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HESI Pediatrics 2025 | 180 NCLEX-Style Questions with
Answers & Detailed Rationales – Growth, Development &
Pediatric Conditions
Question 1
A 2-month-old infant is brought to the clinic for a well-child visit. The nurse notes the infant can
lift the head briefly when prone and follows objects with the eyes. Which statement best
describes the infant’s developmental milestone?
a. The infant is delayed in gross motor and visual tracking skills
b. The infant has age-appropriate gross motor and visual development
c. The infant should be able to roll over at this age
d. The infant’s fine motor skills are advanced for age
ANS: b
Rationale: At 2 months, infants typically lift their head briefly when prone and follow objects
visually. Rolling over usually occurs around 4–6 months, and fine motor skills such as grasping
are emerging but not advanced at this age. The infant is demonstrating normal development.
DIF: Easy | OBJ: Developmental Assessment | TOP: Infant Milestones | MSC: Health Promotion
and Maintenance
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Question 2
A 4-year-old child is admitted with a fractured arm. The nurse knows that according to Piaget’s
theory, this child is in the preoperational stage. Which behavior is expected?
a. Understanding conservation of mass and volume
b. Thinking is egocentric and magical
c. Logical thinking about concrete events
d. Abstract reasoning and hypothetical thinking
ANS: b
Rationale: Children aged 2–7 years are in Piaget’s preoperational stage, characterized by
egocentric thinking and magical reasoning. Conservation and logical thinking develop in the
concrete operational stage (7–11 years), while abstract reasoning occurs in the formal operational
stage (11+ years).
DIF: Moderate | OBJ: Cognitive Development | TOP: Piaget’s Theory | MSC: Health Promotion
and Maintenance
Question 3
A nurse is teaching parents about toddler nutrition. Which statement indicates understanding?
a. “My child should avoid all fats to prevent obesity.”
b. “I should offer small, frequent meals and finger foods.”
c. “Three large meals per day are sufficient.”
d. “Juice can replace one meal if my toddler refuses food.”
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ANS: b
Rationale: Toddlers benefit from small, frequent meals and finger foods that allow self-feeding.
Fats are necessary for growth, juice should not replace meals, and large meals may be
overwhelming for toddlers.
DIF: Easy | OBJ: Nutrition | TOP: Toddler Health | MSC: Health Promotion and Maintenance
Question 4
A 6-year-old child is hospitalized and expresses fear of the dark. Which intervention is most
appropriate?
a. Ignore the fear to avoid reinforcing it
b. Provide a night-light and allow a comfort object
c. Tell the child there is nothing to fear
d. Encourage the child to sleep in the dark to overcome fear
ANS: b
Rationale: Providing a night-light and allowing a comfort object helps a hospitalized child cope
with fears safely. Ignoring or dismissing fears can increase anxiety. Encouraging exposure to
darkness prematurely may worsen the child’s distress.
DIF: Moderate | OBJ: Psychosocial Care | TOP: Coping in Hospitalized Children | MSC: Safe
and Effective Care
Question 5
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A nurse is preparing to administer immunizations to a 12-month-old. Which vaccines are
typically recommended at this age?
a. DTaP, MMR, Varicella, Hib, PCV13
b. Hepatitis B only
c. IPV and Influenza only
d. None; vaccinations start at 18 months
ANS: a
Rationale: At 12 months, children usually receive DTaP (4th dose), MMR, Varicella, Hib (final
dose), and PCV13 (final dose). Hep B and IPV are given earlier. Influenza is seasonal.
Vaccinations do not start at 18 months.
DIF: Easy | OBJ: Immunization | TOP: Pediatric Vaccines | MSC: Health Promotion and
Maintenance
Question 6
A school-age child with asthma is admitted for an acute exacerbation. Which is the nurse’s
priority assessment?
a. Wheezing and respiratory effort
b. Appetite and oral intake
c. Skin turgor
d. Level of play activity
ANS: a
Rationale: In a child with asthma, airway patency and breathing are the highest priorities.
