Pediatric HESI 2023

Correct Answer: B

Rationale: A macule is defined as a flat, discolored area on the skin that is different from surrounding tissue due to a change in color. In this case, the baby has a flat, discolored area on the skin, which fits the description of a macule. A papule is a small, raised solid bump, a vesicle is a small fluid-filled blister, and a scale is a flake of skin that is often dry and rough. Therefore, choices A, C, and D do not accurately describe the flat, discolored area on the baby's skin, making them incorrect.

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: B

Rationale: When parents of a toddler request to be present during a procedure, it is crucial to conduct an individual assessment of the parents. This assessment helps healthcare professionals understand the parents' ability to cope with the procedure, provide support to their child, and ensure a safe and comfortable environment for all involved. Choice A, the type of procedure to be performed, while important, is not the most critical factor in this scenario. Choice C, whether the toddler wants the parents present, is significant but secondary to assessing the parents themselves. Choice D, probable reaction to the toddler's response to pain, is important but focuses more on the child's reaction rather than the parents' capacity to provide appropriate support.

Correct Answer: B

Rationale: For a 2-year-old child, the maximum recommended amount of fluid for an isotonic enema is between 155 to 250 mL. This range is considered safe to prevent overdistension and potential harm to the child's rectum. Choices A, C, and D exceed the safe range for a 2-year-old child and can lead to complications such as bowel perforation or electrolyte imbalances.

Correct Answer: C

Rationale: Infants with Down syndrome are at increased risk of congenital heart defects. Therefore, assessing for abnormal heart sounds is crucial during the physical examination. Bulging fontanels are not typically associated with Down syndrome and may indicate increased intracranial pressure. Stiff lower extremities are not a common finding in Down syndrome and may suggest other musculoskeletal issues. Unusual pupillary reactions are not typically linked to Down syndrome and may be indicative of neurological problems instead.