The nurse is caring for a 5-week-old infant with suspected hypertrophic pyloric stenosis. Which clinical manifestation would indicate this condition?
Bilious vomiting and constipation
Abdominal distention and currant jelly-like stools
Rounded abdomen and hypoactive bowel sounds
Ravenously hungry after vomiting
The Correct Answer is D
Choice A reason:
Bilious vomiting and constipation are not typical manifestations of hypertrophic pyloric stenosis. Bilious vomiting, which is green or yellow, indicates that the vomit contains bile and is usually associated with intestinal obstruction beyond the stomach. Hypertrophic pyloric stenosis typically causes non-bilious, projectile vomiting because the obstruction is at the pylorus, before the bile duct.
Choice B reason:
Abdominal distention and currant jelly-like stools are not indicative of hypertrophic pyloric stenosis. Currant jelly-like stools are a classic sign of intussusception, a different condition where part of the intestine telescopes into itself. While abdominal distention can occur in pyloric stenosis, the presence of currant jelly-like stools points to a different diagnosis.
Choice C reason:
A rounded abdomen and hypoactive bowel sounds can be seen in various gastrointestinal conditions but are not specific to hypertrophic pyloric stenosis. While a rounded abdomen may be present due to gastric distention, hypoactive bowel sounds are not a hallmark of this condition. The primary symptom of pyloric stenosis is projectile vomiting.
Choice D reason:
Ravenously hungry after vomiting is a classic manifestation of hypertrophic pyloric stenosis. Infants with this condition often vomit forcefully after feeding and then appear hungry again because the food does not pass through the pylorus into the intestines. This symptom, along with projectile vomiting, is a key indicator of pyloric stenosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A: OI is Easily Treated
Osteogenesis imperfecta (OI) is not easily treated. It is a genetic disorder characterized by fragile bones that break easily. While there are treatments available to manage symptoms and improve quality of life, there is no cure for OI1. Treatments include medications to strengthen bones, physical therapy, and surgical procedures.
Choice B: With a Later Onset, the Disease Usually Runs a More Difficult Course
The severity of osteogenesis imperfecta can vary widely, but it is not necessarily true that a later onset leads to a more difficult course. The course of the disease depends on the type of OI and the specific genetic mutation involved. Some types of OI are more severe and present earlier in life, while others are milder and may not be diagnosed until later.
Choice C: Braces and PT Exercises are of No Therapeutic Value
This statement is incorrect. Braces and physical therapy (PT) exercises are valuable in managing osteogenesis imperfecta. Physical therapy helps in building muscle strength, improving joint movement, and preventing fractures. Braces can provide support for weak muscles, decrease pain, and keep joints properly aligned.
Choice D: OI is an Inherited Disorder
This statement is true. Osteogenesis imperfecta is a genetic disorder that is usually inherited in an autosomal dominant pattern. This means that a person only needs one copy of the defective gene from one parent to inherit the disorder. In some cases, OI can also occur due to a spontaneous mutation.
Correct Answer is ["A","B","C"]
Explanation
The correct answers are a) Use a straw to administer the medication, b) Give the medication with vitamin C, and c) It is best to give the medication with food.
Choice A reason:
Using a straw to administer ferrous sulfate is recommended to prevent staining of the teeth. Ferrous sulfate, especially in liquid form, can cause discoloration of the teeth if it comes into direct contact with them. By using a straw, the medication bypasses the teeth, reducing the risk of staining.
Choice B reason:
Giving ferrous sulfate with vitamin C is beneficial because vitamin C enhances the absorption of iron. Vitamin C (ascorbic acid) helps convert iron into a form that is more easily absorbed by the body. Therefore, administering ferrous sulfate with a source of vitamin C, such as orange juice, can improve its effectiveness.
Choice C reason:
It is best to give ferrous sulfate with food to reduce gastrointestinal side effects. While iron is best absorbed on an empty stomach, it can cause stomach upset, nausea, and constipation. Taking the medication with food can help mitigate these side effects, making it more tolerable for the child.
Choice D reason:
Giving ferrous sulfate with milk is not recommended. Dairy products, including milk, can interfere with the absorption of iron. Calcium in milk binds with iron, reducing its bioavailability and effectiveness. Therefore, it is best to avoid giving ferrous sulfate with milk or other dairy products.
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