HESI Pediatrics 2025 | 180 NCLEX-Style Questions with
Answers & Detailed Rationales – Growth, Development &
Pediatric Conditions
Question 1
A 2-month-old infant is brought to the clinic for a well-child visit. The nurse notes the infant can
lift the head briefly when prone and follows objects with the eyes. Which statement best
describes the infant’s developmental milestone?
a. The infant is delayed in gross motor and visual tracking skills
b. The infant has age-appropriate gross motor and visual development
c. The infant should be able to roll over at this age
d. The infant’s fine motor skills are advanced for age
ANS: b
Rationale: At 2 months, infants typically lift their head briefly when prone and follow objects
visually. Rolling over usually occurs around 4–6 months, and fine motor skills such as grasping
are emerging but not advanced at this age. The infant is demonstrating normal development.
DIF: Easy | OBJ: Developmental Assessment | TOP: Infant Milestones | MSC: Health Promotion
and Maintenance
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Question 2
A 4-year-old child is admitted with a fractured arm. The nurse knows that according to Piaget’s
theory, this child is in the preoperational stage. Which behavior is expected?
a. Understanding conservation of mass and volume
b. Thinking is egocentric and magical
c. Logical thinking about concrete events
d. Abstract reasoning and hypothetical thinking
ANS: b
Rationale: Children aged 2–7 years are in Piaget’s preoperational stage, characterized by
egocentric thinking and magical reasoning. Conservation and logical thinking develop in the
concrete operational stage (7–11 years), while abstract reasoning occurs in the formal operational
stage (11+ years).
DIF: Moderate | OBJ: Cognitive Development | TOP: Piaget’s Theory | MSC: Health Promotion
and Maintenance
Question 3
A nurse is teaching parents about toddler nutrition. Which statement indicates understanding?
a. “My child should avoid all fats to prevent obesity.”
b. “I should offer small, frequent meals and finger foods.”
c. “Three large meals per day are sufficient.”
d. “Juice can replace one meal if my toddler refuses food.”
,3 | Page
ANS: b
Rationale: Toddlers benefit from small, frequent meals and finger foods that allow self-feeding.
Fats are necessary for growth, juice should not replace meals, and large meals may be
overwhelming for toddlers.
DIF: Easy | OBJ: Nutrition | TOP: Toddler Health | MSC: Health Promotion and Maintenance
Question 4
A 6-year-old child is hospitalized and expresses fear of the dark. Which intervention is most
appropriate?
a. Ignore the fear to avoid reinforcing it
b. Provide a night-light and allow a comfort object
c. Tell the child there is nothing to fear
d. Encourage the child to sleep in the dark to overcome fear
ANS: b
Rationale: Providing a night-light and allowing a comfort object helps a hospitalized child cope
with fears safely. Ignoring or dismissing fears can increase anxiety. Encouraging exposure to
darkness prematurely may worsen the child’s distress.
DIF: Moderate | OBJ: Psychosocial Care | TOP: Coping in Hospitalized Children | MSC: Safe
and Effective Care
Question 5
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A nurse is preparing to administer immunizations to a 12-month-old. Which vaccines are
typically recommended at this age?
a. DTaP, MMR, Varicella, Hib, PCV13
b. Hepatitis B only
c. IPV and Influenza only
d. None; vaccinations start at 18 months
ANS: a
Rationale: At 12 months, children usually receive DTaP (4th dose), MMR, Varicella, Hib (final
dose), and PCV13 (final dose). Hep B and IPV are given earlier. Influenza is seasonal.
Vaccinations do not start at 18 months.
DIF: Easy | OBJ: Immunization | TOP: Pediatric Vaccines | MSC: Health Promotion and
Maintenance
Question 6
A school-age child with asthma is admitted for an acute exacerbation. Which is the nurse’s
priority assessment?
a. Wheezing and respiratory effort
b. Appetite and oral intake
c. Skin turgor
d. Level of play activity
ANS: a
Rationale: In a child with asthma, airway patency and breathing are the highest priorities.
