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HESI Pediatrics Test Bank 2026/2027 100 NCLEX-
Style Pediatric Nursing Questions with Rationales
A+ Guaranteed Pass | Updated for Current
Guidelines
SECTION 1: GROWTH & DEVELOPMENT (Questions 1-15)
Q1. A nurse is assessing a 6-month-old infant during a well-child visit. The mother reports the baby
can sit with support, rolls from prone to supine, and reaches for objects but does not yet transfer
toys between hands. Based on developmental milestones, which action should the nurse
recommend to promote fine motor development?
A. Provide push-pull toys to encourage walking
B. Offer finger foods to encourage pincer grasp development
C. Place rattles in the infant's hands to encourage grasping [CORRECT]
D. Encourage stacking blocks to develop hand-eye coordination
Correct Answer: C Rationale: At 6 months, infants demonstrate palmar grasp and begin
transferring objects hand-to-hand (typically by 7-8 months). Placing rattles in hands encourages
grasping, which is age-appropriate. The pincer grasp develops around 9-10 months, making finger
foods premature. Push-pull toys and block stacking are appropriate for older infants (9-12 months).
Clinical Pearl: Always match developmental activities to the infant's current milestone
achievement to prevent frustration and promote success.
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Q2. A nurse is conducting anticipatory guidance with parents of a 15-month-old toddler. Which
statements by the parents indicate understanding of safety needs for this developmental stage?
(Select all that apply.)
A. "We installed safety gates at the top and bottom of our stairs." [CORRECT]
B. "We keep all medications in a locked cabinet above the refrigerator." [CORRECT]
C. "We allow our toddler to walk around the house with a sippy cup."
D. "We placed outlet covers on all electrical sockets." [CORRECT]
E. "We let our toddler play alone in the backyard while we watch from the window."
Correct Answers: A, B, D Rationale: Fifteen-month-old toddlers are mobile, curious, and lack
safety awareness, requiring environmental modifications. Safety gates prevent falls (leading cause
of injury), locked medication storage prevents poisoning, and outlet covers prevent electrocution.
Walking with cups poses aspiration risks, and unsupervised outdoor play is unsafe at this age.
Clinical Pearl: Toddlers explore through oral and tactile means; poison prevention and fall
prevention are priority nursing education topics.
Q3. The nurse is caring for a 4-year-old child weighing 35 lb (15.9 kg) with orders for amoxicillin
50 mg/kg/day divided BID. The available concentration is 250 mg/5 mL. How many mL should the
nurse administer per dose? (Round to nearest tenth.)
Answer: _____ mL
Correct Answer: 8.0 mL Rationale: Calculation: 15.9 kg × 50 mg/kg/day = 795 mg/day ÷ 2 doses =
397.5 mg per dose. 397.5 mg ÷ 250 mg × 5 mL = 7.95 mL → rounds to 8.0 mL. Safety Check: Verify
safe dose range (40-90 mg/kg/day for amoxicillin in children); 50 mg/kg/day falls within
therapeutic parameters.
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Q4. A nurse is caring for a hospitalized 8-year-old child who is anxious about an upcoming
procedure. The child asks, "Will I get a shot? Will it hurt? Will I be able to go home today?"
According to Piaget's theory of cognitive development, which nursing response is most
appropriate?
A. "Don't worry, you'll be fine. Big kids don't cry about shots."
B. "The medicine might sting a little, but you'll get a sticker afterward if you're brave."
C. "You're asking good questions. The shot will feel like a quick pinch for about 10 seconds, and
you'll go home when the doctor says you're ready." [CORRECT]
D. "Let's not talk about the shot right now. Tell me about your favorite video game."
Correct Answer: C Rationale: School-age children (concrete operational stage) require concrete,
honest, and specific information to reduce anxiety. They understand cause-and-effect and time
concepts. Vague reassurance (Option A) dismisses concerns, bribery (Option B) undermines trust,
and distraction (Option D) avoids addressing legitimate informational needs. Clinical Pearl:
School-age children fear loss of control; providing specific details and allowing participation in care
decisions promotes coping.
Q5. A nurse in the pediatric clinic is assessing a 2-month-old infant. The mother reports the baby
smiles responsively, tracks objects 180 degrees, and has begun cooing. Which additional finding
would the nurse expect at this developmental stage?
