A newborn's failure to pass meconium within the first 24 hours after birth may indicate which of the following?

Abdominal wall defect

Celiac disease.

Intussusception

Hirschsprung disease

Answer and Explanation

The Correct Answer is D

A. Abdominal wall defect:

Failure to pass meconium within the first 24 hours after birth can indicate a potential obstruction in the gastrointestinal tract. While an abdominal wall defect could potentially cause gastrointestinal issues, it is not specifically associated with failure to pass meconium.

B. Celiac disease:

Celiac disease is an autoimmune disorder characterized by an abnormal immune response to gluten. While celiac disease can cause gastrointestinal symptoms, such as diarrhea and abdominal pain, it is not typically associated with failure to pass meconium in the newborn period.

C. Intussusception:

Intussusception occurs when one segment of the intestine telescopes into another, causing a bowel obstruction. While intussusception is a cause of bowel obstruction in infants, it typically presents with symptoms such as colicky abdominal pain, vomiting, and the passage of "currant jelly" stool, rather than failure to pass meconium.

D. Hirschsprung disease:

Hirschsprung disease is a congenital condition characterized by the absence of ganglion cells in the distal portion of the colon, leading to functional obstruction. Failure to pass meconium within the first 24 hours after birth is a classic sign of Hirschsprung disease. This condition requires surgical intervention to remove the affected portion of the colon and restore normal bowel function.

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Correct Answer is A

Explanation

A. "My belly doesn't hurt anymore."

- This statement is concerning because sudden relief from severe right lower quadrant pain in a child with a history of nausea, vomiting, and suspected appendicitis may indicate a rupture or perforation of the appendix. When the appendix ruptures, there may be a temporary alleviation of pain due to the release of pressure. However, this situation is critical and requires immediate medical attention to prevent further complications such as peritonitis or sepsis.

B. "I am hungry and thirsty."

- While it's normal for a child to feel hungry and thirsty, especially if they have been experiencing nausea and vomiting, this statement is not necessarily concerning on its own. However, in the context of suspected appendicitis and severe right lower quadrant pain, it's important for the child to remain NPO (nothing by mouth) to prevent complications in case surgery is needed.

C. "I'm tired and want to take a nap."

- Feeling tired and wanting to rest is not uncommon, especially if the child has been experiencing discomfort or pain for a prolonged period. While this statement may indicate fatigue, it's not inherently concerning in the context of suspected appendicitis. However, it's important for the nurse to monitor the child's energy level and overall condition.

D. "I am scared and I want to go home."

- It's understandable for a child to feel scared or anxious, particularly when facing a medical procedure such as surgery. While this statement reflects the child's emotions, it doesn't necessarily indicate a change in their medical condition. However, it's important for the nurse to address the child's fears and provide emotional support while ensuring that the child receives appropriate medical care.

A. "Take a hot shower daily to relieve itching." B. "Wear loose fitting clothing while you are experiencing itching." C. "Add fabric softener to linens when they are washed." D. "Use a soft bristle brush to gently rub the affected areas."

Correct Answer is B

Explanation

A. "Take a hot shower daily to relieve itching."

This instruction is not recommended because hot water can exacerbate itching and worsen the condition. Hot showers can strip the skin of its natural oils, leading to further dryness and irritation, which may aggravate the itching associated with scabies.

B. "Wear loose fitting clothing while you are experiencing itching."

This instruction is appropriate because loose-fitting clothing can help minimize friction and irritation on the skin affected by scabies. Tight clothing can exacerbate itching and discomfort, so wearing loose clothing can provide relief and allow the skin to breathe.

C. "Add fabric softener to linens when they are washed."

This instruction is not recommended because fabric softeners may contain chemicals or fragrances that can irritate the skin, especially for someone with pruritus or scabies. It's best to use gentle, fragrance-free laundry detergent to wash linens and clothing to minimize potential irritation.

D. "Use a soft bristle brush to gently rub the affected areas."

This instruction is not recommended because using a brush, even if it has soft bristles, can further irritate the skin and potentially spread the scabies mites to other areas of the body. It's best to avoid any abrasive or vigorous rubbing of the affected areas and instead focus on gentle cleansing and moisturizing techniques.

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A newborn's failure to pass meconium within the first 24 hours after birth may indicate which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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