A nurse is caring for a male infant who has a palpable mass in the upper right quadrant and stools mixed with blood and mucus. The nurse should recognize that which of the following diagnoses is associated with these findings?
Hypertrophic pyloric stenosis
Intussusception
Inguinal hernia
Tracheoesophageal fistula
The Correct Answer is B
Choice A reason: Hypertrophic pyloric stenosis is a condition in which the pyloric sphincter becomes thickened and obstructs the passage of food from the stomach to the duodenum. It causes projectile vomiting, dehydration, and weight loss, but not a palpable mass or bloody stools.
Choice B reason: Intussusception is a condition in which a segment of the intestine telescopes into another segment, causing obstruction, inflammation, and ischemia. It causes a palpable mass in the upper right quadrant, abdominal pain, and stools mixed with blood and mucus, also known as "currant jelly" stools.
Choice C reason: Inguinal hernia is a condition in which a part of the intestine protrudes through a weak spot in the abdominal wall near the inguinal canal. It causes a bulge in the groin area, especially when the infant cries or strains. It does not cause a mass in the upper right quadrant or bloody stools.
Choice D reason: Tracheoesophageal fistula is a congenital anomaly in which there is an abnormal connection between the trachea and the esophagus. It causes excessive drooling, choking, coughing, and cyanosis during feeding, but not a palpable mass or bloody stools.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The child has a normal potassium level, as it is within the reference range of 3.5 to 5 mEq/L. Potassium is an electrolyte that helps regulate the fluid balance, nerve impulses, and muscle contractions in the body.
Choice B reason: The child has a low hemoglobin level, as it is below the reference range of 10 to 15.5 g/dL. Hemoglobin is a protein in the red blood cells that carries oxygen to the tissues. Sickle cell anemia is a genetic disorder that causes the red blood cells to have an abnormal shape and become rigid, sticky, and prone to clumping. This can lead to hemolysis, anemia, and reduced oxygen delivery.
Choice C reason: The child has a normal platelet level, as it is within the reference range of 150,000 to 450,000 mm^3^. Platelets are blood cells that help with clotting and prevent bleeding. Sickle cell anemia can cause thrombocytopenia, a low platelet count, due to increased destruction or sequestration of platelets in the spleen.
Choice D reason: The child has a normal blood glucose level, as it is within the reference range of 70 to 110 mg/dL. Blood glucose is the main source of energy for the cells in the body. Sickle cell anemia can cause hypoglycemia, a low blood glucose level, due to impaired glucose metabolism, increased glucose utilization, or decreased glucose production.
Correct Answer is A
Explanation
Choice A reason: This statement indicates a need for clarification, as sodium biphosphate/sodium phosphate is a laxative that can cause bowel perforation in a child with appendicitis. The nurse should question this prescription and avoid giving it to the child.
Choice B reason: This statement is correct, as maintaining NPO status is a standard intervention for a child with suspected appendicitis. It prevents further irritation of the appendix and prepares the child for possible surgery.
Choice C reason: This statement is correct, as monitoring oral temperature every 4 hours is a way to assess for signs of infection and inflammation in a child with suspected appendicitis. The nurse should also monitor for other symptoms such as abdominal pain, nausea, vomiting, and rebound tenderness.
Choice D reason: This statement is correct, as medicating the client for pain every 4 hours as needed is a way to provide comfort and relief for a child with suspected appendicitis. The nurse should use a pain scale to evaluate the effectiveness of the medication and report any changes in the pain level or location.

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