A nurse is giving a newborn her first feeding when the baby starts coughing and choking. This is indicative of which condition?

Enterocolitis

Pyloric stenosis

Tracheoesophageal atresia

Celiac disease

Answer and Explanation

The Correct Answer is C

Choice A reason: Enterocolitis, an inflammatory bowel condition, causes diarrhea and abdominal pain, typically in premature infants or those with Hirschsprung’s disease. It does not cause coughing or choking during feeding, as it affects the intestines, not the airway or esophagus, making it an incorrect diagnosis for this newborn’s feeding-related symptoms.

Choice B reason: Pyloric stenosis causes projectile vomiting due to pyloric muscle hypertrophy, obstructing gastric emptying. It does not typically cause coughing or choking during feeding, as the issue is distal to the esophagus. Tracheoesophageal atresia directly affects airway and esophageal continuity, making it a more likely cause of these symptoms.

Choice C reason: Tracheoesophageal atresia involves an abnormal connection between the trachea and esophagus, causing aspiration during feeding. In newborns, this leads to coughing and choking as milk enters the airway. This congenital defect disrupts normal swallowing, making it the most likely condition causing these symptoms during the first feeding.

Choice D reason: Celiac disease, a gluten-sensitive enteropathy, causes malabsorption, diarrhea, and failure to thrive, typically after gluten introduction. It does not cause coughing or choking during feeding in newborns, as it affects the small intestine, not the airway or esophagus, making it an incorrect diagnosis for these acute symptoms.

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Correct Answer is ["A","B","C","D"]

Explanation

Choice A reason: Diminished peristalsis is a hallmark of Hirschsprung’s disease, caused by absent ganglion cells in the colon, leading to impaired peristalsis and functional obstruction. This results in fecal retention, constipation, and narrowed stools, as the aganglionic segment fails to propel intestinal contents, making diminished peristalsis a key expected finding in affected children.

Choice B reason: Failure to thrive is common in Hirschsprung’s disease due to chronic constipation and nutrient malabsorption from intestinal obstruction. Inadequate caloric intake and energy expenditure from discomfort impair growth, making this a typical finding, reflecting the disease’s impact on nutrition and development in young children.

Choice C reason: Vomiting occurs in Hirschsprung’s disease, especially in severe cases, due to intestinal obstruction from aganglionic segments, causing backup of intestinal contents. This leads to bilious emesis, particularly in infants, as fecal stasis increases intraluminal pressure, making vomiting an expected symptom in this condition.

Choice D reason: Ribbon-like stools are characteristic of Hirschsprung’s disease, resulting from narrowed, aganglionic colon segments that restrict fecal passage, producing thin, ribbon-shaped stools. This reflects the functional obstruction and chronic constipation caused by absent peristalsis, making it a key expected finding in affected children.

Correct Answer is ["3.8"]

Explanation

Step 1 is to convert pounds to kilograms: (22 ÷ 2.2) = 10 Result = 10 kg

Step 2 is to calculate the total daily dose in mg: 10 × 1.5 = 15 Result = 15 mg/day

Step 3 is to determine the number of doses per day when given every 6 hours: 24 ÷ 6 = 4 Result = 4 doses/day

Step 4 is to divide the total daily dose by number of doses: 15 ÷ 4 = 3.75 Result = 3.75 mg per dose

Step 5 is to calculate volume in mL: (3.75 ÷ 1) = 3.75 Result = 3.75 mL

Step 6 is to round to the nearest tenth: 3.75 rounds to 3.8

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A nurse is giving a newborn her first feeding when the baby starts coughing and choking. This is indicative of which condition?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a child who has Hirschsprung’s disease. Which of the following findings should the nurse expect? (Select all that apply)

Correct Answer is ["A","B","C","D"]

Explanation

Correct Answer is ["3.8"]

Explanation

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