Potential causes of constipation include all of the following EXCEPT

Correct Answer: D

Rationale: In the context of pediatric gastrointestinal health, it is crucial for nurses preparing for the NCLEX to understand the potential causes of constipation in children. The correct answer "D) ibuprofen" is not typically associated with causing constipation in children. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for pain relief and reducing inflammation, but it is not a known cause of constipation. Option A, "hypothyroidism," can lead to constipation as it affects metabolism and slows down bowel movements. Hypokalemia, option B, can also cause constipation as low potassium levels can disrupt normal muscle function, including in the intestines. Option C, "lead," can cause constipation as lead poisoning can affect the nerves that control the bowel movements. Educationally, this question highlights the importance of recognizing the various factors that can contribute to constipation in pediatric patients. By understanding these different causes, nurses can effectively assess, intervene, and educate both patients and caregivers on appropriate management strategies to promote gastrointestinal health in children. This knowledge is essential for providing safe and competent care to pediatric patients with gastrointestinal concerns.

Correct Answer: D

Rationale: The most likely diagnosis in this case is superior mesenteric artery syndrome (D). Superior mesenteric artery syndrome, also known as Wilkie's syndrome, occurs due to compression of the third part of the duodenum between the abdominal aorta and the overlying superior mesenteric artery. This compression leads to obstruction of the duodenum, causing symptoms like vomiting, abdominal pain, and potentially gastrointestinal bleeding. The presentation of bile-stained emesis, a tender distended abdomen, and bright-red blood per rectum points towards this diagnosis. Option A, stress ulcers, is unlikely because the symptoms described do not align with stress-related gastrointestinal issues. Intussusception (B) typically presents with colicky abdominal pain and a sausage-shaped mass on palpation, which are not noted in this case. Malrotation (C) usually presents earlier in infancy and is associated with bilious vomiting and a "corkscrew" appearance on imaging, making it less likely in a 5-year-old with this presentation. Educationally, understanding the clinical manifestations and diagnostic approach to gastrointestinal conditions in children is crucial for healthcare providers, especially those preparing for exams like the NCLEX. This question highlights the importance of recognizing rare but critical conditions like superior mesenteric artery syndrome based on specific clinical clues to ensure timely and accurate management.

Correct Answer: B

Rationale: The correct answer is B) tracheoesophageal fistula. In this scenario, the neonate is presenting with drooling and respiratory distress, classic signs of tracheoesophageal fistula. The chest x-ray would show air in the stomach, confirming the diagnosis. Tracheoesophageal fistula is a congenital anomaly where there is an abnormal connection between the trachea and esophagus, leading to issues like aspiration and respiratory distress. Option A) meconium aspiration pneumonia is less likely in this case as there is no history of meconium-stained amniotic fluid or respiratory distress due to meconium aspiration. Option C) tetralogy of Fallot is a congenital heart defect and would not typically present with drooling and respiratory distress. Option D) foreign body would not be the likely diagnosis in a 1-day-old neonate without any history of foreign body ingestion or exposure. This question provides valuable educational context by testing the test-taker's knowledge of pediatric gastrointestinal disorders, emphasizing the importance of recognizing clinical signs and interpreting diagnostic imaging findings to arrive at the correct diagnosis in neonatal patients.

Correct Answer: B

Rationale: The correct answer is B) celiac disease. Celiac disease is a gastrointestinal disorder triggered by the ingestion of gluten-containing foods. In this scenario, the child's symptoms of failure to thrive, poor appetite, abdominal distention, diarrhea, and irritability are indicative of celiac disease. The onset of symptoms around 9 months of age is common as gluten-containing foods are introduced into the diet around that time. Option A) giardiasis is unlikely as it typically presents with foul-smelling, greasy stools and is more common in areas with poor sanitation. Option C) cystic fibrosis may present with similar symptoms but typically also involves respiratory issues which are not described in the question. Option D) mitochondrial myopathy would not typically present with gastrointestinal symptoms like diarrhea and poor appetite. In an educational context, understanding the presentation of pediatric gastrointestinal disorders is crucial for nurses, especially when caring for infants and young children. Recognizing the signs and symptoms of celiac disease can lead to early diagnosis and intervention, which is essential for preventing long-term complications and promoting the child's growth and development. Nurses must be able to differentiate between various pediatric gastrointestinal conditions to provide optimal care and support to their patients and families.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) chronic fatigue syndrome. 1. Chronic fatigue syndrome: This condition is characterized by extreme fatigue that cannot be explained by any underlying medical condition. While fatigue is a symptom shared with the patient's presentation, the presence of jaundice and other symptoms points more towards a hepatobiliary condition rather than chronic fatigue syndrome. 2. Mononucleosis: Mononucleosis can present with symptoms such as malaise, fatigue, anorexia, and jaundice, which overlap with the patient's symptoms. However, considering the patient's demographic and the presence of jaundice, other hepatobiliary conditions are more likely. 3. Chronic active hepatitis: Given the patient's symptoms of jaundice and liver involvement, chronic active hepatitis is a pertinent consideration in the differential diagnosis. 4. Hepatitis B: Hepatitis B is a viral infection that affects the liver and can present with symptoms like jaundice, fatigue, and anorexia, making it relevant to consider in this case. Educational context: Understanding the differential diagnosis in a pediatric patient presenting with symptoms like malaise, fatigue, anorexia, and jaundice is crucial for healthcare providers. This question challenges critical thinking by assessing the ability to differentiate between conditions with overlapping symptoms. By recognizing the specific features of each condition, healthcare professionals can provide accurate diagnosis and appropriate management for pediatric patients with gastrointestinal issues.