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

Correct Answer: B

Rationale: The correct answer is B, failure to pass meconium and abdominal distension. Hirschsprung disease results in the absence of ganglion cells in the distal part of the colon, leading to functional obstruction. Failure to pass meconium is a classic sign due to the inability of affected segment to relax, causing stool accumulation. Abdominal distension occurs as a result of the buildup of stool and gas proximal to the affected segment. Choices A, C, and D do not align with the characteristic clinical manifestations of Hirschsprung disease. Acute diarrhea and dehydration are not typical symptoms. Currant jelly stools and pain are more indicative of intussusception. Projectile vomiting and altered electrolytes are not commonly associated with Hirschsprung disease.

Correct Answer: B

Rationale: The correct answer is B because toddlers typically understand more words and concepts than they can express verbally due to their limited vocabulary and developing language skills. This is supported by research in child development showing that receptive language skills (understanding language) usually precede expressive language skills (speaking). Toddlers may struggle to articulate their thoughts and feelings, leading to frustration. Now, let's evaluate the other choices: A: Language development skills actually accelerate during the toddler period, not slow down. C: While toddlers may have pronunciation issues, most of their speech is usually understood by caregivers. D: A toddler's vocabulary usually ranges from 200 to 500 words, not strictly 600 words.

Correct Answer: B

Rationale: The correct answer is B, Notify practitioner of the observation. This is the most appropriate action because a weaker pulse distal to the catheter insertion site could indicate impaired circulation, potentially leading to complications like ischemia. Notifying the practitioner promptly allows for a timely assessment and intervention to prevent further complications. Elevating the affected extremity (A) may worsen circulation, recording data (C) is important but not as urgent as notifying the practitioner, and applying warm compresses (D) is not indicated for this situation and could exacerbate any circulatory issues.

Correct Answer: A

Rationale: Aortic stenosis is the correct answer as it is a defect that causes narrowing of the aortic valve, leading to obstruction of blood flow from the left ventricle to the aorta. This obstruction increases the workload on the heart and can result in symptoms such as chest pain and heart failure. Tricuspid atresia, atrial septal defect, and transposition of the great arteries do not directly cause obstruction to blood flow in the same way as aortic stenosis. Tricuspid atresia involves the absence of the tricuspid valve, atrial septal defect is a hole in the atrial septum, and transposition of the great arteries involves a switch in the positions of the pulmonary artery and aorta.

Correct Answer: A

Rationale: The correct answer is A: Susceptibility to respiratory infection. Children with congenital heart disease often have compromised immune systems due to their cardiac condition, making them more prone to respiratory infections. This is because the heart defect can affect blood flow to the lungs, leading to decreased oxygen levels and weakened lung function. As a result, these children are at higher risk for respiratory complications. Incorrect choices: B: Bleeding tendencies - While some heart conditions may lead to clotting issues, bleeding tendencies are not a frequent complication of congenital heart disease. C: Frequent vomiting and diarrhea - These symptoms are not typically associated with congenital heart disease, unless there are specific underlying conditions causing them. D: Seizure disorder - Seizures are not a common complication of congenital heart disease; they are more often related to neurological issues or other medical conditions.