Matching: Constipation

Correct Answer: A

Rationale: In this question, the correct answer is A) Hirschsprung disease. Hirschsprung disease is a congenital condition where there is a lack of ganglion cells in the colon, leading to chronic constipation. This condition is commonly seen in pediatric patients and can present with symptoms of constipation, abdominal distention, and failure to pass meconium. Option B) Functional constipation is a common cause of constipation in children and is usually due to dietary factors, lack of fluids, or behavioral issues. It is not typically associated with congenital abnormalities like Hirschsprung disease. Option C) an abscessed tooth is unrelated to constipation. Dental issues can cause pain and discomfort in the mouth but do not directly lead to constipation. Option D) angioedema is a condition characterized by rapid swelling of the deep layers of skin. It is not associated with constipation. Educational context: Understanding the different causes of constipation in pediatric patients is crucial for nurses and healthcare providers. Recognizing the signs and symptoms of conditions like Hirschsprung disease can lead to early diagnosis and appropriate intervention. This knowledge is essential for providing safe and effective care to pediatric patients with gastrointestinal issues.

Correct Answer: D

Rationale: Palatopharyngeal incompetence is a condition where the soft palate fails to close against the back of the throat, leading to speech and swallowing difficulties. In this context, the correct answer, D) improvement after adenoidectomy, is the exception because palatopharyngeal incompetence does not typically improve after adenoidectomy. Adenoidectomy primarily addresses issues with the adenoids, not the soft palate. Option A) hypernasal speech is characteristic of palatopharyngeal incompetence due to the inability to properly close the soft palate, leading to air escaping through the nose during speech. Option B) presence of a submucosal cleft is relevant because it can contribute to palatopharyngeal incompetence by affecting the structure of the palate. Option C) difficulty in pronouncing certain sounds like p, b, d, t, h, and v is common due to the impaired function of the soft palate in forming these sounds correctly. In an educational context, understanding the manifestations of palatopharyngeal incompetence is crucial for healthcare professionals, especially those working with pediatric populations. Recognizing the symptoms and characteristics can aid in early detection and appropriate interventions to improve speech and swallowing functions in affected individuals.

Correct Answer: C

Rationale: The correct answer to the question is C) feed the infant. In the case of pyloric stenosis, feeding the infant can help to trigger the characteristic projectile vomiting associated with this condition. Pyloric stenosis is a condition where there is an obstruction at the junction between the stomach and the small intestine, leading to symptoms such as non-bilious vomiting, weight loss, and dehydration. By feeding the infant, you can elicit the vomiting that is typical of pyloric stenosis, aiding in the diagnosis. Option A) keeping the patient NPO would not help in demonstrating the abnormal physical findings of pyloric stenosis as it would not provoke the vomiting necessary for diagnosis. Option B) giving intravenous glucagon is not the standard diagnostic method for pyloric stenosis. It is not routinely used in diagnosing this condition. Option D) examining the infant under anesthesia is not necessary for diagnosing pyloric stenosis. The characteristic vomiting pattern seen after feeding is usually sufficient for diagnosis. Educationally, understanding the importance of eliciting specific symptoms through appropriate interventions is crucial in pediatric nursing practice. Recognizing the signs and symptoms of pyloric stenosis and knowing how to elicit them can lead to timely diagnosis and treatment, ultimately improving patient outcomes.

Correct Answer: D

Rationale: In this question, option D is the correct answer. Hirschsprung disease is a condition where there is a lack of ganglion cells in the distal colon, leading to functional obstruction. Breast-fed infants may appear less ill than formula-fed infants because breast milk is easier to digest and can mask some symptoms of Hirschsprung disease, delaying diagnosis. Option A is incorrect because Hirschsprung disease can occur in preterm infants, although it is more common in full-term infants. Option B is incorrect as males are more commonly affected by Hirschsprung disease than females. Option C is incorrect as Hirschsprung disease is not typically associated with VATER syndrome, which is a different set of congenital anomalies. Educationally, understanding Hirschsprung disease is crucial for nursing students preparing for the NCLEX exam, as it is a common pediatric gastrointestinal disorder. Knowing the signs and symptoms, diagnostic procedures, and treatment options for this condition is essential for providing safe and effective care to pediatric patients. Recognizing the unique clinical presentations in different patient populations, such as breast-fed vs. formula-fed infants, can aid in early identification and management of Hirschsprung disease.

Correct Answer: A

Rationale: The next appropriate test for a patient with a hematocrit of 29% and stable vital signs would be an upper gastrointestinal endoscopy. This test is indicated to evaluate for sources of chronic gastrointestinal bleeding, such as peptic ulcers, esophagitis, or gastritis, which could be contributing to the patient's low hematocrit. Option B, ESR (erythrocyte sedimentation rate), is a nonspecific test used to detect inflammation in the body and is not the most appropriate test in this scenario where a specific cause of bleeding needs to be identified. Option C, angiography, is an invasive test used to visualize blood vessels and is not typically the initial investigation for a patient with a low hematocrit and stable vital signs. Option D, Meckel scan, is used to detect the presence of a Meckel's diverticulum, a congenital outpouching of the small intestine that can cause gastrointestinal bleeding. However, an upper gastrointestinal endoscopy would be more appropriate as the first step in evaluating this patient's condition. In an educational context, understanding the rationale behind selecting the appropriate diagnostic test is crucial in providing safe and effective patient care. It is important for nurses to have a solid foundation in clinical decision-making to ensure the best outcomes for their patients.