Pediatric HESI 2023

Correct Answer: D

Rationale: The most crucial factor in successful toilet training is the parents' commitment to consistently work with their child. While parents' attitude and willingness are important, the key is their dedication to the process. The child's motivation and ability are also significant but rely heavily on parental guidance and support. Therefore, the correct choice is the parents' commitment to work on toilet training.

Correct Answer: B

Rationale: During a vaso-occlusive crisis in sickle cell anemia, the most important nursing intervention is to administer pain medication. Pain management is crucial in alleviating the intense pain experienced by the patient. Administering oxygen (Choice A) may be necessary in some cases to improve oxygenation, but pain relief takes precedence during a vaso-occlusive crisis. Monitoring fluid intake (Choice C) is important for hydration but is not the priority during a crisis. Encouraging physical activity (Choice D) is contraindicated during a vaso-occlusive crisis as it can exacerbate pain and tissue damage.

Correct Answer: A

Rationale: The correct answer is to advise the parents to avoid exposure to allergens. Asthma attacks are commonly triggered by allergens such as pollen, dust mites, pet dander, and mold. By minimizing the child's contact with these triggers, the likelihood of asthma attacks can be reduced. Encouraging regular exercise can be beneficial for overall health but may not directly prevent asthma attacks. Providing a high-protein diet and increasing fluid intake are important for general health but are not specific preventive measures for asthma attacks.

Correct Answer: C

Rationale: The correct answer is C: palpable olive-like mass. In pyloric stenosis, a palpable olive-like mass can often be felt in the abdomen due to the hypertrophied pyloric muscle. This mass is a key characteristic finding in infants with pyloric stenosis. Choice A, abdominal rigidity, is more commonly associated with conditions like peritonitis. Choice B, substernal retraction, is not typically seen in pyloric stenosis but can be a sign of respiratory distress. Choice D, marked distention of the lower abdomen, is not specific to pyloric stenosis and can be present in various abdominal conditions.

Correct Answer: A

Rationale: The priority nursing diagnosis for a 7-year-old boy with diabetes insipidus is deficient fluid volume related to dehydration. Diabetes insipidus leads to excessive urination and fluid loss, which can result in dehydration. This diagnosis should take precedence as restoring fluid balance is crucial in managing this condition. Choices B, C, and D are less of a priority in this case. Excess fluid volume related to edema is not typically associated with diabetes insipidus. Deficient knowledge about fluid intake and imbalanced nutrition related to excess weight may be important but addressing the dehydration and fluid volume deficit is the most critical aspect in the immediate care of a child with diabetes insipidus.