Which of the following is a classic hallmark sign associated with intussusception in infants?
Projectile vomiting.
Severe diarrhea.
Currant-jelly stools.
Bilious vomiting.
The Correct Answer is C
Intussusception involves the telescoping of one intestinal segment into another, causing lymphatic and venous obstruction. Knowledge of gastrointestinal manifestations is critical to identify life-threatening ischemia and bowel necrosis in infants presenting with sudden abdominal pain and stool changes.
Choice A rationale
Projectile vomiting is a characteristic clinical finding of hypertrophic pyloric stenosis, not intussusception. It results from gastric outlet obstruction due to muscular thickening, occurring without the presence of bile, typically seen in infants aged three to six weeks.
Choice B rationale
Severe diarrhea typically indicates infectious gastroenteritis or malabsorption syndromes. In intussusception, the bowel is obstructed by the invagination process, which usually prevents the passage of normal diarrheal stools as the intestinal lumen becomes physically blocked and compressed.
Choice C rationale
Currant-jelly stools contain a mixture of blood and mucus, occurring as the compressed intestinal mucosa sheds. This classic hallmark reflects venous congestion and ischemia within the intussusceptum, indicating a high risk for impending bowel perforation and necrosis.
Choice D rationale
Bilious vomiting suggests a distal intestinal obstruction but is not specific to intussusception. While it can occur as the condition progresses, it lacks the diagnostic specificity of the vascular-related stool changes that define the classic clinical presentation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Streptococcal pharyngitis requires complete eradication of Group A Beta-Hemolytic Streptococcus. Nurses must apply knowledge of autoimmune sequelae to explain how residual bacteria can trigger systemic inflammatory responses, leading to permanent organ damage if the full pharmacological course is not completed.
Choice A rationale
While rapid return to school is a benefit of treatment, it is not the primary clinical goal. School return is usually permitted 24 hours after starting antibiotics, but this does not address the prevention of long-term systemic complications.
Choice B rationale
Reducing transmission is a secondary public health benefit, but it does not represent the primary medical necessity for the specific patient. The focus of complete therapy is the prevention of post-streptococcal autoimmune reactions within the child's own body.
Choice C rationale
Preventing antibiotic resistance is a global health priority, but the clinical rationale for pediatric streptococcal infections specifically targets the high risk of heart and kidney damage. Resistance is a broad concern rather than a patient-specific prophylactic goal.
Choice D rationale
Untreated Group A Streptococcus can lead to acute rheumatic fever, causing permanent cardiac valve damage, or acute glomerulonephritis, leading to renal failure. Completion of the full antibiotic course is essential to eliminate the antigens that trigger these.
Correct Answer is C
Explanation
This scenario requires applying knowledge of immunology and vaccine timing following the administration of blood products or immunoglobulins. Understanding how exogenous antibodies interfere with the replication of live-attenuated vaccines is crucial for ensuring effective immunization schedules in pediatric patients.
Choice A rationale
The rotavirus vaccine is a live-attenuated virus usually administered in early infancy. Since this child is older and having an annual exam, this vaccine is not typically indicated, regardless of the timing of the prior immunoglobulin treatment.
Choice B rationale
High-dose immunoglobulin treatment interferes with the immune response to the live MMR vaccine. Guidelines usually recommend delaying live vaccines for 8 to 11 months after IVIG to ensure the child can mount an appropriate endogenous antibody response.
Choice C rationale
The inactivated influenza vaccine does not contain live virus and is not affected by circulating antibodies from immunoglobulin therapy. It should be administered annually to children to provide protection against seasonal viral strains without requiring any delay.
Choice D rationale
Varicella is a live-attenuated vaccine. Similar to MMR, the exogenous antibodies from the 4-month-ago IVIG treatment will likely neutralize the vaccine virus before it can trigger a long-term immune memory, necessitating a longer delay before administration.
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