Pediatric HESI 2024

Correct Answer: B

Rationale: The correct answer is B: Steroids. Children receiving steroids should not receive the varicella vaccine as it can increase the risk of severe infection due to the immunosuppressive effects of steroids. Insulin (Choice A), antibiotics (Choice C), and anticonvulsants (Choice D) do not interact with the varicella vaccine in the same way as steroids, and therefore, they are not contraindicated.

Correct Answer: D

Rationale: While catheterization can be uncomfortable, it does not typically result in long-term psychological harm, and obtaining a sterile specimen is important for accurate diagnosis.

Correct Answer: C

Rationale: In a child with suspected Addison disease, the presence of hyperpigmentation (bronzing of the skin) and hypotension are key clinical findings. Hyperpigmentation is due to increased ACTH stimulation, resulting in melanocyte stimulation. Hypotension occurs due to decreased aldosterone production and subsequent sodium loss. Choices A, B, and D are incorrect. Arrested height and increased weight are not typical of Addison disease; thin, fragile skin and multiple bruises are more indicative of conditions like Cushing's syndrome; blurred vision and enuresis are not typically associated with Addison disease.

Correct Answer: B

Rationale: The most important factor in preparing a toddler for additional surgery is their previous experience of hospitalization. This familiarity can help reduce anxiety and fear associated with the hospital environment and medical procedures. Choice A, satisfying the child's wishes, may not always be feasible or in the child's best interest during medical procedures. Choice C, preventing the child from being with strangers, may not address the core issue of preparing the child for surgery. Choice D, ensuring the child still receives parental affection, is important but may not directly address the preparation needed for surgery.

Correct Answer: B

Rationale: The correct answer is B: Steroids. Children receiving steroids should not receive the varicella vaccine as it can increase the risk of severe infection due to the immunosuppressive effects of steroids. Insulin (Choice A), antibiotics (Choice C), and anticonvulsants (Choice D) do not interact with the varicella vaccine in the same way as steroids, and therefore, they are not contraindicated.