The MOST likely cause of a neonate presented with watery and voluminous stool which is mistaken for urine.

Correct Answer: A

Rationale: The correct answer is A) congenital microvillus disease. In this condition, the neonate presents with watery and voluminous stool, which can be mistaken for urine due to its appearance. Congenital microvillus disease is a rare genetic disorder affecting the small intestine's ability to absorb nutrients properly. This leads to severe diarrhea and malabsorption of nutrients, resulting in the characteristic stool presentation described in the question. Option B) congenital enterokinase deficiency is incorrect because this condition primarily affects protein digestion by impairing the activation of trypsinogen to trypsin, leading to protein malabsorption, not watery stool. Option C) congenital trypsinogen deficiency is incorrect as it leads to impaired protein digestion, not the watery stool described in the question. Option D) congenital bile acid malabsorption is incorrect as it primarily affects fat absorption, leading to fatty stools, not watery and voluminous stool as seen in congenital microvillus disease. Understanding pediatric gastrointestinal disorders is crucial for nurses and healthcare professionals caring for neonates and children. Recognizing the signs and symptoms of conditions like congenital microvillus disease is essential for timely diagnosis and intervention to prevent complications like malnutrition and dehydration. Knowledge of these conditions is vital for providing quality care and improving patient outcomes in pediatric settings.

Correct Answer: D

Rationale: Rationale: In Tangier disease, there is a deficiency in the ATP-binding cassette transporter A1 (ABCA1) protein, leading to impaired cellular cholesterol efflux. As a result, individuals with Tangier disease exhibit extremely low levels of plasma cholesterol, not increased levels as seen in the general population. This is why option D, "increased plasma cholesterol," is the correct answer. Option A, "orange tonsils," is a feature of Tangier disease due to cholesterol accumulation in the tonsils, leading to their characteristic orange appearance. Option B, "hepatosplenomegaly," is also seen in Tangier disease due to cholesterol deposition in the liver and spleen. Option C, "relapsing neuropathy," is associated with Tangier disease as a result of lipid deposition in nerve tissues. Understanding the features of Tangier disease is crucial for nurses and healthcare professionals, especially those preparing for the NCLEX exam. Recognizing these distinct clinical manifestations can aid in early diagnosis and appropriate management of patients with rare genetic disorders like Tangier disease. It also highlights the importance of lipid metabolism in maintaining overall health and the consequences of its dysregulation in various diseases.

Correct Answer: B

Rationale: The correct answer is B) Escherichia coli O157:H7. Antibiotics are not indicated and may be detrimental in this foodborne bacterial illness because they can increase the risk of hemolytic uremic syndrome (HUS), a severe complication associated with this strain of E. coli. By disrupting the bacterial cell wall, antibiotics may trigger the release of more toxins, worsening the condition. Enterotoxigenic E. coli (Option A) causes traveler's diarrhea and is typically treated with antibiotics. Enterohemorrhagic E. coli (Option C) can lead to HUS, but antibiotics are still contraindicated due to the risk of exacerbating toxin release. Campylobacter jejuni (Option D) is usually treated with antibiotics as well. In an educational context, understanding the rationale behind not using antibiotics in specific bacterial infections is crucial for nursing students preparing for the NCLEX exam. It emphasizes the importance of evidence-based practice and the potential consequences of inappropriate antibiotic use, highlighting the need for proper assessment and intervention strategies in clinical practice.

Correct Answer: C

Rationale: In this question, the correct answer is C) Yersinia. Yersinia enterocolitica is a bacterium that can cause gastroenteritis. Immunoglobulin A (IgA) nephropathy is a condition where IgA immune complexes deposit in the kidneys, leading to inflammation and damage. Yersinia infection can trigger an immune response that results in IgA nephropathy as an extraintestinal manifestation. A) Salmonella is a common cause of food poisoning but is not typically associated with IgA nephropathy. B) Shigella is another bacterium that causes intestinal infection but is not linked to IgA nephropathy. D) Campylobacter is a common cause of bacterial diarrhea but is not known to be associated with IgA nephropathy. Educationally, understanding the extraintestinal manifestations of enteric infections is crucial for healthcare professionals, especially when considering systemic complications like IgA nephropathy. This knowledge helps in early recognition, appropriate management, and prevention of potential long-term consequences for patients. It reinforces the importance of thorough assessment and understanding of the interconnectedness of different body systems in pediatric patients.

Correct Answer: C

Rationale: Ciprofloxacin is the drug of choice for the treatment of Campylobacter jejuni infections because it is effective against this particular bacterium. Campylobacter jejuni is a common cause of bacterial gastroenteritis in children and adults, and ciprofloxacin has shown good efficacy in treating these infections. Option A) Salmonella: Ciprofloxacin is not typically the first-line treatment for Salmonella infections. In fact, the use of ciprofloxacin in Salmonella infections is discouraged due to concerns of increasing antibiotic resistance. Option B) Shigella: While ciprofloxacin may be used in some cases of Shigella infections, resistance to this drug is becoming more common. Other antibiotics like azithromycin or ceftriaxone are often preferred for treating Shigella infections. Option D) Clostridium difficile: Ciprofloxacin is not the drug of choice for Clostridium difficile infections. The primary treatment for C. difficile infections involves stopping the causative antibiotic, supportive care, and in some cases, the use of specific antibiotics like metronidazole or vancomycin. Educational context: Understanding the appropriate use of antibiotics in treating pediatric gastrointestinal infections is crucial to prevent antibiotic resistance and ensure effective treatment. By knowing the specific pathogens targeted by each antibiotic, healthcare providers can make informed decisions to provide the best care for their patients.