A full-term newborn has not passed meconium within the first 48 hours of life and is exhibiting abdominal distension and vomiting. The healthcare provider suspects Hirschsprung's disease. What is the underlying pathophysiologic cause of this condition?
Overstimulation of parasympathetic nerves resulting in rapid bowel transit
Absence of ganglionic nerve cells in a portion of the colon, causing a lack of peristalsis
Obstruction caused by hypertrophy of intestinal smooth muscle
inflammation of the intestinal mucosa leading to motility loss
The Correct Answer is B
A. Overstimulation of parasympathetic nerves resulting in rapid bowel transit is incorrect because Hirschsprung’s disease is characterized by decreased or absent bowel motility, not increased motility. Rapid transit would lead to diarrhea rather than constipation and failure to pass meconium.
B. Absence of ganglionic nerve cells in a portion of the colon, causing a lack of peristalsis is correct because Hirschsprung’s disease is a congenital disorder caused by aganglionosis. The affected segment of the colon lacks enteric (Meissner and Auerbach) ganglion cells, resulting in failure of peristalsis, functional obstruction, and accumulation of stool proximal to the affected area.
C. Obstruction caused by hypertrophy of intestinal smooth muscle is incorrect because this mechanism is more consistent with conditions such as pyloric stenosis, not Hirschsprung’s disease. Hirschsprung’s is a neurologic defect, not a muscle hypertrophy problem.
D. Inflammation of the intestinal mucosa leading to motility loss is incorrect because Hirschsprung’s disease is not an inflammatory condition. While inflammation may occur secondary to bowel obstruction, it is not the primary pathophysiologic cause.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Scarlet fever is incorrect because, although it presents with a fever and rash, it is typically associated with a sandpaper-like rash, pastia lines, and pharyngeal infection with exudate. Conjunctival injection, "strawberry" tongue, and extremity changes are not characteristic.
B. Kawasaki disease is correct because the child meets the classic diagnostic criteria: persistent fever >5 days, bilateral non-exudative conjunctival injection, oral mucosal changes (red cracked lips, strawberry tongue), peripheral extremity changes (swelling, erythema, desquamation), and polymorphous rash. Kawasaki disease is an acute systemic vasculitis that primarily affects children under 5 and can lead to coronary artery aneurysms if untreated. Early recognition and treatment with intravenous immunoglobulin (IVIG) and aspirin are critical.
C. Rheumatic fever is incorrect because it typically occurs weeks after a group A streptococcal infection and presents with carditis, arthritis, chorea, and subcutaneous nodules, rather than conjunctival injection, strawberry tongue, or extremity edema.
D. Measles is incorrect because measles presents with Koplik spots, a cephalocaudal spreading maculopapular rash, and cough, coryza, and conjunctivitis. Extremity swelling and strawberry tongue are not features of measles.
Correct Answer is B
Explanation
A. Teaching the family about long-term management of asthma is incorrect because asthma management is not directly related to latex allergy, although children with latex allergy may have an increased risk of atopy. The focus should be on latex avoidance.
B. Avoiding using any latex product is correct. Children with spina bifida are at high risk for latex allergy due to frequent surgical procedures and exposure to latex-containing medical products. Complete avoidance of latex in medical equipment, gloves, toys, and household items is the most important preventive intervention to reduce the risk of anaphylaxis or allergic reactions.
C. Administering medication for long-term desensitization is incorrect because there is currently no safe or standard desensitization therapy for latex allergy. Management focuses on prevention and avoidance.
D. Using only nonallergenic latex products is partially misleading. There is no guarantee that “nonallergenic” latex products are completely safe; therefore, latex-free alternatives should be used instead of relying on “nonallergenic” labels.
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