The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder?

Sausage-shaped mass palpated in the upper right abdominal quadrant

The passage of currant jelly-like stools

Bile-stained fecal emesis

Failure to pass meconium stool in the first 24 hours after birth

Answer and Explanation

The Correct Answer is D

A. Sausage-shaped mass palpated in the upper right abdominal quadrant.
Explanation: A sausage-shaped mass in the upper right abdominal quadrant is more indicative of Hirschsprung's disease, not imperforate anus. In Hirschsprung's disease, there is a lack of ganglion cells in the rectum, leading to obstruction and a palpable mass.
B. The passage of currant jelly-like stools.
Explanation: The passage of currant jelly-like stools is characteristic of intussusception, a condition where one portion of the intestine telescopes into another. It is not associated with imperforate anus.
C. Bile-stained fecal emesis.
Explanation: Bile-stained fecal emesis suggests a possible intestinal obstruction or other gastrointestinal issue, but it is not a specific manifestation of imperforate anus. Imperforate anus is primarily characterized by the absence of a normal anal opening.
D. Failure to pass meconium stool in the first 24 hours after birth.
Explanation:
Imperforate anus refers to a congenital condition in which the opening to the anus is absent or improperly formed. One of the clinical manifestations is the failure to pass meconium stool within the first 24 hours after birth. Meconium is the thick, sticky, greenish-black substance that constitutes a newborn's first stools. The absence of meconium passage suggests a potential obstruction.

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Correct Answer is A

Explanation

A. Administer prednisone on an alternate-day schedule.
Explanation: Prednisone, a corticosteroid, is often prescribed to manage inflammation and symptoms in juvenile idiopathic arthritis. An alternate-day schedule helps minimize the risk of side effects associated with prolonged corticosteroid use.
B. Apply cool compresses for 20 minutes every hour.
Incorrect: While cool compresses can provide relief for joint pain associated with arthritis, applying them every hour may be excessive and is not a standard recommendation. It's important to use cooling measures judiciously.
C. Encourage the child to take a 45-minute nap daily.
Incorrect: While adequate rest is important for overall health, suggesting a specific duration for a nap may not be universally applicable. The child's need for rest and sleep should be based on individual factors, and a specific time frame is not a standard recommendation for juvenile idiopathic arthritis.
D. Allow the child to stay at home on days when her joints are painful.
Incorrect: While it's important to consider the child's comfort and well-being, keeping the child at home solely on days of joint pain may not be necessary. The goal is to manage symptoms effectively to allow participation in normal daily activities, including school. Restricting activities solely based on joint pain is not the typical approach to managing juvenile idiopathic arthritis.

A. The immunization schedule will need to be altered." B. The child will receive all of the immunizations except for the pollo series. C. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination. D. The child should not receive any hepatitis vaccines."

Correct Answer is C

Explanation

A. "The immunization schedule will need to be altered."
Incorrect: This is too vague and does not provide specific information about the child's immunization schedule.
B. "The child will receive all of the immunizations except for the polio series."
Incorrect: There is no indication that the child should not receive the polio vaccine. Children with cystic fibrosis are generally recommended to receive all appropriate vaccinations.
C. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."
Correct Answer: Children with cystic fibrosis should receive the recommended basic series of immunizations, including vaccines for diseases such as diphtheria, pertussis, tetanus, measles, mumps, rubella, polio, Haemophilus influenzae type b (Hib), hepatitis B, and others. Additionally, they should receive a yearly influenza vaccination to help prevent respiratory complications.
D. "The child should not receive any hepatitis vaccines."
Incorrect: There is no general contraindication for children with cystic fibrosis to receive hepatitis vaccines. The nurse should recommend the appropriate vaccines, including those for hepatitis B, as per the standard immunization schedule.

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The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder?

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Naxlex Comprehensive Predictor Exams

A nurse is providing discharge instructions to a parent and his school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include?

Correct Answer is A

Explanation

The clinic nurse is providing instructions to the parent of a child with cystic fibrosis regarding the immunization schedule for the child. Which statement would the nurse make to the parent?

Correct Answer is C

Explanation

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