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
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Ridged abdomen - This finding is not typically associated with Hirschsprung disease. Instead, the abdomen may appear distended or bloated due to the accumulation of stool in the colon.
B. Ribbonlike, foul-smelling stools - This is a characteristic finding in Hirschsprung disease. Because the affected portion of the colon lacks nerve cells (ganglion cells) responsible for peristalsis, stool movement is impaired, leading to the passage of narrow, ribbonlike stools. These stools may also have a foul odor due to bacterial overgrowth in the affected area.
C. Projectile vomiting - Projectile vomiting is not a common finding in Hirschsprung disease. It is more commonly associated with conditions such as pyloric stenosis or gastroesophageal reflux.
D. Chronic hunger - Chronic hunger is not a typical finding in Hirschsprung disease. Instead, affected infants may experience feeding difficulties, constipation, and failure to thrive due to the obstruction of stool in the colon. They may also exhibit symptoms such as abdominal distention, vomiting, and refusal to feed.

Correct Answer is B
Explanation
A. Allowing siblings to visit the client in the hospital
- Allowing siblings to visit the client in the hospital is a compassionate gesture and promotes family-centered care. However, it may not directly address the concept of atraumatic care, which focuses on minimizing physical and psychological stress related to healthcare procedures.
B. Using a doll to demonstrate an invasive procedure
- Using a doll to demonstrate an invasive procedure is an example of atraumatic care. It allows the nurse to provide preparatory information to the child in a non-threatening and understandable manner. By visually demonstrating the procedure on a doll, the child can better understand what will happen, reducing anxiety and fear.
C. Encouraging communication between the parents and nurse
- Encouraging communication between the parents and nurse is important for providing holistic care and addressing the child's needs. While effective communication is essential, it may not directly demonstrate the concept of atraumatic care unless it involves discussing how to minimize stress and anxiety during procedures.
D. Arranging the room to accommodate religious practices
- Arranging the room to accommodate religious practices is a form of patient-centered care and respects the cultural and religious beliefs of the patient and family. While important for overall comfort and respect for the patient's values, it may not directly relate to the concept of atraumatic care, which specifically focuses on reducing stress and anxiety during healthcare procedures.
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