A nurse is caring for a toddler who has intussusception.
Which of the following manifestations should the nurse expect?
Mucus and blood in stools.
Increased appetite.
Jaundice.
Drooling.
The Correct Answer is A
Choice A rationale
Mucus and blood in stools, often described as “currant jelly” stools, are a common symptom of intussusception.
Choice B rationale
Increased appetite is not typically associated with intussusception. In fact, children with this condition may experience decreased appetite due to abdominal pain.
Choice C rationale
Jaundice is not a symptom of intussusception. Jaundice, a yellowing of the skin and eyes, is more commonly associated with liver conditions.
Choice D rationale
Drooling is not a typical symptom of intussusception. Symptoms of intussusception are primarily gastrointestinal, including abdominal pain and bloody stools.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Assessing fluid balance is the priority action when caring for a child with severe diarrhea. Diarrhea can lead to significant fluid and electrolyte loss, which can result in dehydration. Early recognition and treatment of dehydration are crucial to prevent further complications.
Choice B rationale
While maintaining fluid therapy is an important part of managing severe diarrhea, the first step should be to assess the child’s fluid balance.
Choice C rationale
Rehydration is a key part of the treatment for severe diarrhea, but it should be done after assessing the child’s fluid balance.
Choice D rationale
Introducing a regular diet is usually done after the acute phase of diarrhea has resolved and the child’s fluid balance has been restored.
Correct Answer is D
Explanation
Choice A rationale
Rapid respirations are not typically a manifestation of hypoglycemia. They are more commonly associated with conditions that cause metabolic acidosis, such as diabetic ketoacidosis.
Choice B rationale
Diminished reflexes are not a typical manifestation of hypoglycemia. They may be seen in conditions affecting the nervous system.
Choice C rationale
Acetone breath is not a manifestation of hypoglycemia. It is a sign of ketoacidosis, which is a complication of hyperglycemia, not hypoglycemia.
Choice D rationale
Diaphoresis, or sweating, is a common symptom of hypoglycemia. The body produces sweat as part of the sympathetic nervous system’s response to hypoglycemia.
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