The telephone triage nurse at a pediatric clinic knows each call is important. Which call would require attentiveness from the nurse because of an increased risk for mortality?

A 3-week-old infant born at 35 weeks’ gestation with gastroenteritis

A term 2-week-old infant of American Indian descent with an upper respiratory infection

A post-term 4-week-old infant, Black descent, with moderate emesis after feeding

A 1-week-old infant born at 40 weeks’ gestation with symptoms of cough

Answer and Explanation

The Correct Answer is A

a) A 3-week-old infant born at 35 weeks’ gestation with gastroenteritis: Premature infants are more vulnerable to complications, and gastroenteritis can lead to dehydration, which can be critical for a newborn.

b) A term 2-week-old infant of American Indian descent with an upper respiratory infection: While concerning, it might not pose an immediate threat of mortality compared to conditions affecting premature infants.

c) A post-term 4-week-old infant, Black descent, with moderate emesis after feeding: Vomiting after feeding might indicate various issues but might not immediately suggest a high risk of mortality.

d) A 1-week:old infant born at 40 weeks’ gestation with symptoms of cough: Cough alone might not indicate severe conditions in a newborn.

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Correct Answer is B

Explanation

a) Acute diarrhea, dehydration: Not typically associated with Hirschsprung disease, which involves constipation.

b) Failure to pass meconium, abdominal distension: Characteristic signs of Hirschsprung disease due to the absence of ganglion cells in the distal colon, leading to constipation and distension.

c) Gelatinous stools, pain: Uncommon features of Hirschsprung disease.

d) Projectile vomiting, altered electrolytes: These symptoms are not typically seen in Hirschsprung disease; they might indicate other conditions affecting the gastrointestinal tract.

A. Side lying B. Knees to chest C. Prone D. Back

Correct Answer is B

Explanation

a) Side lying: Unlikely to improve oxygenation significantly during a Tet spell.

b) Knees to chest: This position can help improve oxygenation by increasing systemic vascular resistance and decreasing right-to-left shunting in Tetralogy of Fallot during a Tet spell.

c) Prone: May not be ideal as it might interfere with breathing in a child experiencing a Tet spell.

d) Back: While the supine position is generally recommended for most situations, in a Tet spell, knee-to-chest positioning might be more beneficial for oxygenation.

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The telephone triage nurse at a pediatric clinic knows each call is important. Which call would require attentiveness from the nurse because of an increased risk for mortality?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A newborn is diagnosed with Hirschsprung disease. Which clinical manifestations found on assessment support this newborn’s diagnosis?

Correct Answer is B

Explanation

You are caring for a 2-year-old child with tetralogy of Fallot that is experiencing a TET spell. What positioning will best promote oxygenation for this child?

Correct Answer is B

Explanation

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