The nurse is reviewing the client's medical record and notes a diagnosis of Hirschsprung's Disease. Which of the following correlates to this illness?

The intestine is twisted around itself causing severe pain

The child's intestine has a large blockage of scar tissue

The child's intestine has slipped inside of itself.

The intestine is missing crucial nerves to aid in peristalsis

Answer and Explanation

The Correct Answer is D

A. The intestine is twisted around itself causing severe pain: This describes volvulus, a different condition that causes intestinal obstruction and ischemia.

B. The child's intestine has a large blockage of scar tissue: This describes intestinal strictures, which can occur due to Crohn’s disease or previous surgery, not Hirschsprung’s disease.

C. The child's intestine has slipped inside of itself: This describes intussusception, where one part of the intestine telescopes into another, causing obstruction.

D. The intestine is missing crucial nerves to aid in peristalsis: Hirschsprung’s disease is a congenital disorder where the ganglion cells (nerve cells responsible for peristalsis) are absent in parts of the intestine, leading to obstruction and difficulty passing stool.

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Correct Answer is ["A","B","C"]

Explanation

A. Avoid drawing blood from the affected extremity: Blood draws, IVs, and BP measurements should never be done on the fistula arm to prevent damage and thrombosis.

B. Auscultate the fistula for the sound of a bruit: A bruit (whooshing sound) confirms blood flow through the fistula, indicating patency.

C. Palpate the site to identify the presence of a thrill: A thrill (vibration) should be felt over the fistula. Absence may indicate clotting or failure.

D. Irrigate the fistula with saline to maintain patency: A fistula is never irrigated. Only dialysis staff should access it.

E. Keep the fistula clamped until ready to perform dialysis: AV fistulas are not clamped. Clamping could obstruct blood flow.

A. Notify the health care provider B. Administer a 1-liter bolus of normal saline C. Inspect the biopsy site dressing D. Position the client on the right side

Correct Answer is C

Explanation

A. Notify the health care provider: While notifying the provider is important, assessing the client comes first to determine if there is active bleeding.

B. Administer a 1-liter bolus of normal saline: Fluid resuscitation is used for shock, but the cause of symptoms must be assessed first.

C. Inspect the biopsy site dressing: The most concerning complication after a liver biopsy is internal bleeding, as the liver is highly vascular. Pallor and near-syncope may indicate hemorrhage. The priority action is to assess the biopsy site for bleeding before taking further action.

D. Position the client on the right side: Clients are typically positioned on the right side after a liver biopsy to apply pressure and reduce bleeding risk, but since the client is already experiencing symptoms of hypovolemia, assessment and intervention for potential hemorrhage take precedence.

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The nurse is reviewing the client's medical record and notes a diagnosis of Hirschsprung's Disease. Which of the following correlates to this illness?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with End Stage Renal Disease has a mature Arteriovenous Fistula. Which of the following interventions would the nurse include in the client's plan of care? Select All that Apply

Correct Answer is ["A","B","C"]

Explanation

The nurse is caring for a client who returned from a liver biopsy 30 minutes ago. The client presses the call light and upon arrival in the room the client is pale and complaining of feeling as if they might pass out what of the following is the nurses priority action?

Correct Answer is C

Explanation

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