Which diagnostic test is both diagnostic and therapeutic for intussusception?

Barium or air enema

Abdominal x-ray

Abdominal ultrasound

Computed tomography (CT) scan

Answer and Explanation

The Correct Answer is A

Choice A reason: Barium or air enema is both diagnostic and therapeutic for intussusception. It visualizes the telescoped bowel segment (diagnostic) and applies pressure to reduce the invagination (therapeutic), resolving most cases non-surgically. This dual role makes it the standard approach, aligning with the correct answer.

Choice B reason: Abdominal x-ray can suggest intussusception by showing air-fluid levels or obstruction but is not therapeutic. It lacks the specificity to confirm the diagnosis and cannot reduce the telescoped bowel, making it an incorrect choice for a test that serves both diagnostic and therapeutic purposes.

Choice C reason: Abdominal ultrasound is highly sensitive for diagnosing intussusception, showing the “target sign” of telescoped bowel. However, it is not therapeutic, as it cannot reduce the invagination. It is used for confirmation, not treatment, making it incorrect for a dual-purpose test in this context.

Choice D reason: CT scans can diagnose intussusception by visualizing bowel obstruction but are not therapeutic. They involve radiation exposure, making them less preferred in children, and do not reduce the telescoped bowel, making this an incorrect choice for a test with both diagnostic and therapeutic roles.

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Correct Answer is D

Explanation

Choice A reason: Tenderness over McBurney’s point suggests appendicitis, not hypertrophic pyloric stenosis, which involves pyloric muscle hypertrophy causing gastric outlet obstruction. This condition presents with vomiting and a palpable mass, not right lower quadrant tenderness, making this an incorrect finding for the diagnosis.

Choice B reason: The FACES scale assesses pain, but hypertrophic pyloric stenosis typically causes discomfort from vomiting, not localized epigastric/umbilical pain rated at 6. Infants may show fussiness, not specific pain scores, making this an incorrect and non-specific finding for the suspected condition.

Choice C reason: A sausage-shaped mass is associated with intussusception, not hypertrophic pyloric stenosis. The latter causes a firm, olive-shaped mass in the upper right quadrant due to pyloric hypertrophy, making this finding incorrect for the suspected diagnosis in a 6-week-old with forceful vomiting.

Choice D reason: A firm, olive-shaped mass in the upper right quadrant is a hallmark of hypertrophic pyloric stenosis, caused by thickened pyloric muscle obstructing gastric outflow. Palpable during exam, it correlates with the forceful vomiting described, making this the most likely and correct physical finding.

A. Your older child has a stronger liver and kidneys, which have helped her to better rid her body of the lead B. Some children are better able to metabolize toxins such as lead after exposure C. It is likely your older child may have had elevated levels earlier in life but has gotten over the condition D. Younger children are often impacted because their play behaviors place them on the floor and they often put things into their mouths

Correct Answer is D

Explanation

Choice A reason: Liver and kidney function do not significantly differ in lead metabolism between young and older children. Lead is stored in bones and tissues, and all children are susceptible to toxicity. The older child’s lower exposure, not stronger organs, explains the difference, making this an incorrect explanation.

Choice B reason: There is no evidence that some children metabolize lead better after exposure. Lead absorption and toxicity depend on exposure, not individual metabolic differences. Younger children’s behaviors increase exposure risk, making this a vague and scientifically inaccurate explanation for the observed difference in lead levels.

Choice C reason: Assuming the older child had elevated lead levels earlier without evidence is speculative. Lead levels persist without intervention, and the older child’s normal levels likely reflect lower exposure due to behavior, not recovery, making this an incorrect and unsupported explanation for the mother.

Choice D reason: Younger children (7 months, 4 years) engage in floor play and hand-to-mouth behaviors, increasing ingestion of lead from dust or objects in contaminated environments. Older children (9 years) are less likely to exhibit these behaviors, reducing exposure, making this the correct and most accurate explanation.

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Which diagnostic test is both diagnostic and therapeutic for intussusception?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

Correct Answer is D

Explanation

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