Which assessment finding would the nurse expect in an infant with Hirschsprung's disease?
Constipation with foul-smelling, ribbon-like stool.
"Currant jelly" stool.
Passage of foul-smelling, fatty stools.
Mucoid, bloody diarrhea.
The Correct Answer is A
A. This is the correct answer. Hirschsprung's disease causes a lack of nerve cells in the colon, leading to difficulty with bowel movement. The result is constipation and the passage of small, ribbon-like stools due to the narrowed areas of the colon. The stool can also be foul-smelling.
B. "Currant jelly" stool is typically associated with intussusception, not Hirschsprung's disease. This stool appears red and mucus-like and suggests a bowel obstruction or infection.
C. Foul-smelling, fatty stools (steatorrhea) are characteristic of malabsorption disorders like cystic fibrosis, not Hirschsprung's disease.
D. Mucoid, bloody diarrhea is more common in conditions like infectious colitis or inflammatory bowel disease, not Hirschsprung's disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Gross motor skill development is important for an infant’s overall development, but it is not the primary focus when caring for an infant with a cleft palate. Gross motor skills typically develop at a normal rate unless there are additional concerns.
B. Fine motor skill development is also important, but for an infant with a cleft palate, the primary concern is related to communication and feeding difficulties. Fine motor development generally follows the same trajectory unless there are complicating factors.
C. Speech and language acquisition is the most important area to focus on when planning care for an infant with a cleft palate. A cleft palate can significantly impact the infant’s ability to produce sounds and develop normal speech patterns. Early intervention and support from speech therapists are essential to address these issues.
D. Cognitive development is vital for all infants, but cleft palate primarily affects speech and feeding, making speech and language acquisition the most immediate concern for overall development.
Correct Answer is ["A","B","C","E","F"]
Explanation
A. Neurological assessment is critical in identifying potential complications, especially in cases of head injury, infection, or brain-related conditions. A change in mental status or neurological findings (e.g., confusion, loss of consciousness) warrants immediate follow-up.
B. Basic metabolic panel provides key information on electrolyte imbalances, kidney function, and acid-base status. Imbalances or abnormalities, such as hyperkalemia or hyponatremia, can indicate life-threatening conditions.
C. Blood pressure/heart rate is crucial to monitor because abnormalities in these vital signs can indicate cardiovascular instability, shock, or autonomic dysfunction. Significant changes require immediate intervention.
D. Abdominal assessment is important but not always immediately urgent unless signs of acute abdominal issues (e.g., severe pain, distention, or bleeding) are present.
E. Complete blood count is essential for monitoring for signs of infection, anemia, or bleeding disorders. Abnormalities such as low hemoglobin or a high white blood cell count require further investigation.
F. Pain assessment is important but may not always indicate an immediate life-threatening issue. However, uncontrolled pain or new-onset severe pain can signal a complication, such as infection or tissue damage, which needs prompt attention.
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