A. Ability to sit without support
B. Social smile and vowel sounds [CORRECT]
C. Stranger anxiety
D. Pincer grasp development
Correct Answer: B Rationale: At 2 months, infants demonstrate social smiling (beyond reflexive
smiling), cooing (vowel sounds), and visual tracking. Sitting without support develops at 6-8
months, stranger anxiety peaks at 6-9 months, and pincer grasp emerges at 9-10 months. Clinical
Pearl: The social smile is a critical developmental marker indicating attachment formation and
neurological maturation; absence warrants referral.
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Q6. A nurse is providing discharge teaching to parents of a newborn. Which statements indicate
understanding of newborn safety and sleep recommendations? (Select all that apply.)
A. "We will place the baby on his back for every sleep." [CORRECT]
B. "We have a crib with a firm mattress and tight-fitting sheet." [CORRECT]
C. "We'll keep the baby's room at 68-72°F to prevent overheating." [CORRECT]
D. "We bought a soft, fluffy bumper pad to keep the baby comfortable."
E. "We'll let the baby sleep in our bed for the first month for easier feeding."
Correct Answers: A, B, C Rationale: Back sleeping reduces SIDS risk by 50%, firm sleep surfaces
prevent suffocation, and room temperature of 68-72°F prevents overheating (SIDS risk factor).
Bumper pads and bed-sharing increase suffocation and SIDS risk. Clinical Pearl: The ABCs of safe
sleep (Alone, Back, Crib) are non-negotiable nursing education points; document parental
understanding for liability protection.
Q7. A nurse is assessing a 12-year-old female patient whose mother is concerned she is "too short."
The nurse reviews the growth chart and finds the child is at the 25th percentile for height,
consistent with previous measurements. The child reports menarche occurred 6 months ago. Which
nursing response is most appropriate?
A. "Your daughter needs growth hormone testing immediately."
B. "Girls typically gain only 2-3 inches after menarche; her current percentile is appropriate for her
growth pattern." [CORRECT]
C. "She's just a late bloomer. She'll catch up to her peers by age 16."
D. "You should increase her protein intake to promote growth."
Correct Answer: B Rationale: Girls experience the pubertal growth spurt before menarche and
typically gain only 2-3 inches (5-7.5 cm) after menarche. Consistent growth at the 25th percentile
indicates normal growth velocity. Growth hormone deficiency presents with crossing percentiles
HESI Pediatrics Test Bank 2026/2027 100 NCLEX-
Style Pediatric Nursing Questions with Rationales
A+ Guaranteed Pass | Updated for Current
Guidelines
SECTION 1: GROWTH & DEVELOPMENT (Questions 1-15)
Q1. A nurse is assessing a 6-month-old infant during a well-child visit. The mother reports the baby
can sit with support, rolls from prone to supine, and reaches for objects but does not yet transfer
toys between hands. Based on developmental milestones, which action should the nurse
recommend to promote fine motor development?
A. Provide push-pull toys to encourage walking
B. Offer finger foods to encourage pincer grasp development
C. Place rattles in the infant's hands to encourage grasping [CORRECT]
D. Encourage stacking blocks to develop hand-eye coordination
Correct Answer: C Rationale: At 6 months, infants demonstrate palmar grasp and begin
transferring objects hand-to-hand (typically by 7-8 months). Placing rattles in hands encourages
grasping, which is age-appropriate. The pincer grasp develops around 9-10 months, making finger
foods premature. Push-pull toys and block stacking are appropriate for older infants (9-12 months).
Clinical Pearl: Always match developmental activities to the infant's current milestone
achievement to prevent frustration and promote success.
, 2
Q2. A nurse is conducting anticipatory guidance with parents of a 15-month-old toddler. Which
statements by the parents indicate understanding of safety needs for this developmental stage?
(Select all that apply.)
A. "We installed safety gates at the top and bottom of our stairs." [CORRECT]
B. "We keep all medications in a locked cabinet above the refrigerator." [CORRECT]
C. "We allow our toddler to walk around the house with a sippy cup."
D. "We placed outlet covers on all electrical sockets." [CORRECT]
E. "We let our toddler play alone in the backyard while we watch from the window."
Correct Answers: A, B, D Rationale: Fifteen-month-old toddlers are mobile, curious, and lack
safety awareness, requiring environmental modifications. Safety gates prevent falls (leading cause
of injury), locked medication storage prevents poisoning, and outlet covers prevent electrocution.
Walking with cups poses aspiration risks, and unsupervised outdoor play is unsafe at this age.
Clinical Pearl: Toddlers explore through oral and tactile means; poison prevention and fall
prevention are priority nursing education topics.
