A child has been diagnosed with Hirschsprung's disease. Which of the following findings would the nurse expect the parents to report in the child's history? Select all that apply.
Ribbon-like stools.
Distended abdomen.
Chronic constipation.
Black and tarry stools.
Correct Answer : A,B,C
Choice A rationale:
Ribbon-like stools are a classic sign of Hirschsprung's disease, indicating narrowed or obstructed bowel segments due to the absence of ganglion cells in the intestine's muscular layers.
Choice B rationale:
A distended abdomen is common in Hirschsprung's disease due to the accumulation of stool and gas in the narrowed segments of the intestine.
Choice C rationale:
Chronic constipation is a result of the dysfunctional intestinal motility caused by Hirschsprung's disease. The absence of ganglion cells leads to a lack of peristalsis and difficulty passing stools.
Choice D rationale:
Black and tarry stools are indicative of upper gastrointestinal bleeding, often caused by conditions like peptic ulcers. This finding is not directly related to Hirschsprung's disease.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
X-linked dominant disorders are characterized by a mutation on the X chromosome that results in the expression of the trait in both males and females. Hemophilia, however, is more commonly associated with males, which is not consistent with an X-linked dominant pattern.
Choice B rationale:
Autosomal recessive disorders require the inheritance of two mutated alleles, one from each parent, to express the trait. Hemophilia does not follow this pattern, as the patient's sisters do not have the condition despite having affected parents.
Choice C rationale:
Autosomal dominant disorders only require the inheritance of one mutated allele from an affected parent to express the trait. Hemophilia does not align with an autosomal dominant pattern, as the patient's sisters would likely be affected if it were.
Choice D rationale:
Hemophilia is a classic example of an X-linked recessive disorder. The gene responsible for producing clotting factor is located on the X chromosome, and males have only one X chromosome, making them more susceptible to the disorder. Females, with two X chromosomes, usually act as carriers unless both X chromosomes carry the mutation.
Correct Answer is A
Explanation
Choice A rationale:
This response acknowledges the client's feelings, addresses the immediate situation, and offers an alternative without judgment.
Choice B rationale:
Asking "What's wrong? Haven't you ever lost a game before?”. might come across as dismissive and insensitive to the client's emotions.
Choice C rationale:
Simply saying "I am sure you'll win the next game”. minimizes the client's feelings and does not address the current situation.
Choice D rationale:
Telling the client that "other children will not want to play with you if you act like that”. is a negative and shaming response, which is counterproductive to building a therapeutic relationship.
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