Pediatric HESI 2024

Correct Answer: A

Rationale: The nurse should suspect measles in this child. The presence of a high fever, irritability, runny nose, rash, and Koplik spots (small, red spots with blue-white centers in the mouth) are classic signs of measles. Measles is a highly contagious viral illness that can lead to serious complications if not managed promptly. Chickenpox (choice B) presents with a different rash pattern and does not typically involve Koplik spots. Fifth disease (choice C) and scarlet fever (choice D) also have distinct clinical presentations and are not characterized by the specific symptoms described in this case.

Correct Answer: C

Rationale: The correct answer is C. At the age of 8, children are typically eager to take on responsibilities and participate in self-care activities. This is a crucial developmental characteristic to consider when educating a child about managing a chronic condition like type 1 diabetes. Choice A is incorrect as children at this age are usually in the concrete operational stage, not abstract level, of cognition. Choice B is incorrect because while peer influence is important, it does not reach its peak at this age. Choice D is incorrect as exploring self-identity is more characteristic of adolescence, not 8-year-old children.

Correct Answer: C

Rationale: Visible peristalsis and weight loss are classic clinical manifestations of pyloric stenosis. Visible peristalsis refers to the wave-like movements in the abdomen caused by the stomach trying to empty into the intestines due to the obstruction at the pylorus. Weight loss is often seen due to inadequate feeding and vomiting associated with this condition. Choices A, B, and D are not typical of pyloric stenosis. Abdominal rigidity and pain on palpation are more indicative of conditions like peritonitis. A rounded abdomen and hypoactive bowel sounds are more suggestive of conditions like constipation or bowel obstruction. Distention of the lower abdomen and constipation are not specific to pyloric stenosis and may be seen in various gastrointestinal issues.

Correct Answer: D

Rationale: Pegs and pounding boards are recommended as play materials for toddlers to express their anger in a constructive manner. These tools provide a safe and effective outlet for the child's emotions through physical activity. Options A, B, and C do not offer the same interactive and expressive qualities that pegs and pounding boards provide. A ball and bat may encourage aggressive behavior, a wad of clay is more suitable for creative expression rather than anger management, and a punching bag may promote violent behavior which is not appropriate for toddlers.

Correct Answer: B

Rationale: Antifungal agents are the appropriate treatment for candidal diaper rash as it is a fungal infection. Corticosteroids, antibiotics, and retinoids are not indicated for this condition. Corticosteroids may worsen fungal infections, antibiotics are used for bacterial infections, and retinoids are typically used for acne and skin conditions unrelated to candidal diaper rash.