The nurse is caring for a 5-week-old infant presenting with a history of projectile vomiting after feedings.

Which additional finding should the nurse expect to assess?

Rebound tenderness in the left lower abdominal quadrant.

Stool that consists of mucus and blood.

Olive-size mass in the epigastric area.

Frequent burping accompanied by poor feeding.

Answer and Explanation

The Correct Answer is C

In a 5-week-old infant presenting with a history of projectile vomiting after feedings, the nurse should expect to assess an olive-size mass in the epigastric area. This finding is consistent with pyloric stenosis, a condition in which the muscle at the bottom of the stomach that controls the ﬂow of food into the small intestine becomes thickened and narrowed.

Rebound tenderness in the left lower abdominal quadrant, stool that consists of mucus and blood, and frequent burping accompanied by poor feeding are not typically associated with pyloric stenosis.

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Correct Answer is A

Explanation

The adolescent client's symptoms of localized pain, swelling, and tenderness, particularly at night, are suggestive of a malignancy such as osteosarcoma, which is the most common primary bone tumor in children and adolescents.

Radial ossification in the soft tissues is a characteristic finding in osteosarcoma and is indicative of bone production by malignant cells. Other imaging modalities, such as X-rays, computed tomography (CT), and magnetic resonance imaging (MRI), may also reveal osteolytic or osteoblastic lesions in the bone.

Growing pains are a common, benign condition that occur in children and do not typically present with the

symptoms described in the case scenario.

Rhabdomyolysis is a medical emergency that involves the breakdown of skeletal muscle tissue and release of muscle fiber contents into the bloodstream. It can present with muscle pain, swelling, and tenderness, but typically occurs as a result of injury, infection, or drug toxicity.

Hemosiderosis is a rare condition characterized by the accumulation of iron in various tissues, including the liver, spleen, and bone marrow. It may present with symptoms such as fatigue, joint pain, and abdominal pain, but is not typically associated with the symptoms and imaging findings described in the case scenario.

Therefore, the nurse should consider osteosarcoma as the probable cause of the adolescent client's symptoms and imaging findings, and should collaborate with the healthcare team to develop a plan of care for diagnosis and treatment.

A. Have the child blow a cotton ball and have the parent catch it. B. Place a toy in the child's hands while listening to the breath sounds. C. Oﬀer the child bubbles before the stethoscope is placed. D. Allow the child to use a stethoscope on a stuﬀed animal.

Correct Answer is D

Explanation

To ensure the cooperation of a preschooler during an assessment of lung sounds, the nurse can allow the child to use a stethoscope on a stuﬀed animal. This helps the child understand what is happening and feel more comfortable with the procedure. Having the child blow a cotton ball (A), placing a toy in the child's hands (B), and oﬀering bubbles (C ) may distract the child but do not directly involve them in the procedure.

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The nurse is caring for a 5-week-old infant presenting with a history of projectile vomiting after feedings. Which additional finding should the nurse expect to assess?

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Correct Answer is A

Explanation

The nurse is assessing the lung sounds of a preschooler. Which action should the nurse implement to ensure the child's cooperation?

Correct Answer is D

Explanation

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The nurse is caring for a 5-week-old infant presenting with a history of projectile vomiting after feedings.

Which additional finding should the nurse expect to assess?