A nurse is caring for a 6-week-old infant diagnosed with pyloric stenosis. Which of the following clinical manifestations should the nurse expect?
Distended neck veins
Red currant jelly stools
Weight loss
Occasional vomiting
The Correct Answer is C
A. Distended neck veins are typically seen in cases of heart failure or other circulatory issues, not pyloric stenosis.
B. Red currant jelly stools are associated with intussusception, not pyloric stenosis.
C. Weight loss is a common manifestation of pyloric stenosis due to vomiting and poor nutrient intake. This occurs as the narrowing of the pylorus obstructs the passage of food.
D. Occasional vomiting could be a sign of pyloric stenosis, but the hallmark feature is projectile vomiting, which occurs more frequently and is often more forceful.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Fruit juice is high in sugar and does not provide the same hydration as water. It is important to limit juice intake to avoid overconsumption of sugars and to encourage water as the primary fluid.
B. Allowing a toddler unlimited sweets and snacks is not advisable, as it can lead to poor nutritional habits and imbalanced diet. Picky eating should be addressed with nutritious alternatives, not by offering sweets.
C. Offering a variety of foods from different food groups ensures a balanced diet that includes essential nutrients for growth and development. This is the correct approach for toddler nutrition.
D. Dairy products are an important source of calcium and vitamin D for toddlers. Avoiding them without a medical reason can result in nutritional deficiencies.
Correct Answer is B
Explanation
A. Administering saline drops may be appropriate if there is a foreign body or irritation, but it is not the priority in a case of blurred vision.
B. The priority is to assess the child's visual acuity to determine the severity and possible cause of the blurred vision. This is essential to guide further diagnostic steps.
C. Cleansing the eyes may be helpful if there is visible debris or infection, but it is not the first priority in assessing blurred vision.
D. Obtaining a history is important but would follow after the visual acuity assessment, as it can help provide context for the symptoms.
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