Which of these specific measurements is the best index of a child’s general health?

Choice A reason: The systolic pressure (top number) measures arterial pressure during heart contraction, accurately explaining 118/82 mm Hg. This clear, correct definition educates the patient, making it the best reply.

Choice B reason: Diastolic pressure (bottom number) reflects arterial pressure at rest, not stroke volume. Systolic pressure is correctly defined as contraction pressure, so this is incorrect for explaining the numbers.

Choice C reason: Dismissing blood pressure as complex is unhelpful; both numbers matter. Systolic pressure is accurately defined as heart contraction pressure, so this is incorrect for patient education.

Choice D reason: Stating the numbers are normal (118/82 is prehypertension) avoids explaining their meaning. Defining systolic pressure clarifies the reading, so this is incorrect for answering the question.

Choice A reason: Herniated brainstem causes bilateral pupil changes and severe neurological signs, not unilateral dilation. Unilateral pupil dilation suggests increased intracranial pressure, so this is incorrect for these findings.

Choice B reason: Unilateral pupil dilation and nonreactivity, as seen in the right pupil, indicate increased intracranial pressure, often from mass effect compressing the oculomotor nerve. This is critical, making it the correct finding.

Choice C reason: Subdural hemorrhage may cause pressure but isn’t specific to these pupil changes. Unilateral dilation points to increased intracranial pressure as the immediate concern, so this is less precise.

Choice D reason: Cerebral edema contributes to pressure but is a broader term. Unilateral pupil dilation specifically suggests increased intracranial pressure, a more immediate and precise diagnosis, so this is incorrect.