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
Choice A reason:
A 7-year-old child with diabetes insipidus and a urine specific gravity of 1.016 is not in immediate danger. Diabetes insipidus is a condition characterized by excessive thirst and excretion of large amounts of severely diluted urine. A urine specific gravity of 1.016 is within the normal range (1.005 to 1.030). Therefore, this child does not require immediate assessment.
Choice B reason:
A 4-year-old child with asthma and a PCO2 of 37 mm Hg is also not in immediate danger. Asthma is a chronic condition that can cause difficulty breathing, but a PCO2 level of 37 mm Hg is within the normal range (35-45 mm Hg). This indicates that the child’s respiratory status is currently stable, and immediate assessment is not required.
Choice C reason:
A 1-year-old toddler with roseola and a temperature of 39°C (102.2°F) is experiencing a common viral infection that typically causes a high fever followed by a rash. While the fever is high, it is not uncommon for roseola and can be managed with antipyretics and supportive care. This child does not require immediate assessment.
Choice D reason:
A 10-year-old child with sickle cell anemia reporting 8 out of 10 chest pain is in immediate danger and requires urgent assessment. Chest pain in a child with sickle cell anemia can indicate acute chest syndrome, a severe and potentially life-threatening complication. Acute chest syndrome is characterized by chest pain, fever, and respiratory distress, and it requires prompt medical intervention. Therefore, this child should be assessed first.
Correct Answer is A
Explanation
The correct answer is a) Androgens.
Choice A reason:
Congenital adrenal hyperplasia (CAH) is a group of genetic disorders affecting the adrenal glands, which are responsible for producing vital hormones such as cortisol, aldosterone, and androgens. In CAH, there is a deficiency of the enzyme 21-hydroxylase, which is crucial for the synthesis of cortisol and aldosterone. As a result, the adrenal glands overproduce androgens, leading to symptoms such as ambiguous genitalia in newborns, early puberty, and rapid growth. Androgens are male sex hormones, including testosterone, which play a significant role in the development of male characteristics.
Choice B reason:
Vitamin K is a fat-soluble vitamin essential for blood clotting and bone health. It is not related to the overproduction of hormones in congenital adrenal hyperplasia. Vitamin K deficiency can lead to bleeding disorders, but it does not cause the symptoms associated with CAH, such as ambiguous genitalia or early puberty. Therefore, this choice is incorrect.
Choice C reason:
Gonadotropins are hormones produced by the pituitary gland that stimulate the gonads (ovaries and testes) to produce sex hormones and gametes (eggs and sperm). While gonadotropins play a role in sexual development and reproduction, they are not overproduced in congenital adrenal hyperplasia. The primary issue in CAH is the overproduction of androgens due to enzyme deficiencies in the adrenal glands. Therefore, this choice is incorrect.
Choice D reason:
Vitamin D is a fat-soluble vitamin essential for calcium absorption and bone health. It is not related to the overproduction of hormones in congenital adrenal hyperplasia. Vitamin D deficiency can lead to bone disorders such as rickets in children and osteomalacia in adults, but it does not cause the symptoms associated with CAH. Therefore, this choice is incorrect.
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