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What statement best describes Hirschsprung disease?
- A. The colon has an aganglionic segment.
- B. It results in frequent evacuation of solids, liquid, and gas.
- C. The neonate passes excessive amounts of meconium.
- D. It results in excessive peristaltic movements within the gastrointestinal tract.
Correct Answer: A
Rationale: Hirschsprung disease involves an aganglionic colon segment, causing mechanical obstruction and reduced evacuation. It leads to liquid stool leakage, not frequent evacuation, difficulty passing meconium, and decreased, not excessive, peristalsis.
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A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube?
- A. Prevent spread of infection.
- B. Monitor electrolyte balance.
- C. Prevent abdominal distention.
- D. Maintain accurate record of output.
Correct Answer: C
Rationale: The NG tube prevents abdominal distention by suctioning gastrointestinal secretions. It doesn?t prevent infection, electrolyte monitoring is secondary, and while output records are important, the primary purpose is distention prevention.
What clinical manifestation should be the most suggestive of acute appendicitis?
- A. Rebound tenderness
- B. Bright red or dark red rectal bleeding
- C. Abdominal pain that is relieved by eating
- D. Colicky, cramping, abdominal pain around the umbilicus
Correct Answer: D
Rationale: Colicky, periumbilical pain that becomes constant and may shift to the right lower quadrant is the hallmark of acute appendicitis. Rebound tenderness is unreliable and painful, bleeding is not typical, and pain relieved by eating is not associated with appendicitis.
A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child?
- A. It is unnecessary because of childs age.
- B. It is essential because it will be an adjustment.
- C. Preparation is not needed because the colostomy is temporary.
- D. Preparation is important because the child needs to deal with negative body image.
Correct Answer: B
Rationale: Preparing a preschooler for a colostomy using simple explanations and visual aids helps them adjust to the procedure. Preparation is necessary despite age, temporary status doesn?t negate the need, and body image concerns are less relevant at this age.
What statement is most descriptive of Meckel diverticulum?
- A. It is acquired during childhood.
- B. Intestinal bleeding may be mild or profuse.
- C. It occurs more frequently in females than in males.
- D. Medical interventions are usually sufficient to treat the problem.
Correct Answer: B
Rationale: Meckel diverticulum often presents with mild to profuse intestinal bleeding due to its congenital nature. It?s present at birth, not acquired, is more common in males, and typically requires surgical removal, not just medical management.
What procedure is most appropriate for assessment of an abdominal circumference related to a bowel obstruction?
- A. Measuring the abdomen after feedings
- B. Marking the point of measurement with a pen
- C. Measuring the circumference at the symphysis pubis
- D. Using a new tape measure with each assessment to ensure accuracy
Correct Answer: B
Rationale: Marking the measurement point with a pen ensures consistent abdominal circumference assessment at the same location, typically the umbilicus. Measuring after feedings is inappropriate with NPO status, the symphysis pubis is too low, and a new tape measure is unnecessary.