What clinical manifestation in a newborn would cause a nurse to suspect the diagnosis of tracheoesophageal fistula (TEF)?

An orogastric tube fails to pass at birth.

The infant has a low birth weight.

It is visually identified at the time of delivery.

Dry mouth and nares, little to no oral secretions at delivery.

Answer and Explanation

The Correct Answer is A

Choice A reason: This is the correct choice. If an orogastric tube fails to pass, it may indicate a blockage or abnormal connection, such as a tracheoesophageal fistula.
Choice B reason: Low birth weight can be associated with many conditions and is not specific to TEF.
Choice C reason: TEF is not typically visible without special imaging or procedures; it cannot be visually identified at delivery.
Choice D reason: Dry mouth and nares with little to no oral secretions could indicate other conditions and are not specific to TEF. TEF often presents with excessive oral secretions.

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Correct Answer is B

Explanation

Choice A reason: Severe fatigue is a symptom that can be associated with many conditions and is not specific to Wilms tumor.
Choice B reason: This is the correct choice. A palpable abdominal mass is often the first sign of a Wilms tumor that prompts medical evaluation.
Choice C reason: Seizures are not typically associated with Wilms tumor.
Choice D reason: Hematuria can occur with Wilms tumor, but it is not as common as the presentation of an abdominal mass.

A. "The baby's 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor." B. "I placed the baby in the infant swing. His 6-year-old brother was running through the house and tripped over the swing, causing it to fall." C. "I was walking up the steps and slipped on the ice, falling while carrying my baby." D. "I did not realize that my baby was able to roll over yet, and I was just gone a minute to check on dinner when the baby rolled off of the couch and onto our tile floor."

Correct Answer is D

Explanation

Choice A reason: This choice might not arouse suspicion as it could be a plausible accident involving siblings.

Choice B reason: This choice also might not arouse suspicion as accidents can happen when children are playing and not being watched closely.

Choice C reason: This choice is less likely to arouse suspicion as slipping on ice is a common accident.

Choice D reason: This is the correct choice. The statement may arouse suspicion because it suggests negligence, as the caregiver left the baby unattended in a potentially dangerous situation.

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What clinical manifestation in a newborn would cause a nurse to suspect the diagnosis of tracheoesophageal fistula (TEF)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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