A nurse is assessing a newborn. Which of the following should the nurse understand is a clinical manifestation of pyloric stenosis?
Projectile vomiting after feedings.
Absent bowel sounds.
Increased sodium levels.
Golf ball-sized mass over the left quadrant.
The Correct Answer is A
Choice A rationale
Projectile vomiting after feedings is a classic symptom of pyloric stenosis. This occurs because the enlarged pyloric muscle obstructs the passage of food from the stomach to the small intestine.
Choice B rationale
Absent bowel sounds are not typically associated with pyloric stenosis. While this condition affects the gastrointestinal tract, it does not typically cause a complete absence of bowel sounds.
Choice C rationale
Increased sodium levels are not a typical finding in a newborn with pyloric stenosis. In fact, these infants may have low sodium levels due to vomiting.
Choice D rationale
A golf ball-sized mass over the left quadrant is not a typical finding in a newborn with pyloric stenosis. The classic physical examination finding in pyloric stenosis is a palpable “olive-like” mass in the right upper quadrant of the abdomen.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale
Neonatal Abstinence Syndrome (NAS) is a group of problems that occur in a newborn who was exposed to addictive opiate drugs while in the mother’s womb. While NAS can pose risks to a newborn, it is not considered the greatest risk.
Choice B rationale
Developmental Dysplasia of the Hip (DDH) is a condition where the “ball and socket” joint of the hip does not properly form in babies and young children. While DDH can pose risks to a newborn, it is not considered the greatest risk.
Choice C rationale
Subgaleal hemorrhage is a rare but potentially lethal condition in newborns, usually resulting from vacuum-assisted delivery. While it can pose risks to a newborn, it is not considered the greatest risk.
Choice D rationale
Congenital cardiac defects are the most common type of birth defect. They can alter the way blood flows through the heart and pose a significant risk to a newborn.
Correct Answer is D
Explanation
Choice A rationale
While seeing a counselor could be beneficial for some women experiencing doubts and second thoughts about their pregnancy, suggesting this as an initial response may make the client feel that her feelings are abnormal or require professional help.
Choice B rationale
Asking if the client has spoken to her mother about these feelings assumes that the client has a good relationship with her mother or that her mother is available for support, which may not be the case.
Choice C rationale
Telling the client not to worry and that she will be fine once the baby is born may minimize her feelings and does not acknowledge her current emotional state.
Choice D rationale
Ambivalent feelings are quite common for women early in pregnancy. This response validates the client’s feelings and reassures her that what she is experiencing is normal.
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