The nurse is caring for a 5-week-old infant with suspected hypertrophic pyloric stenosis. Which clinical manifestation would indicate this condition?
Bilious vomiting and constipation
Abdominal distention and currant jelly-like stools
Rounded abdomen and hypoactive bowel sounds
Ravenously hungry after vomiting
The Correct Answer is D
Choice A reason:
Bilious vomiting and constipation are not typical manifestations of hypertrophic pyloric stenosis. Bilious vomiting, which is green or yellow, indicates that the vomit contains bile and is usually associated with intestinal obstruction beyond the stomach. Hypertrophic pyloric stenosis typically causes non-bilious, projectile vomiting because the obstruction is at the pylorus, before the bile duct.
Choice B reason:
Abdominal distention and currant jelly-like stools are not indicative of hypertrophic pyloric stenosis. Currant jelly-like stools are a classic sign of intussusception, a different condition where part of the intestine telescopes into itself. While abdominal distention can occur in pyloric stenosis, the presence of currant jelly-like stools points to a different diagnosis.
Choice C reason:
A rounded abdomen and hypoactive bowel sounds can be seen in various gastrointestinal conditions but are not specific to hypertrophic pyloric stenosis. While a rounded abdomen may be present due to gastric distention, hypoactive bowel sounds are not a hallmark of this condition. The primary symptom of pyloric stenosis is projectile vomiting.
Choice D reason:
Ravenously hungry after vomiting is a classic manifestation of hypertrophic pyloric stenosis. Infants with this condition often vomit forcefully after feeding and then appear hungry again because the food does not pass through the pylorus into the intestines. This symptom, along with projectile vomiting, is a key indicator of pyloric stenosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is d. Frequent serial casting is tried first
Choice A reason:
Infants do not outgrow clubfoot on their own. Without treatment, the condition can lead to significant disability and difficulty walking. Early intervention is crucial to correct the deformity and ensure proper foot function.
Choice B Reason:
Surgical intervention is not the first line of treatment for mild cases of clubfoot. Surgery is typically reserved for severe cases or when nonsurgical methods, such as casting, have failed. The goal is to correct the foot’s position using less invasive methods whenever possible.
Choice C Reason:
Traction with foot manipulation is not a standard treatment for clubfoot. The primary nonsurgical treatment involves the Ponseti method, which includes gentle manipulation and serial casting to gradually correct the foot’s position.
Choice D Reason:
Frequent serial casting, known as the Ponseti method, is the first line of treatment for clubfoot. This method involves weekly manipulation and casting of the foot to gradually move it into the correct position. It is highly effective and is the preferred initial treatment for most cases of clubfoot.
Correct Answer is C
Explanation
Choice A reason:
A diet consisting of low-fat, low-carbohydrate foods is not specifically recommended for managing severe edema associated with acute glomerulonephritis. While a balanced diet is important, the primary dietary focus should be on reducing sodium intake to prevent fluid retention and manage edema. Therefore, this choice is not the most appropriate recommendation.
Choice B reason:
Decreasing the number of calories in the child’s diet is not a primary recommendation for managing severe edema associated with acute glomerulonephritis. The focus should be on reducing sodium intake rather than calorie restriction. Adequate nutrition is essential for the child’s overall health and recovery1. Therefore, this choice is not the most appropriate recommendation.
Choice C reason:
Avoiding adding salt to the child’s food is a key recommendation for managing severe edema associated with acute glomerulonephritis. Sodium can lead to water retention, which can worsen edema and increase blood pressure. A low-sodium diet helps to reduce fluid retention and manage the symptoms of glomerulonephritis. This is the most appropriate dietary recommendation for managing severe edema in this condition.
Choice D reason:
Increasing the amount of protein in the child’s diet is not recommended for managing severe edema associated with acute glomerulonephritis1. In fact, protein intake may need to be monitored and possibly restricted to prevent the buildup of waste products in the blood1. The primary dietary focus should be on reducing sodium intake to manage edema. Therefore, this choice is not the most appropriate recommendation.
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