The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which sign of this disorder documented?
Ribbon-like stools
Profuse projectile vomiting
Bright red blood and mucus in the stools
Watery diarrhea
The Correct Answer is C
A. Ribbon-like stools
Explanation: Ribbon-like or pencil-thin stools are associated with conditions affecting the rectum, such as colorectal cancer, but they are not a typical sign of intussusception.
B. Profuse projectile vomiting
Explanation: Profuse projectile vomiting is not a typical sign of intussusception. Vomiting may occur, but it is not the primary characteristic feature.
C. Bright red blood and mucus in the stools
Explanation:
Intussusception is a condition in which one part of the intestine slides into another, causing a blockage. One of the classic signs of intussusception is the presence of "currant jelly" stools, which are characterized by a mixture of bright red blood and mucus in the stools. This occurs due to the compression of the blood vessels in the intestine, leading to bleeding and mucosal discharge.
D. Watery diarrhea
Explanation: Watery diarrhea is not a typical sign of intussusception. The condition is more commonly associated with abdominal pain, vomiting, and the characteristic "currant jelly" stools.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "Has the child had any difficulty swallowing food?"
Explanation:
Cleft palate repair can impact various aspects of a child's development, and one potential long-term effect is difficulty with swallowing or feeding. This question is relevant to assessing the child's oral and feeding function, which can be influenced by the cleft palate repair.
B. "Does the child play with an imaginary friend?"
Explanation: Imaginary play and social interactions are not directly related to the long-term effects of cleft palate repair. This question focuses more on social and imaginative development.
C. "Does the child respond when called by name?"
Explanation: Responsiveness to one's name is a general developmental milestone and is not directly related to the long-term effects of cleft palate repair.
D. "Was the child recently treated for pneumonia?"
Explanation: While respiratory issues can be a concern in children with a history of cleft palate, this question is more specific to recent health issues and does not address the long-term effects of cleft palate repair.
Correct Answer is B
Explanation
A. "I will limit my child's fluid intake."
Incorrect: Limiting fluid intake is not typically recommended for children with CF. Maintaining hydration is important, especially since individuals with CF may have increased salt losses in sweat.
B. "We will give our child pancreatic enzymes with snacks and meals."
Correct Answer: This response indicates an understanding of the importance of giving pancreatic enzymes to assist with digestion, as individuals with CF often have pancreatic insufficiency. Pancreatic enzymes help in the absorption of nutrients from food.
C. "We will restrict the amount of salt in our child's food."
Incorrect: While it's true that individuals with CF may need to increase their salt intake due to increased salt losses in sweat, this response suggests restricting salt, which is not in line with the nutritional needs of a child with CF.
D. "I will prepare low-fat meals with limited protein for my child."
Incorrect: Children with CF often need a higher calorie intake, including healthy fats and adequate protein. Restricting fat and protein is not in line with the nutritional needs of a child with CF.
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