A pediatric client is admitted to the unit with failure to thrive. The mother states that the child has been "spitting up" and excessively crying immediately after every bottle. What diagnostic test will the nurse anticipate to confirm a diagnosis?

Upper gastrointestinal series to determine structural abnormalities from gastroesophageal reflux

Biopsy of small intestine mucosa to rule out celiac disease

Ultrasound to assess for presence of pyloric stenosis

Lower gastrointestinal series to assess for an intestinal blockage

Answer and Explanation

The Correct Answer is A

A. An upper gastrointestinal series is commonly used to diagnose gastroesophageal reflux (GER), which can cause symptoms like spitting up and crying after feedings, leading to failure to thrive. This test helps visualize the esophagus, stomach, and duodenum for abnormalities.

B. A biopsy of the small intestine is typically done to diagnose celiac disease, which is less likely in this clinical scenario.

C. An ultrasound is used to diagnose pyloric stenosis, which presents with projectile vomiting and is less consistent with the described symptoms.

D. A lower gastrointestinal series is used to detect intestinal blockages, which are not suggested by the symptoms of spitting up and crying immediately after feeding.

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Correct Answer is B

Explanation

A. Mild illnesses like nasopharyngitis (a common cold) do not typically contraindicate vaccination, so there is no need to delay immunization.

B. It is essential to evaluate for allergies to vaccine components, such as gelatin or neomycin, which could contraindicate the administration of the varicella vaccine.

C. The first dose of the varicella vaccine is recommended at 12-15 months of age, not at 4 years of age, so it is appropriate to administer it during this well-check.

D. The varicella vaccine is administered subcutaneously, not intramuscularly, so this is not the correct route for administration.

A. The infant has passed several tar-like stools. B. The infant has not gained weight and has stooled once. C. The infant has not stooled. D. The infant has passed hard, pellet-like stools.

Correct Answer is C

Explanation

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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A pediatric client is admitted to the unit with failure to thrive. The mother states that the child has been "spitting up" and excessively crying immediately after every bottle. What diagnostic test will the nurse anticipate to confirm a diagnosis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During a well-check for a 12-month-old, the nurse plans to administer the first dose of the varicella vaccine. What is an appropriate action for the nurse to take?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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