The clinic nurse reviews the record of an infant and notes that the primary health care provider (PHCP) has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which sign most likely led the parent to seek health care for the infant?
Diarrhea
Regurgitation of feedings
Projectile vomiting
Foul-smelling ribbon-like stools
The Correct Answer is D
A. Diarrhea
Explanation: Diarrhea is not a typical sign of Hirschsprung's disease. Instead, the condition is associated with constipation due to the obstructed passage of stool.
B. Regurgitation of feedings
Explanation: Regurgitation of feedings is not a characteristic sign of Hirschsprung's disease. It may be seen in other gastrointestinal conditions, but not specifically in this disorder.
C. Projectile vomiting
Explanation: Projectile vomiting is not a typical sign of Hirschsprung's disease. It may be associated with conditions such as pyloric stenosis, but it is not a characteristic feature of Hirschsprung's disease.
D. Foul-smelling ribbon-like stools
Explanation:
Hirschsprung's disease is a congenital condition characterized by the absence of ganglion cells in the rectum and a portion of the colon. The lack of ganglion cells results in functional obstruction, causing stool to accumulate in the affected area. One of the hallmark signs is the presence of foul-smelling, ribbon-like stools, often described as "fecal pellets" or "pellets" due to the obstructed passage of stool.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. That lethargy and vomiting are normal with mumps:
Incorrect: Lethargy and vomiting are not typical symptoms of mumps. These symptoms could indicate a separate issue that requires medical attention.
B. To continue to monitor the child:
Incorrect: Given the reported symptoms of lethargy and vomiting, a passive approach of continuing to monitor may delay necessary medical intervention. The child should be assessed promptly.
C. To bring the child to the clinic to be seen by the pediatrician:
Correct Answer: Lethargy and vomiting are not typical symptoms of uncomplicated mumps. These symptoms could be indicative of other issues, and it's important for the pediatrician to evaluate the child to determine the cause and provide appropriate care.
D. That there is nothing to be concerned about as long as there is no fever:
Incorrect: While fever is a common symptom of mumps, the absence of fever does not negate the need for further evaluation when there are concerning symptoms like lethargy and vomiting. The child should be seen by a healthcare provider to determine the cause of these symptoms.
Correct Answer is D
Explanation
A. Administer 0.9% sodium chloride IV solution: Although IV fluids might be necessary to maintain hydration and circulation, this is not the priority over preventing the spread of infection.
B. Assist with obtaining an x-ray of the child's neck.Imaging can help confirm the diagnosis but should be done after ensuring infection control measures.
C. Initiate IV antibiotics.Antibiotics are crucial for treatment but should follow the implementation of droplet precautions to prevent the spread of infection.
D. Place the child on droplet precautions.
Epiglottitis is a medical emergency primarily caused by bacterial infections, such as Haemophilus influenzae type B (Hib). The first priority is to ensure the safety of both the patient and others by preventing the spread of infection.Placing the child on droplet precautions helps to contain the bacteria and protect healthcare workers and other patients.

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