A nurse is caring for a 3-day-old newborn and suspects Hirschsprung disease. What finding best supports the nurse's concern?

The infant has passed several tar-like stools.

The infant has not gained weight and has stooled once.

The infant has not stooled.

The infant has passed hard, pellet-like stools.

Answer and Explanation

The Correct Answer is C

A. Passing tar-like stools is normal for newborns within the first few days of life and does not indicate Hirschsprung disease.

B. Limited stooling and poor weight gain may suggest feeding issues but are not as indicative of Hirschsprung disease as the absence of stool.

C. The absence of stool (failure to pass meconium within 24-48 hours) is a classic sign of Hirschsprung disease, a condition where the absence of ganglion cells in the intestines leads to a blockage.

D. Passing hard, pellet-like stools may indicate constipation but is not specific to Hirschsprung disease, especially in a newborn.

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Correct Answer is B

Explanation

A. Insulin doses should not be reduced when sick, as illness often increases blood glucose levels.

B. Eating a snack before physical activity helps prevent hypoglycemia, demonstrating a good understanding of how to manage blood glucose levels during exercise.

C. Counting carbohydrates, not fat calories, is essential for managing blood glucose levels in diabetes.

D. Blood glucose levels are typically checked before meals and at other key times, rather than only after meals.

A. "Your child needs to go to the hospital as soon as possible." B. "Have your child use their inhaled corticosteroid and follow it with albuterol." C. "Your child needs to administer salmeterol right away." D. "Continue to watch the PEFR readings and call back if they go below 40%."

Correct Answer is B

Explanation

A. A PEFR of 45% of the personal best indicates a moderate asthma exacerbation, but immediate hospitalization is not necessarily required unless there are severe symptoms or other indicators of serious distress.

B. At 45% of the personal best PEFR, the child is experiencing a moderate asthma exacerbation. The recommended action is to use a quick-relief inhaler like albuterol, which is effective in providing immediate relief. Inhaled corticosteroids are part of the long-term management but should not replace the use of a quick-relief inhaler during an exacerbation.

C. Salmeterol is a long-acting beta-agonist used for maintenance therapy and is not typically used for acute exacerbations. Albuterol is preferred in this situation for immediate relief.

D. While monitoring PEFR is important, action should be taken when PEFR falls below 50% of the personal best, and more immediate intervention is needed at 45% of the personal best.

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A nurse is caring for a 3-day-old newborn and suspects Hirschsprung disease. What finding best supports the nurse's concern?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a school-age client who has a new diagnosis of type 1 diabetes mellitus. Which statement by the client indicates an understanding of the teaching?

Correct Answer is B

Explanation

A school-age client with asthma has been monitoring their daily peak expiratory flow rates(PEFR). The client's mother calls the clinic to report that the PEFR was at 45% of their personal best. Which guidance should the nurse provide to the mother?

Correct Answer is B

Explanation

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A nurse is caring for a 3-day-old newborn and suspects Hirschsprung disease. What finding best supports the nurse's concern?

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