A nurse is assessing a 1-year-old child. Which of the following disorders should the nurse suspect?
Nephrotic syndrome
Pyloric stenosis
Intussusception
The Correct Answer is C
Choice A Reason:
Nephrotic syndrome is a kidney disorder that causes the body to excrete too much protein in the urine. It is characterized by symptoms such as swelling (edema), particularly around the eyes and in the ankles and feet, foamy urine due to excess protein, and weight gain due to fluid retention. While nephrotic syndrome can occur in children, it is less likely to be the primary suspicion in a 1-year-old presenting with acute symptoms such as severe abdominal pain, vomiting, and bloody stools, which are more indicative of intussusception.
Choice B Reason:
Pyloric stenosis is a condition that affects infants, typically between birth and 6 months of age. It involves the thickening of the pylorus muscle, which blocks food from entering the small intestine. Symptoms include projectile vomiting, dehydration, and weight loss. Although pyloric stenosis is a serious condition that requires medical attention, it is less likely to be suspected in a 1-year-old child compared to intussusception, which is more common in this age group.
Choice C Reason:
Intussusception is a serious condition in which part of the intestine slides into an adjacent part of the intestine, causing a blockage. This condition is most common in children between 3 months and 3 years old56. Symptoms include sudden, severe abdominal pain, vomiting, bloody stools (often described as “currant jelly” stools), and a palpable lump in the abdomen. Given the age of the child and the acute nature of the symptoms, intussusception is the most likely diagnosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A: Tell me more about what you are thinking
This response is the most appropriate because it opens up a dialogue with the adolescent, allowing them to express their fears and concerns. It shows empathy and provides emotional support, which is crucial in such a sensitive situation. By encouraging the adolescent to share their thoughts, the nurse can better understand their emotional state and provide appropriate support and information.
Choice B: Your doctor can tell you about your prognosis
While it is true that the doctor can provide detailed information about the prognosis, this response might come across as dismissive. It does not address the adolescent’s immediate emotional needs or provide the comfort and support they are seeking. The nurse’s role includes providing emotional support and facilitating communication, making this response less effective in addressing the adolescent’s concerns.
Choice C: You should just focus on getting better
This response is not appropriate because it dismisses the adolescent’s fears and concerns. It implies that their feelings are not valid and that they should ignore their worries. This can lead to increased anxiety and a sense of isolation. It is important for the nurse to acknowledge the adolescent’s feelings and provide a safe space for them to express their emotions.
Choice D: You should discuss this with your parents when they return
While involving the parents in such discussions is important, this response does not address the adolescent’s immediate need for support and reassurance. It may make the adolescent feel that their concerns are being brushed aside. The nurse should provide immediate emotional support and then involve the parents in the discussion when they return.
Correct Answer is A
Explanation
Choice A Reason:
In coarctation of the aorta, the narrowing of the aorta typically occurs after the arteries that supply the upper body branch off. This results in higher blood pressure in the arms and lower blood pressure in the legs. The difference in blood pressure between the upper and lower extremities is a key diagnostic indicator of this condition.
Choice B Reason:
Increased blood pressure in both the arms and the legs is not characteristic of coarctation of the aorta. This condition specifically causes a disparity in blood pressure between the upper and lower parts of the body due to the narrowing of the aorta.
Choice C Reason:
Decreased blood pressure in both the arms and the legs is not a typical manifestation of coarctation of the aorta. The condition usually leads to increased blood pressure in the upper body and decreased blood pressure in the lower body.
Choice D Reason:
Decreased blood pressure in the arms with increased blood pressure in the legs is the opposite of what is seen in coarctation of the aorta. The narrowing of the aorta causes higher pressure in the upper body and lower pressure in the lower body.
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