The parents of a 6-week-old infant boy come to the clinic for evaluation because the infant has been vomiting, and it is becoming more forceful and increasing over the last week. A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical exam, what would the nurse most likely find?

Choice A reason: The school-age stage applies to families with children primarily aged 6-12 years. While the 8-year-old fits this stage, the family also includes a 2-year-old (preschool) and a 14-year-old (adolescent), spanning multiple developmental stages, making this an incorrect choice for the family’s overall stage.

Choice B reason: The adolescent stage focuses on families with children aged 13-18 years. Although the 14-year-old is an adolescent, the presence of a 2-year-old and an 8-year-old indicates the family spans preschool, school-age, and adolescent stages, making this an incomplete description of the family’s developmental stage.

Choice C reason: The preschool stage involves families with children aged 3-5 years. The 2-year-old is close to this stage, but the 8-year-old (school-age) and 14-year-old (adolescent) place the family across multiple developmental stages, making preschool stage an incorrect choice for the family’s overall development.

Choice D reason: Family development theory recognizes mixed developmental stages when children span multiple age groups. With a 2-year-old (toddler/preschool), 8-year-old (school-age), and 14-year-old (adolescent), the family navigates diverse developmental needs, making this the correct stage to describe their current developmental dynamics.

Choice A reason: Sudden resolution of pain in appendicitis may indicate perforation, as inflammation spreads beyond the appendix, reducing localized pressure. This is a medical emergency requiring immediate surgical intervention to prevent peritonitis or sepsis, making this statement the most concerning and warranting urgent nurse attention.

Choice B reason: Worsening pain with movement is expected in appendicitis due to peritoneal irritation and inflammation of the appendix. While concerning, it is consistent with uncomplicated appendicitis and less alarming than sudden pain resolution, which suggests perforation, making this statement less urgent for immediate intervention.

Choice C reason: Right lower quadrant pain rated 7/10 is a common symptom of appendicitis, reflecting ongoing inflammation. It is expected and does not indicate an immediate change in condition like perforation. While requiring monitoring, it is less concerning than sudden pain resolution, which signals a critical complication.

Choice D reason: Nausea and vomiting are common in appendicitis due to visceral irritation and inflammation. Vomiting twice in three hours is concerning but expected and does not indicate an immediate emergency like perforation. It requires supportive care but is less urgent than sudden pain resolution in this context.