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: D

Rationale: Severe coughing spells are a hallmark clinical manifestation of pertussis. Pertussis, also known as whooping cough, is characterized by paroxysms of rapid, consecutive coughs followed by a distinctive 'whoop' sound as the patient gasps for air. This intense coughing can lead to vomiting, exhaustion, and sometimes a characteristic 'whoop' sound. Inspiratory stridor (Choice B) is more commonly associated with croup, not pertussis. Nasal congestion (Choice C) is not a typical feature of pertussis. While a cough is present in pertussis, the specific type of cough described in Choice A (dry, hacking cough) is not the predominant feature observed in pertussis.

Correct Answer: B

Rationale: The correct answer is B: "Toddlers are learning to assert independence, and this behavior is expected at this age." At 18 months, toddlers are in the stage of developing autonomy and independence. They may exhibit behaviors like temper tantrums and defiance as they assert their independence and test limits. It is crucial for parents and caregivers to understand that these behaviors are typical for toddlers at this age. Choice A is incorrect because discipline should be age-appropriate and focus on positive reinforcement rather than preventing antisocial behaviors. Choice C is inappropriate as leaving a toddler alone in a crib after explaining unacceptable behavior is not a recommended approach and can lead to feelings of abandonment. Choice D is inaccurate as the described behavior is more related to asserting independence rather than the initiative stage of development.

Correct Answer: B

Rationale: The correct dietary instruction for a child with GERD is to avoid gluten. Gluten is a protein found in wheat, barley, and rye, and it can exacerbate GERD symptoms in some individuals. Avoiding gluten can help reduce inflammation and irritation in the gastrointestinal tract, thereby alleviating symptoms of GERD. Choices A, C, and D are incorrect because while spicy foods, high-fat foods, and dairy products can trigger GERD symptoms in some individuals, avoiding gluten specifically is more relevant for managing GERD.

Correct Answer: B

Rationale: The correct answer is B. Live vaccines like MMR should not be given to immunosuppressed infants because their weakened immune systems may not handle the vaccine safely. Choice A is incorrect as delaying the MMR vaccine until the infant reaches 2 years of age does not address the issue of immunosuppression. Choice C is incorrect because administering live vaccines to an immunosuppressed individual could lead to serious complications. Choice D is incorrect as immediate action is required to prevent potential harm to the immunosuppressed infant.