The nurse is caring for a 5-week-old infant who has been experiencing projectile vomiting after feedings. What additional symptom should the nurse anticipate?
Stool containing mucus and blood.
An olive-sized mass in the epigastric region.
Frequent burping accompanied by poor feeding.
Rebound tenderness in the left lower abdominal quadrant.
The Correct Answer is B
Choice A rationale
While it’s possible for an infant with projectile vomiting to have stool containing mucus and blood, this is not typically associated with the condition that most commonly causes projectile vomiting in infants, which is pyloric stenosis.
Choice B rationale
An olive-sized mass in the epigastric region is a classic symptom of pyloric stenosis. This condition occurs when the muscle between the stomach and the small intestine (the pylorus) thickens, preventing food from moving from the stomach to the intestine.
Choice C rationale
Frequent burping and poor feeding can be symptoms of many different conditions in infants, but they are not typically associated with pyloric stenosis.
Choice D rationale
Rebound tenderness in the left lower abdominal quadrant is a symptom of conditions like appendicitis, but it is not typically associated with pyloric stenosis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice B rationale
The absence of continuous headaches in the child indicates that the VP shunt is functioning normally. A VP shunt is used to treat hydrocephalus by draining excess cerebrospinal fluid from the brain to the abdomen. If the shunt is functioning properly, it should relieve pressure on the brain and reduce symptoms such as headaches.
Choice A rationale
While growth in height could be a positive sign of overall health and development, it does not specifically indicate that a VP shunt is functioning properly.
Choice C rationale
The presence of an intracranial pressure (ICP) monitoring probe does not indicate whether the shunt is functioning properly. The probe is a device used to measure ICP and does not provide information about the functionality of the shunt.
Choice D rationale
Being afebrile with normal vital signs postoperatively is a positive sign, but it does not specifically indicate that the shunt is functioning properly.
Correct Answer is C
Explanation
Choice A rationale
While a list of achievement timeline for developmental milestones can provide useful information about the child’s overall development, it may not be the most critical information when planning care for an umbilical hernia repair.
Choice B rationale
The mother’s use of alcohol, drugs, or cigarettes during pregnancy can have long-term effects on the child’s health, but it may not be the most relevant information for planning care for an umbilical hernia repair.
Choice C rationale
Knowing how the child reacted to any previous hospitalizations can provide valuable insight into the child’s previous healthcare experiences. This information can help the nurse plan care that is appropriate for the child’s emotional and developmental needs during the hospitalization for an umbilical hernia repair.
Choice D rationale
A history of rubella, rubeola, or chicken pox is important for the child’s medical history, but it may not be the most critical information when planning care for an umbilical hernia repair.
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