All of the following are features of achalasia EXCEPT

Correct Answer: D

Rationale: Rationale: The correct answer is option D) usually diagnosed before school age. Achalasia is a rare motility disorder of the esophagus characterized by the inability of the lower esophageal sphincter to relax, resulting in difficulty swallowing (dysphagia), regurgitation of undigested food, chest pain, and weight loss. While achalasia can occur at any age, it is more commonly diagnosed in adults rather than in children. Option A) dysphagia for solids and liquids is a feature of achalasia as the impaired esophageal motility affects the passage of both solids and liquids through the esophagus. Option B) may be accompanied by undernutrition is true as untreated achalasia can lead to weight loss and malnutrition due to difficulty in swallowing and inadequate intake of nutrients. Option C) may be misdiagnosed as asthma is also a common occurrence as the symptoms of achalasia such as chest pain and difficulty breathing can mimic asthma, leading to a misdiagnosis. In an educational context, understanding the clinical features of achalasia is crucial for pediatric nurses to provide early identification, intervention, and support for children with this condition. By differentiating achalasia from other gastrointestinal and respiratory disorders, nurses can collaborate with healthcare providers to ensure timely diagnosis and appropriate management to improve the quality of life for pediatric patients with achalasia.

Correct Answer: B

Rationale: In healthy full-term infants, passing meconium within the first 48 hours of birth is expected. The correct answer is B) 90%. This timing is indicative of normal functioning of the gastrointestinal system in newborns. Meconium is the first stool passed by a newborn and consists of amniotic fluid, intestinal epithelial cells, lanugo, mucus, and bile. Option A) 99% is incorrect as not all infants will pass meconium within the first 48 hours. While it is a majority, it is not the case for every single infant. Option C) 80% and option D) 70% are also incorrect as they underestimate the frequency of passing meconium within the specified time frame. Understanding the expected timeline for passing meconium is crucial for nurses caring for newborns. It serves as an important indicator of gastrointestinal health and functioning. Nurses should be aware of this normal variation to identify any potential issues promptly. Educating nursing students on these normal milestones helps them provide quality care and intervene appropriately if deviations from the norm occur.

Correct Answer: C

Rationale: In pediatric gastrointestinal nursing, understanding the typical presenting symptoms of peptic ulcer disease in infants and younger children is crucial for accurate diagnosis and effective interventions. In this case, the correct answer is C) epigastric pain. Epigastric pain is a common symptom in older children and adults with peptic ulcer disease, but it is not a usual presenting symptom in infants and younger children. Young children may not be able to articulate or localize their pain in the epigastric region as effectively as older individuals. Feeding difficulty (Option A) is often seen in infants with peptic ulcer disease due to discomfort while eating. Vomiting (Option B) can occur as a result of irritation in the gastrointestinal tract. Hematemesis (Option D), which is vomiting blood, can be a severe symptom of peptic ulcer disease in children. Educationally, it is important for pediatric nurses to be aware of the differences in how peptic ulcer disease may present in infants and younger children compared to older patients. This knowledge enables nurses to conduct thorough assessments, provide appropriate interventions, and collaborate effectively with healthcare providers to ensure optimal care for pediatric patients with gastrointestinal issues.

Correct Answer: D

Rationale: In pediatric gastrointestinal nursing, understanding umbilical hernias is crucial when educating parents. The correct answer is D) More often in premature infants. This is because premature infants have less developed abdominal muscles, making them more prone to umbilical hernias due to the small size and fragility of their abdominal wall. Option A) More often in large infants is incorrect because the size of the infant does not directly correlate with the occurrence of umbilical hernias. Option B) In white infants more than in African American infants is incorrect as umbilical hernias can occur in any ethnicity. Option C) Twice as often in male infants is incorrect as the occurrence of umbilical hernias is not gender-specific. Educationally, it's important to highlight the increased risk of umbilical hernias in premature infants to ensure parents are informed about the potential issues their baby may face. Nurses should provide anticipatory guidance to parents of premature infants on how to monitor and care for their baby's umbilical area to prevent complications associated with umbilical hernias.

Correct Answer: D

Rationale: In caring for a 14-year-old with celiac disease, it is essential for the nurse to ensure that the patient follows a strict gluten-free diet. Option D, which includes cheese, banana slices, rice cakes, and whole milk, is the correct meal choice as it is gluten-free. Option A includes rye toast, which contains gluten, making it unsuitable for someone with celiac disease. Option B with pancakes likely contains gluten unless specified otherwise, and sausage links may also contain gluten as fillers. Option C includes oat cereal, which may be contaminated with gluten unless certified gluten-free, and breakfast pastries typically contain gluten. Educationally, understanding the importance of a gluten-free diet in celiac disease management is crucial for nurses caring for pediatric patients. By choosing the correct meal option, the nurse ensures the patient's adherence to dietary restrictions, promoting better health outcomes and symptom management for the patient.