Pediatric HESI

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Sample questions from Pediatric HESI

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 6-month-old infant can roll from the abdomen to the back but not yet sit independently. Which nursing response is most appropriate?

   • A.Teach the caregiver to practice standing the infant with support to promote motor development.
   • B.Recognize that rolling is an expected skill and assess sitting ability and overall development at follow-up.
   • C.Explain that independent sitting is expected in every infant by 6 months and arrange urgent evaluation.
   • D.Recommend limiting floor play until the infant can sit without assistance.

   Rationale: Rolling and emerging sitting skills are consistent with typical development around this age, and development varies among infants. A single skill does not establish a developmental delay, so assess the full pattern of milestones and follow progress. Urgent referral, supported standing, and restricting floor play are not indicated by this information.

2. 2.The nurse assesses a 2-year-old at a well-child visit. Which findings are expected for this age? Select all that apply.

   • A.Has a vocabulary of only two or three words.
   • B.Understands simple directions.
   • C.Walks up and down stairs with both feet on each step.
   • D.Uses a spoon, with some spilling.
   • E.Shares toys consistently and cooperatively with peers.
   • F.Uses two-word phrases.

   Rationale: Two-word phrases, following simple directions, using a spoon with some spilling, and beginning to manage stairs are expected skills around age 2. Consistent cooperative sharing is not typical because parallel play and limited sharing are common at this age. A vocabulary of only two or three words is substantially below expectation and warrants further assessment.

3. 3.The caregiver of a 4-month-old asks how to reduce the risk of sudden infant death syndrome. Which instruction is best?

   • A.Use a firm, flat sleep surface and place the infant supine for every sleep.
   • B.Allow the infant to sleep in the caregiver's bed if the caregiver is nearby.
   • C.Use a soft pillow to keep the infant positioned on the back.
   • D.Place the infant prone for sleep after feeding.

   Rationale: Placing an infant supine on a firm, flat, separate sleep surface reduces the risk of sleep-related death. Prone positioning and soft bedding increase risk, even when used with the intent of improving comfort or positioning. Room sharing is appropriate, but bed sharing is not recommended.

4. 4.A 9-month-old pulls to stand and cruises along furniture but does not walk independently. How should the nurse interpret this finding?

   • A.It is abnormal because all infants should walk by 9 months.
   • B.It indicates a fine motor problem.
   • C.It indicates a gross motor delay requiring immediate therapy.
   • D.It is consistent with expected development because independent walking commonly occurs later.

   Answer and rationale are in the full material.

5. 5.The nurse assesses a 3-year-old who resists sharing toys and plays beside, rather than with, other children. Which interpretation is most appropriate?

   • A.This is typical cooperative play for a school-age child.
   • B.This indicates the child has not developed object permanence.
   • C.This is consistent with parallel play typical of toddlers.
   • D.This confirms impaired social development.

   Answer and rationale are in the full material.