A nurse is caring for a male infant who has a palpable mass in the upper right quadrant and stools mixed with blood and mucus. The nurse should recognize that which of the following diagnoses is associated with these findings?
Hypertrophic pyloric stenosis
Intussusception
Inguinal hernia
Tracheoesophageal fistula
The Correct Answer is B
Choice A reason: Hypertrophic pyloric stenosis is a condition in which the pyloric sphincter becomes thickened and obstructs the passage of food from the stomach to the duodenum. It causes projectile vomiting, dehydration, and weight loss, but not a palpable mass or bloody stools.
Choice B reason: Intussusception is a condition in which a segment of the intestine telescopes into another segment, causing obstruction, inflammation, and ischemia. It causes a palpable mass in the upper right quadrant, abdominal pain, and stools mixed with blood and mucus, also known as "currant jelly" stools.
Choice C reason: Inguinal hernia is a condition in which a part of the intestine protrudes through a weak spot in the abdominal wall near the inguinal canal. It causes a bulge in the groin area, especially when the infant cries or strains. It does not cause a mass in the upper right quadrant or bloody stools.
Choice D reason: Tracheoesophageal fistula is a congenital anomaly in which there is an abnormal connection between the trachea and the esophagus. It causes excessive drooling, choking, coughing, and cyanosis during feeding, but not a palpable mass or bloody stools.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is the best option to prevent reflux, as it allows gravity to help keep the stomach contents down. The nurse should advise the parent to keep the baby upright for at least 30 minutes after each feeding.
Choice B reason: Positioning the baby side lying during sleep is not recommended, as it can increase the risk of sudden infant death syndrome (SIDS). The nurse should instruct the parent to place the baby on the back for sleep, and elevate the head of the crib slightly.
Choice C reason: Thickening the baby's formula with oatmeal may help reduce reflux, but it is not the first choice, as it can cause overfeeding, constipation, or allergic reactions. The nurse should suggest this option only if prescribed by the provider.
Choice D reason: Feeding the baby formula rather than breast milk is not a good option, as breast milk is easier to digest and has many benefits for the baby's health and development. The nurse should encourage the parent to continue breastfeeding, and offer smaller and more frequent feedings.
Correct Answer is D
Explanation
Choice A reason: Drooling is not a sign of hemorrhage, but rather a sign of difficulty swallowing or breathing. Drooling may occur after a tonsillectomy due to throat pain or swelling, but it does not indicate bleeding.
Choice B reason: Poor fluid intake is not a sign of hemorrhage, but rather a sign of dehydration or nausea. Poor fluid intake may occur after a tonsillectomy due to throat pain or fear of swallowing, but it does not indicate bleeding.
Choice C reason: Increased pain is not a sign of hemorrhage, but rather a sign of inflammation or infection. Increased pain may occur after a tonsillectomy due to tissue damage or healing, but it does not indicate bleeding.
Choice D reason: Frequent swallowing is a sign of hemorrhage, as it indicates that the child is trying to clear blood from the throat. Frequent swallowing may occur after a tonsillectomy due to bleeding from the surgical site or a ruptured blood vessel.
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