A nurse is caring for a 3-day-old newborn and suspects Hirschsprung disease. What finding best supports the nurse's concern?
The infant has passed several tar-like stools.
The infant has not gained weight and has stooled once.
The infant has not stooled.
The infant has passed hard, pellet-like stools.
The Correct Answer is C
A. Passing tar-like stools is normal for newborns within the first few days of life and does not indicate Hirschsprung disease.
B. Limited stooling and poor weight gain may suggest feeding issues but are not as indicative of Hirschsprung disease as the absence of stool.
C. The absence of stool (failure to pass meconium within 24-48 hours) is a classic sign of Hirschsprung disease, a condition where the absence of ganglion cells in the intestines leads to a blockage.
D. Passing hard, pellet-like stools may indicate constipation but is not specific to Hirschsprung disease, especially in a newborn.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Urinary and bowel continence is expected by age 4, so this does not warrant further investigation.
B. Tying shoes is a skill typically developed later, around 5-6 years of age, so not being able to do so at age 4 is not concerning.
C. Having an imaginary friend is common in children around this age and is not a cause for concern.
D. Speaking in 2-3 word sentences is typical for a younger child, around 2 years of age. By age 4, a child should be able to speak in more complex sentences, so this finding warrants further investigation.
Correct Answer is D
Explanation
A. While explaining discharge instructions is important, it is not the immediate priority following cast application.
B. Educating the client to elevate the leg is important to reduce swelling, but it is not the first priority.
C. Administering pain relief is necessary, but assessing circulation, sensation, and movement is more critical to identify any early signs of complications.
D. Performing a neurovascular assessment is the priority action because it ensures that there is no compromise to blood flow, sensation, or movement in the affected limb, which could indicate complications such as compartment syndrome.
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