A nurse is assessing a child who has appendicitis. Which of the following findings should the nurse expect?
Pain
High fever
Constipation
Bradycardia
The Correct Answer is A
Choice A reason: Pain is an expected finding for a child who has appendicitis, as it is caused by the inflammation and infection of the appendix, which is a small pouch attached to the cecum. Pain usually begins around the umbilicus and then shifts to the right lower quadrant, and it may worsen with movement, coughing, or deep breathing.
Choice B reason: High fever is not an expected finding for a child who has appendicitis, as it indicates a severe infection or a perforation of the appendix, which can lead to peritonitis or sepsis. A mild fever may be present in some cases of appendicitis, but it is not a specific or reliable sign.
Choice C reason: Constipation is not an expected finding for a child who has appendicitis, as it is not related to the function or location of the appendix. Constipation may be caused by many other factors, such as dehydration, diet, medication, or bowel habits. Diarrhea may occur in some cases of appendicitis, but it is also not a specific or reliable sign.
Choice D reason: Bradycardia is not an expected finding for a child who has appendicitis, as it indicates a decreased heart rate, which can be a sign of shock, hypothermia, or cardiac problems. Bradycardia is defined as a heart rate below 60/min in children older than 1 year, or below 100/min in infants younger than 1 year. Tachycardia, or an increased heart rate, may occur in some cases of appendicitis, as a result of pain, fever, or dehydration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Keeping the baby in an upright position after feedings is an effective strategy to prevent or reduce gastroesophageal reflux, as it allows gravity to help the stomach contents stay down. The parent should hold the baby upright for at least 20 to 30 minutes after each feeding, and avoid placing the baby in a car seat or swing, which can increase the abdominal pressure.
Choice B reason: Feeding the baby formula rather than breast milk is not necessary for gastroesophageal reflux, as breast milk is easier to digest and less likely to cause reflux than formula. The parent should continue to breastfeed the baby, unless there is a medical reason to switch to formula. The parent should also avoid overfeeding the baby, and burp the baby frequently during and after feedings.
Choice C reason: Positioning the baby lying on his stomach is not recommended for gastroesophageal reflux, as it can increase the risk of aspiration, suffocation, and sudden infant death syndrome (SIDS). The parent should place the baby on his back to sleep, and elevate the head of the crib or bassinet by 30 degrees to reduce the reflux.
Choice D reason: Thickening the baby's formula with honey is not advised for gastroesophageal reflux, as honey can cause botulism, a serious and potentially fatal illness, in infants under one year of age. The parent should not add any thickening agents to the formula, unless prescribed by the provider. Some studies suggest that thickening the formula with rice cereal may reduce the reflux, but the evidence is inconclusive and the practice may have adverse effects, such as increased caloric intake, constipation, or food allergies.
Correct Answer is B
Explanation
Choice A reason: Nephritic syndrome is a kidney disorder that causes inflammation and damage to the glomeruli, the filtering units of the kidneys. It can cause hematuria (blood in the urine), proteinuria (protein in the urine), hypertension (high blood pressure), and edema (swelling). However, it does not cause a palpable abdominal mass, which is a characteristic sign of Wilms tumor.
Choice B reason: Wilms tumor is a malignant tumor of the kidney that occurs mainly in children under 5 years of age. It can cause a large, firm, and painless abdominal mass, hematuria, abdominal pain, fever, and hypertension. It is the most common renal tumor in children and requires prompt diagnosis and treatment.
Choice C reason: Pyloric stenosis is a condition that causes narrowing of the pylorus, the outlet of the stomach. It can cause projectile vomiting, dehydration, weight loss, and a palpable olive-shaped mass in the upper abdomen. However, it does not cause hematuria or a large abdominal mass.
Choice D reason: Intussusception is a condition that occurs when a part of the intestine slides into another part, causing a blockage. It can cause abdominal pain, vomiting, bloody stools, and a sausage-shaped mass in the abdomen. However, it does not cause hematuria or a large abdominal mass.
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