A newborn's failure to pass meconium within the first 24 hours after birth may indicate which of the following?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Hirschsprung disease. A newborn's failure to pass meconium within the first 24 hours after birth may indicate Hirschsprung disease, a condition where there is a lack of ganglion cells in the rectum and colon, leading to a functional obstruction. Meconium is the infant's first stool, and the absence of passing it indicates a potential issue in the bowel. Option B) Celiac disease is an autoimmune disorder triggered by gluten consumption and does not directly affect meconium passage. Option C) Intussusception is the telescoping of one segment of the intestine into another and typically presents with colicky abdominal pain, not a meconium passage issue in a newborn. Option D) Abdominal wall defect, such as gastroschisis or omphalocele, usually presents with visible abnormalities in the abdominal wall and does not directly impact meconium passage. Educationally, understanding the significance of meconium passage in newborns is crucial for early identification of underlying conditions. Nurses must recognize abnormal signs like the absence of meconium to prompt further assessment and intervention. This question reinforces the importance of recognizing Hirschsprung disease as a potential cause of meconium retention in newborns.

Correct Answer: A

Rationale: The correct answer is A) Infant cereal can be introduced by spoon when the extrusion reflex fades. This is the right choice because the extrusion reflex, which causes infants to automatically push out anything placed in their mouth, needs to diminish before introducing solid foods to prevent choking and ensure the infant is developmentally ready for spoon feeding. Option B) is incorrect because the eruption of the first tooth is not an adequate indicator of readiness for solid foods. Teeth development varies among infants and is not a reliable milestone for introducing solids. Option C) is incorrect because tripling the birth weight is not a universally accepted guideline for introducing pureed foods. The readiness for solid foods is more related to developmental milestones and reflexes rather than weight gain alone. Option D) is incorrect because while breast milk or formula can provide adequate nutrition for the first year of life, it does not address the specific milestone of the extrusion reflex fading, which is crucial for safe and effective feeding of solid foods. In an educational context, it is essential for nurses to educate parents on the developmental cues and reflexes that indicate a baby's readiness for solid foods to ensure safe feeding practices and support the infant's nutritional needs. Understanding these milestones can help parents make informed decisions about introducing new foods to their infants and promote healthy feeding habits from an early age.

Correct Answer: C

Rationale: The correct answer is C) He now mimics the gestures of his father. In the resolution of the Oedipal complex during the phallic stage of Freud's psychosexual development, a child typically identifies with the same-sex parent to resolve feelings of competition and jealousy towards the opposite-sex parent. By mimicking the gestures of his father, Kenneth is demonstrating identification with the same-sex parent, indicating that he has resolved his Oedipal conflict. Option A) He now assumes the role of his father is incorrect because at this stage, the child is not assuming the actual role of the parent but rather identifying with them. Option B) He now assumes the role of his mother is incorrect as the resolution involves identification with the same-sex parent. Option D) He now mimics the gestures of his mother is incorrect for the same reason. In an educational context, understanding Freud's psychosexual stages can provide insights into children's behavior and development. Recognizing how children navigate these stages can help caregivers and educators support them effectively through various developmental challenges.

Correct Answer: B

Rationale: The correct answer is B) Noisy eructations. Gino's presentation with severe vomiting, weight loss, epigastric pain, distention, and a palpable olive-size mass in the right upper quadrant is indicative of pyloric stenosis. Noisy eructations, known as "projectile vomiting," are a classic symptom of pyloric stenosis due to the forceful expulsion of gastric contents. This occurs because the hypertrophied pyloric muscle obstructs the passage of food from the stomach to the duodenum, leading to projectile vomiting. Excessive salivation (option A) is not typically associated with pyloric stenosis. Decreased frequency of stools (option C) is not a common symptom of pyloric stenosis and would not explain Gino's presentation. Fresh blood in the stool (option D) is also not a typical finding in pyloric stenosis. In an educational context, understanding the key clinical manifestations of pyloric stenosis is crucial for pediatric nurses preparing for the NCLEX exam. Recognizing the signs and symptoms of pyloric stenosis can aid in prompt diagnosis and intervention, ultimately improving patient outcomes. Studying specific pediatric conditions like pyloric stenosis helps nurses provide safe and effective care to pediatric patients.

Correct Answer: B

Rationale: The correct answer is B) ventricular septal defect, overriding the aorta, pulmonic stenosis, right ventricular hypertrophy. In Tetralogy of Fallot, these four defects are characteristic: a ventricular septal defect allows mixing of oxygenated and deoxygenated blood; overriding aorta causes blood from both ventricles to flow into the aorta; pulmonic stenosis restricts blood flow to the lungs; and right ventricular hypertrophy develops due to increased workload. Option A is incorrect as it describes defects associated with other conditions like aortic valve coarctation, pulmonic valve stenosis, and mitral valve stenosis not typically seen in Tetralogy of Fallot. Option C includes defects like tricuspid valve atresia, atrial septal defect, hypoplastic right ventricle, and PDA which are not part of Tetralogy of Fallot. Understanding these specific defects associated with Tetralogy of Fallot is crucial for nurses caring for pediatric patients with this condition. Knowing the pathophysiology helps in providing appropriate care, anticipating complications, and educating patients and families about the condition.