A child is admitted with extensive burns. The nurse notes burns on the child's lips and singed nasal hairs. The nurse should suspect that the child has a(n)

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Question 1 of 5

A child is admitted with extensive burns. The nurse notes burns on the child's lips and singed nasal hairs. The nurse should suspect that the child has a(n)

Correct Answer: B

Rationale: Burns on the lips and singed nasal hairs are indicative of an inhalation injury. This suggests that the child has likely inhaled hot gases or smoke, leading to damage in the respiratory tract. Choice A, chemical burn, is incorrect because the symptoms described are more aligned with inhalation rather than direct contact with chemicals. Choice C, electrical burn, is incorrect as there are no mentions of contact with an electrical source. Choice D, hot-water scald, is also incorrect as the presentation of burns on the lips and singed nasal hairs is not characteristic of scald injuries.

Question 2 of 5

What is the typical therapeutic management treatment for children with Hirschsprung disease?

Correct Answer: D

Rationale: The most common treatment for Hirschsprung disease is the surgical removal of the affected section of the bowel. This procedure entails excising the part of the colon that lacks nerve cells crucial for normal bowel function. Daily enemas (Choice A) can offer temporary relief for constipation but do not address the root cause of the condition, which is the absence of nerve cells. A low-fiber diet (Choice B) is not a primary therapy for Hirschsprung disease and may not effectively manage the disorder. A permanent colostomy (Choice C) is typically considered in severe cases where other interventions have failed and is not the standard management approach for Hirschsprung disease.

Question 3 of 5

While waiting for the administration of air pressure to reduce the intussusception, the boy passes a normal brown stool. Which nursing action is the most appropriate for the nurse to take?

Correct Answer: A

Rationale: The correct answer is to notify the practitioner. The passage of a normal brown stool in a child with intussusception could indicate spontaneous reduction of the intussusception. It is crucial to inform the practitioner immediately so that they can reassess the situation and determine the next steps, which may include adjusting the planned intervention. Measuring abdominal girth (choice B) may be important in assessing for abdominal distension but is not the most immediate action required in this scenario. Auscultating for bowel sounds (choice C) is a routine nursing assessment but does not take precedence over notifying the practitioner in this critical situation. Taking vital signs, including blood pressure (choice D), is also important but notifying the practitioner is more urgent to address the unexpected change in the patient's condition.

Question 4 of 5

Why does a cleft lip predispose an infant to infection?

Correct Answer: D

Rationale: The correct answer is D. Mouth breathing due to a cleft lip can dry the mucous membranes, making them more susceptible to infection. Choice A is incorrect because waste products do not accumulate along the defect to predispose the infant to infection. Choice B is incorrect as there is no evidence of inadequate circulation being a primary factor in infection predisposition in cleft lip cases. Choice C is incorrect because although ineffective feeding may lead to other issues, it is not the main reason for infection predisposition in infants with a cleft lip.

Question 5 of 5

After an infant has had corrective surgery for hypertrophic pyloric stenosis (HPS), what should the nurse teach a parent to do immediately after a feeding to limit vomiting?

Correct Answer: B

Rationale: Correct Answer: B. Placing the infant in an infant seat is essential after feeding to help keep the head elevated and reduce the risk of vomiting. This position helps prevent regurgitation of formula or milk. Rocking the infant (Choice A) is incorrect because it may exacerbate vomiting due to the movement. Placing the infant flat on the right side (Choice C) is incorrect as it does not promote proper digestion and can increase the risk of vomiting. Keeping the infant awake with sensory stimulation (Choice D) is incorrect as it does not directly address the physiological need to reduce vomiting after feeding.

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