HESI Pediatrics Exam Prep 2026 | Practice
Questions, Answers & Detailed Rationales |
Pediatric Nursing Review for Growth,
Development & Clinical Success
• This practice exam contains 200 carefully crafted HESI-style pediatric nursing
questions designed to mirror the real exam's difficulty, format, and clinical
reasoning demands.
• Use this material by reading each question thoroughly, selecting your answer
before checking the correct option and EXPERT RATIONALE — this active recall
approach maximizes retention and exam readiness.
HESI PEDIATRICS EXAM PREP 2026 Practice Questions, Answers & Detailed
EXPERT RATIONALE Pediatric Nursing Review — Growth, Development &
Clinical Success
QUESTION 1
A nurse is assessing a 2-month-old infant. Which reflex should the nurse
expect to be present at this age?
A. Babinski reflex
B. Parachute reflex
C. Landau reflex
D. Moro reflex
E. Neck-righting reflex
CORRECT ANSWER: D. Moro reflex
EXPERT RATIONALE: The Moro (startle) reflex is present from birth and persists until
approximately 4–6 months of age. It is a normal finding in a 2-month-old. The parachute
reflex appears around 8–9 months, the Landau reflex around 3 months but fully by 6
months, and the neck-righting reflex around 4–6 months.
,QUESTION 2
A 4-year-old child is brought to the clinic. Which developmental milestone
should the nurse expect this child to have achieved?
A. Riding a bicycle without training wheels
B. Tying shoelaces independently
C. Drawing a person with at least 6 body parts
D. Hopping on one foot and skipping
E. Reading simple sentences
CORRECT ANSWER: D. Hopping on one foot and skipping
EXPERT RATIONALE: By age 4, children can hop on one foot and may begin skipping.
Drawing a person with 6 parts is typically achieved around age 5. Reading and tying
shoelaces are school-age milestones. Riding a bicycle without training wheels is expected
around age 6–7.
QUESTION 3
A nurse is caring for a child with epiglottitis. Which finding requires the most
immediate nursing intervention?
A. Low-grade fever of 38°C
B. Mild sore throat
C. Drooling and sitting in a tripod position
D. Mild hoarseness
E. Slight decrease in appetite
CORRECT ANSWER: C. Drooling and sitting in a tripod position
EXPERT RATIONALE: Drooling and the tripod position (leaning forward on hands to
maximize airway opening) are classic signs of epiglottitis indicating severe airway
compromise. This is a life-threatening emergency requiring immediate intervention. The
,nurse should not attempt to visualize the throat as this can cause complete airway
obstruction.
QUESTION 4
A nurse is educating parents about car seat safety for a 6-month-old infant.
Which statement by the parent indicates a need for further teaching?
A. "I will keep my baby rear-facing until at least age 2."
B. "The car seat should be at a 45-degree angle."
C. "I will place the car seat in the front passenger seat."
D. "The harness straps should be at or below the baby's shoulders."
E. "I will register the car seat with the manufacturer."
CORRECT ANSWER: C. "I will place the car seat in the front passenger seat."
EXPERT RATIONALE: Infants and young children should always ride in the back seat. The
front seat with an active airbag poses a significant risk of injury or death to a rear-facing
infant. All other statements reflect correct car seat safety practices.
QUESTION 5
A 10-year-old is admitted with a blood glucose of 520 mg/dL, Kussmaul
respirations, and fruity breath. Which condition does the nurse suspect?
A. Hypoglycemia
B. Diabetic ketoacidosis (DKA)
C. Hyperglycemic hyperosmolar state
D. Type 2 diabetes mellitus
E. Addisonian crisis
CORRECT ANSWER: B. Diabetic ketoacidosis (DKA)
, EXPERT RATIONALE: DKA is characterized by hyperglycemia (>300 mg/dL), Kussmaul
respirations (deep, rapid breathing to compensate for metabolic acidosis), and fruity
breath from ketone production. It is most commonly associated with Type 1 diabetes
mellitus in children and requires immediate fluid resuscitation and insulin therapy.
QUESTION 6
A nurse is reviewing growth patterns. At what age does birth weight typically
triple?
A. 6 months
B. 9 months
C. 12 months
D. 18 months
E. 24 months
CORRECT ANSWER: C. 12 months
EXPERT RATIONALE: Birth weight doubles by approximately 4–6 months and triples by
12 months of age. This is a standard growth parameter used to evaluate adequate
infant nutrition and development.
QUESTION 7
A nurse is caring for a child with nephrotic syndrome. Which assessment
finding is most characteristic of this condition?
