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 ["A","C","E"]
Explanation
A. "The manifestations are lessened by taking the prednisone every other day instead of daily."
Correct Answer: Cushingoid characteristics can be associated with long-term corticosteroid use. Taking prednisone every other day, rather than daily, can help minimize these manifestations while still providing the needed therapeutic effect.
B. "You need to be sure to talk to the doctor about the Cushingoid characteristics."
Incorrect: While it is important for the parents to communicate with the doctor, this statement is less therapeutic than option 3, which opens up a more collaborative and supportive conversation.
C. "Which manifestations of this condition do you find most troublesome?"
Correct Answer: This open-ended question allows the parents to express their concerns and frustrations. It facilitates communication between the parents and healthcare provider to address specific issues they find most troublesome.
D. "I am sure it will be all right; they hardly look unusual."
Incorrect: Downplaying the parents' concerns may not be the most therapeutic approach. Acknowledging their concerns and providing information about the reversible nature of cushingoid characteristics would be more helpful.
E. "The cushingoid appearance will gradually disappear once the corticosteroids are tapered and discontinued."
Correct Answer: Cushingoid characteristics are reversible, and they tend to improve as the dose of corticosteroids is tapered and eventually discontinued.

Correct Answer is B
Explanation
A. The child is too young to receive antibiotics: This statement doesn't address the actual reason for not prescribing antibiotics for croup, which is primarily due to its viral nature.
B. "Antibiotics are not indicated unless a bacterial infection is present."
Explanation:
Viral laryngotracheobronchitis, commonly known as croup, is typically caused by a viral infection, most commonly by the parainfluenza virus. Antibiotics are not effective against viruses. Therefore, unless a bacterial infection is also present, prescribing antibiotics is not necessary or beneficial in treating croup.
C. The child may be allergic to antibiotics: While antibiotic allergies are a consideration, it doesn't explain why antibiotics are not prescribed for viral illnesses like croup.
D. The child still has the maternal antibodies from birth and does not need antibiotics: Maternal antibodies can offer some protection against infections, but the primary reason for not using antibiotics in viral infections like croup is because antibiotics are ineffective against viruses.

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