An infant who presents with a shrill or high-pitched cry should be evaluated for:
hypocalcemia.
increased intracranial pressure.
upper airway obstruction.
vocal cord paralysis.
The Correct Answer is B
Rationale:
A. Hypocalcemia in infants typically presents with tremors, jitteriness, positive Chvostek or Trousseau signs, and seizures, rather than a shrill cry.
B. A shrill or high-pitched cry is a classic neurologic sign that may indicate increased intracranial pressure (ICP) or central nervous system irritation. Additional signs may include lethargy, irritability, vomiting, and bulging fontanel.
C. Upper airway obstruction usually produces stridor, noisy breathing, or retractions, but not a shrill cry.
D. Vocal cord paralysis may cause a weak, hoarse, or breathy cry, not the high-pitched, shrill cry associated with neurologic issues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Bowel cleansing may be considered if constipation is contributing, but it is not the standard next step when behavioral strategies alone fail.
B. Urinalysis is useful for ruling out underlying urinary tract infections or diabetes but is typically performed earlier in the evaluation process.
C. A bedwetting alarm is a first-line second-step intervention after behavioral modifications have not produced improvement. It conditions the child to wake in response to bladder fullness and has demonstrated efficacy in reducing nocturnal enuresis.
D. Referral to a pediatric urologist is generally reserved for refractory cases, underlying anatomic abnormalities, or complicated presentations, not as the immediate next step after failed behavioral therapy.
Correct Answer is C
Explanation
Rationale:
A. Nasal grunting is a sound produced during exhalation due to partial airway obstruction, not visible enlargement of the nostrils.
B. Nasal stridor refers to a high-pitched sound during breathing caused by upper airway obstruction, not the physical widening of nasal openings.
C. Nasal flaring is the visible enlargement of both nostrils during inspiration, often seen in infants and young children as a sign of respiratory distress. It helps reduce airway resistance and increase airflow.
D. Nasal obstruction is a blockage of nasal passages and does not describe the outward flaring of nostrils.
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