Q3. The nurse is caring for a 4-year-old child weighing 35 lb (15.9 kg) with orders for amoxicillin
50 mg/kg/day divided BID. The available concentration is 250 mg/5 mL. How many mL should the
nurse administer per dose? (Round to nearest tenth.)
Answer: _____ mL
Correct Answer: 8.0 mL Rationale: Calculation: 15.9 kg × 50 mg/kg/day = 795 mg/day ÷ 2 doses =
397.5 mg per dose. 397.5 mg ÷ 250 mg × 5 mL = 7.95 mL → rounds to 8.0 mL. Safety Check: Verify
safe dose range (40-90 mg/kg/day for amoxicillin in children); 50 mg/kg/day falls within
therapeutic parameters.
, 3
Q4. A nurse is caring for a hospitalized 8-year-old child who is anxious about an upcoming
procedure. The child asks, "Will I get a shot? Will it hurt? Will I be able to go home today?"
According to Piaget's theory of cognitive development, which nursing response is most
appropriate?
A. "Don't worry, you'll be fine. Big kids don't cry about shots."
B. "The medicine might sting a little, but you'll get a sticker afterward if you're brave."
C. "You're asking good questions. The shot will feel like a quick pinch for about 10 seconds, and
you'll go home when the doctor says you're ready." [CORRECT]
D. "Let's not talk about the shot right now. Tell me about your favorite video game."
Correct Answer: C Rationale: School-age children (concrete operational stage) require concrete,
honest, and specific information to reduce anxiety. They understand cause-and-effect and time
concepts. Vague reassurance (Option A) dismisses concerns, bribery (Option B) undermines trust,
and distraction (Option D) avoids addressing legitimate informational needs. Clinical Pearl:
School-age children fear loss of control; providing specific details and allowing participation in care
decisions promotes coping.
Q5. A nurse in the pediatric clinic is assessing a 2-month-old infant. The mother reports the baby
smiles responsively, tracks objects 180 degrees, and has begun cooing. Which additional finding
would the nurse expect at this developmental stage?
A. Ability to sit without support
B. Social smile and vowel sounds [CORRECT]
C. Stranger anxiety
D. Pincer grasp development
Correct Answer: B Rationale: At 2 months, infants demonstrate social smiling (beyond reflexive
smiling), cooing (vowel sounds), and visual tracking. Sitting without support develops at 6-8
months, stranger anxiety peaks at 6-9 months, and pincer grasp emerges at 9-10 months. Clinical
Pearl: The social smile is a critical developmental marker indicating attachment formation and
neurological maturation; absence warrants referral.
, 4
Q6. A nurse is providing discharge teaching to parents of a newborn. Which statements indicate
understanding of newborn safety and sleep recommendations? (Select all that apply.)
A. "We will place the baby on his back for every sleep." [CORRECT]
B. "We have a crib with a firm mattress and tight-fitting sheet." [CORRECT]
C. "We'll keep the baby's room at 68-72°F to prevent overheating." [CORRECT]
D. "We bought a soft, fluffy bumper pad to keep the baby comfortable."
E. "We'll let the baby sleep in our bed for the first month for easier feeding."
Correct Answers: A, B, C Rationale: Back sleeping reduces SIDS risk by 50%, firm sleep surfaces
prevent suffocation, and room temperature of 68-72°F prevents overheating (SIDS risk factor).
Bumper pads and bed-sharing increase suffocation and SIDS risk. Clinical Pearl: The ABCs of safe
sleep (Alone, Back, Crib) are non-negotiable nursing education points; document parental
understanding for liability protection.
Q7. A nurse is assessing a 12-year-old female patient whose mother is concerned she is "too short."
The nurse reviews the growth chart and finds the child is at the 25th percentile for height,
consistent with previous measurements. The child reports menarche occurred 6 months ago. Which
nursing response is most appropriate?
A. "Your daughter needs growth hormone testing immediately."
B. "Girls typically gain only 2-3 inches after menarche; her current percentile is appropriate for her
growth pattern." [CORRECT]
C. "She's just a late bloomer. She'll catch up to her peers by age 16."
D. "You should increase her protein intake to promote growth."
Correct Answer: B Rationale: Girls experience the pubertal growth spurt before menarche and
typically gain only 2-3 inches (5-7.5 cm) after menarche. Consistent growth at the 25th percentile
indicates normal growth velocity. Growth hormone deficiency presents with crossing percentiles
