On deep palpation of the infant's abdomen, the NP palpates a 2-cm firm mass in the right upper quadrant (RUQ). This finding is consistent with:
Hirschsprung's disease.
Wilm's tumor.
pyloric stenosis.
intussusception.
The Correct Answer is B
Rationale:
A. Hirschsprung’s disease typically presents with chronic constipation, abdominal distention, and failure to pass meconium, rather than a discrete RUQ mass.
B. Wilm’s tumor is a renal malignancy in children that often presents as a firm, non-tender abdominal mass in the right or left upper quadrant, sometimes noticed by parents or during a routine exam. Care must be taken not to palpate aggressively, as the tumor is fragile and can rupture.
C. Pyloric stenosis usually presents with projectile vomiting and a palpable “olive-like” mass in the right upper quadrant near the epigastrium, but the mass is smaller (~1–2 cm) and associated with gastric outlet obstruction symptoms.
D. Intussusception may present with sausage-shaped abdominal mass and intermittent pain, often in the right lower quadrant, along with currant jelly stools, rather than a firm, fixed RUQ mass.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Gingival hypertrophy is a hallmark sign of acute myeloid leukemia (AML) in children, caused by infiltration of leukemic cells into the gingival tissues. It may lead to bleeding, swelling, and oral discomfort.
B. Hepatosplenomegaly is more commonly associated with acute lymphoblastic leukemia (ALL) rather than AML.
C. Priapism is rare and usually related to sickle cell disease rather than leukemia.
D. Visual disturbances are not a common presenting sign of AML in children.
Correct Answer is A
Explanation
Rationale:
A. Gonorrhea can present with vaginal discharge and irritation, which can mimic bacterial vaginosis, making it an important condition to consider in the differential diagnosis.
B. Pelvic inflammatory disease typically involves upper genital tract infection with symptoms such as lower abdominal pain, fever, and cervical motion tenderness, rather than isolated vaginal discharge.
C. HPV infection usually presents with genital warts or asymptomatic infection and is not typically confused with bacterial vaginosis.
D. Syphilis presents with characteristic lesions such as chancres or rash, not the thin, gray-white vaginal discharge associated with bacterial vaginosis.
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