When a 2-week-old infant is seen for irritability, poor appetite, and rapid head growth with observable distended scalp veins, the nurse recognizes these signs as indicative of which disorder?
Cerebral palsy
Syndrome of inappropriate antidiuretic hormone (SIADH)
Hydrocephalus
Reye's syndrome
The Correct Answer is C
Hydrocephalus refers to a condition characterized by an abnormal accumulation of cerebrospinal fluid (CSF) within the ventricles of the brain. In infants, hydrocephalus can cause the head to enlarge rapidly as a result of the increased pressure exerted by the accumulating fluid. This is known as "rapid head growth." The increased intracranial pressure canlead to irritability and poor appetite in infants.
The distended scalp veins are another common sign of hydrocephalus. As the fluid accumulates, it puts pressure on theblood vessels in the brain, causing the veins in the scalp to become more visible and distended.
Cerebral palsy in (option A) is incorrect because is a neurological disorder that affects body movement and musclecoordination, but it does not typically present with rapid head growth or distended scalp veins.
Syndrome of inappropriate antidiuretic hormone (SIADH) in (option B) is incorrect because it is a condition characterized by excessive secretion of antidiuretic hormone, leading to fluid imbalance, but it does not usually cause rapid head growth or distended scalp veins. Reye's syndrome (D) is a rare condition that primarily affects the liver and brain, and it does not typically present with rapid head growth or distended scalp veins.
Therefore, based on the signs described, hydrocephalus (C) is the most likely disorder in this case. It is important to seekmedical attention promptly for a proper diagnosis and appropriate management of hydrocephalus in infants.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
When caring for a child with an open fracture, the nurse should carefully assess for signs and symptoms of infection. An open fracture refers to a fracture where the bone is exposed through the skin, creating a direct pathway for microorganisms to enter and cause infection. Infection is a significant concern in open fractures and can lead to serious complications if not identified and treated promptly. Signs of infection may include increased pain, swelling, redness, warmth, purulent drainage, fever, or systemic signs of infection such as elevated white blood cell count.
Osteoarthritis in (option A) is incorrect because it, is not an immediate concern in the care of a child with an open fracture. Osteoarthritis refers to degenerative joint disease that typically develops over time and is not directly related to the acute management of an open fracture.
epiphyseal disruption in (option B) is incorrect because it, refers to an injury involving the growth plate (epiphyseal plate) that can affect bone growth and development. While it is a potential concern in fractures that involve the growth plate, it is not specific to open fractures and may not be an immediate priority in the initial assessment of an open fracture.
periosteum thickening in (option D) is incorrect because it, may occur in response to injury and fracture healing, but it is not specifically associated with open fractures and is not a primary focus in the initial assessment of an open fracture.
Correct Answer is C
Explanation
Celiac disease is an autoimmune disorder triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. It causes damage to the lining of the small intestine, leading to malabsorption of nutrients. The characteristic symptoms of celiac disease include abdominal distention, underweight or failure to thrive, thin arms and legs, and foul-smelling stools.
intussusception in (option A) is incorrect because it, refers to a condition where a portion of the intestine telescopes into an adjacent section, causing an obstruction. While intussusception can present with symptoms such as abdominal pain, vomiting, and currant jelly-like stools, it is not typically associated with failure to thrive.
imperforate anus, in (option B) is incorrect because it is a congenital condition in which the opening of the anus is blocked or absent. It can cause difficulties with passing stools, but it is not typically associated with failure to thrive or the specific assessment findings described.
irritable bowel syndrome (IBS) in (option D) is incorrect because it, is a chronic disorder of the gastrointestinal tract characterized by recurrent abdominal pain, changes in bowel habits, and bloating. While IBS can cause gastrointestinal symptoms, it is not typically associated with failure to thrive, underweight, or the specific assessment findings mentioned.
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