A. Hematuria and hypertension
B. Massive proteinuria and generalized edema
C. Flank pain and dysuria
D. Oliguria and metabolic alkalosis
E. Elevated BUN with normal creatinine
Questions, Answers & Detailed Rationales |
Pediatric Nursing Review for Growth,
Development & Clinical Success
• This practice exam contains 200 carefully crafted HESI-style pediatric nursing
questions designed to mirror the real exam's difficulty, format, and clinical
reasoning demands.
• Use this material by reading each question thoroughly, selecting your answer
before checking the correct option and EXPERT RATIONALE — this active recall
approach maximizes retention and exam readiness.
HESI PEDIATRICS EXAM PREP 2026 Practice Questions, Answers & Detailed
EXPERT RATIONALE Pediatric Nursing Review — Growth, Development &
Clinical Success
QUESTION 1
A nurse is assessing a 2-month-old infant. Which reflex should the nurse
expect to be present at this age?
A. Babinski reflex
B. Parachute reflex
C. Landau reflex
D. Moro reflex
E. Neck-righting reflex
CORRECT ANSWER: D. Moro reflex
EXPERT RATIONALE: The Moro (startle) reflex is present from birth and persists until
approximately 4–6 months of age. It is a normal finding in a 2-month-old. The parachute
reflex appears around 8–9 months, the Landau reflex around 3 months but fully by 6
months, and the neck-righting reflex around 4–6 months.
,QUESTION 2
A 4-year-old child is brought to the clinic. Which developmental milestone
should the nurse expect this child to have achieved?
A. Riding a bicycle without training wheels
B. Tying shoelaces independently
C. Drawing a person with at least 6 body parts
D. Hopping on one foot and skipping
E. Reading simple sentences
CORRECT ANSWER: D. Hopping on one foot and skipping
EXPERT RATIONALE: By age 4, children can hop on one foot and may begin skipping.
Drawing a person with 6 parts is typically achieved around age 5. Reading and tying
shoelaces are school-age milestones. Riding a bicycle without training wheels is expected
around age 6–7.
QUESTION 3
A nurse is caring for a child with epiglottitis. Which finding requires the most
immediate nursing intervention?
A. Low-grade fever of 38°C
B. Mild sore throat
C. Drooling and sitting in a tripod position
D. Mild hoarseness
E. Slight decrease in appetite
CORRECT ANSWER: C. Drooling and sitting in a tripod position
EXPERT RATIONALE: Drooling and the tripod position (leaning forward on hands to
maximize airway opening) are classic signs of epiglottitis indicating severe airway
compromise. This is a life-threatening emergency requiring immediate intervention. The
,nurse should not attempt to visualize the throat as this can cause complete airway
obstruction.
QUESTION 4
A nurse is educating parents about car seat safety for a 6-month-old infant.
Which statement by the parent indicates a need for further teaching?
A. "I will keep my baby rear-facing until at least age 2."
B. "The car seat should be at a 45-degree angle."
C. "I will place the car seat in the front passenger seat."
D. "The harness straps should be at or below the baby's shoulders."
E. "I will register the car seat with the manufacturer."
CORRECT ANSWER: C. "I will place the car seat in the front passenger seat."
EXPERT RATIONALE: Infants and young children should always ride in the back seat. The
front seat with an active airbag poses a significant risk of injury or death to a rear-facing
infant. All other statements reflect correct car seat safety practices.
QUESTION 5
A 10-year-old is admitted with a blood glucose of 520 mg/dL, Kussmaul
respirations, and fruity breath. Which condition does the nurse suspect?
A. Hypoglycemia
B. Diabetic ketoacidosis (DKA)
C. Hyperglycemic hyperosmolar state
D. Type 2 diabetes mellitus
E. Addisonian crisis
CORRECT ANSWER: B. Diabetic ketoacidosis (DKA)
, EXPERT RATIONALE: DKA is characterized by hyperglycemia (>300 mg/dL), Kussmaul
respirations (deep, rapid breathing to compensate for metabolic acidosis), and fruity
breath from ketone production. It is most commonly associated with Type 1 diabetes
mellitus in children and requires immediate fluid resuscitation and insulin therapy.
QUESTION 6
A nurse is reviewing growth patterns. At what age does birth weight typically
triple?
A. 6 months
B. 9 months
C. 12 months
D. 18 months
E. 24 months
CORRECT ANSWER: C. 12 months
EXPERT RATIONALE: Birth weight doubles by approximately 4–6 months and triples by
12 months of age. This is a standard growth parameter used to evaluate adequate
infant nutrition and development.
QUESTION 7
A nurse is caring for a child with nephrotic syndrome. Which assessment
finding is most characteristic of this condition?
A. Hematuria and hypertension
B. Massive proteinuria and generalized edema
C. Flank pain and dysuria
D. Oliguria and metabolic alkalosis
E. Elevated BUN with normal creatinine
