Which finding in a newborn is suggestive of tracheoesophageal fistula?

Choking on the first feeding

Palpable mass in the sternal area

Visible peristalsis across abdomen

Failure to pass meconium in 24 hours

Answer and Explanation

The Correct Answer is A

Choice A reason: Tracheoesophageal fistula (TEF) involves an abnormal tracheoesophageal connection, causing aspiration during feeding. In newborns, choking on the first feeding occurs as milk enters the airway via the fistula, leading to respiratory distress. This is a hallmark sign, requiring urgent evaluation to confirm TEF and prevent complications like pneumonia.

Choice B reason: A palpable mass in the sternal area may indicate a congenital anomaly like a sternal cleft or tumor, but it is not associated with tracheoesophageal fistula. TEF affects airway and esophageal function, causing choking during feeding, not palpable masses, making this finding irrelevant to the condition’s pathophysiology.

Choice C reason: Visible peristalsis across the abdomen suggests gastrointestinal motility issues, like hypertrophic pyloric stenosis, but is not specific to tracheoesophageal fistula. TEF causes respiratory symptoms like choking due to airway aspiration, not abdominal motility changes, making this finding incorrect for diagnosing this congenital airway-esophageal defect.

Choice D reason: Failure to pass meconium in 24 hours suggests Hirschsprung’s disease or intestinal atresia, affecting bowel motility. Tracheoesophageal fistula primarily impacts feeding and respiration due to airway-esophageal connection, not meconium passage, making this finding unrelated to the condition’s presentation in a newborn during feeding.

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Correct Answer is C

Explanation

Choice A reason: Hypoglycemia in diabetes has a rapid onset due to sudden drops in blood glucose (<70 mg/dL), triggering sympathetic responses like trembling. This statement is correct, as it reflects the acute nature of hypoglycemic episodes, requiring no clarification, as the parent understands the urgency of symptom recognition.

Choice B reason: Nausea and trembling are common hypoglycemia symptoms, resulting from autonomic activation and cerebral glucose deprivation. This statement is correct, as these signs indicate low blood glucose, prompting timely intervention like glucose administration. The parent’s understanding aligns with hypoglycemia pathophysiology, requiring no further clarification in diabetes education.

Choice C reason: Feeling hot is not typical of hypoglycemia, which causes diaphoresis and cool, clammy skin due to sympathetic activation. Instead, feeling cold or sweaty is common. This statement is incorrect, indicating a need for clarification to ensure the parent recognizes accurate hypoglycemia symptoms for timely intervention in diabetes management.

Choice D reason: Sweating is a hallmark of hypoglycemia, caused by catecholamine release in response to low blood glucose. This statement is correct, as diaphoresis signals an acute need for glucose to prevent complications like seizures. The parent’s understanding is accurate, requiring no clarification in diabetes discharge teaching.

A. Steroids B. Antibiotics C. Fungicides D. Analgesics

Correct Answer is A

Explanation

Choice A reason: Nephrotic syndrome causes massive proteinuria, hypoalbuminemia, and edema due to reduced oncotic pressure. Steroids, like prednisone, reduce glomerular inflammation, decrease protein leakage, and restore oncotic pressure, alleviating edema. By targeting the underlying immune-mediated damage, steroids effectively reduce fluid retention, making them the primary medication class for managing edema in this condition.

Choice B reason: Antibiotics treat bacterial infections, which nephrotic syndrome patients are prone to due to immunoglobulin loss, but they do not address edema. Edema results from hypoalbuminemia, not infection. Antibiotics are used for complications like peritonitis, not for reducing fluid retention, making them ineffective for the primary management of nephrotic syndrome edema.

Choice C reason: Fungicides treat fungal infections, which are rare in nephrotic syndrome unless immunocompromised from prolonged steroid use. Edema in nephrotic syndrome stems from proteinuria and low albumin, not fungal pathology. Fungicides have no role in reducing fluid retention, making them irrelevant for addressing the primary pathophysiological mechanism of edema.

Choice D reason: Analgesics relieve pain, which is not a primary feature of nephrotic syndrome. Edema results from hypoalbuminemia, causing fluid shifts into interstitial spaces. Pain management does not address this mechanism or reduce fluid retention. Steroids target the root cause, making analgesics inappropriate for managing edema in nephrotic syndrome.

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Which finding in a newborn is suggestive of tracheoesophageal fistula?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing discharge teaching with the parent of a child who has a new diagnosis of diabetes mellitus. Which of the following statements by the parent requires a clarification of the teaching?

Correct Answer is C

Explanation

The nurse planning care for a child with nephrotic syndrome knows the classification of medication used to reduce edema in nephrotic syndrome is:

Correct Answer is A

Explanation

A nurse is caring for an infant who has gastroesophageal reflux. The nurse should place the infant in which of the following positions after feeding?

A hospitalized child has varicella. The nurse arranges for which type of infection precautions?

Which instructions should the nurse give parents about caring for a child with acute glomerulonephritis with edema?

What nursing action would be avoided when caring for a child diagnosed with Wilms’ tumor?

The nurse is caring for a child diagnosed with nephrosis. Symptoms that are characteristic of nephrosis include which of the following? (Select all that apply)

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