A nurse is caring for a 3-day-old newborn and suspects Hirschsprung disease. What finding best supports the nurse's concern?
The infant has passed several tar-like stools.
The infant has not gained weight and has stooled once.
The infant has not stooled.
The infant has passed hard, pellet-like stools.
The Correct Answer is C
Rationale:
A. Passing tar-like stools is normal for newborns within the first few days of life and does not indicate Hirschsprung disease.
B. Limited stooling and poor weight gain may suggest feeding issues but are not as indicative of Hirschsprung disease as the absence of stool.
C. The absence of stool (failure to pass meconium within 24-48 hours) is a classic sign of Hirschsprung disease, a condition where the absence of ganglion cells in the intestines leads to a blockage.
D. Passing hard, pellet-like stools may indicate constipation but is not specific to Hirschsprung disease, especially in a newborn.
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Correct Answer is B
Explanation
Rationale:
A. A child recovering from nasopharyngitis could still be contagious, and since children with leukemia have compromised immune systems, they are at higher risk of infections.
B. A child with nephrotic syndrome, although potentially needing special care, does not pose the same infection risk as a child recovering from an infectious disease. Therefore, they are a more suitable roommate for a child with leukemia.
C. A child with gastroenteritis may still be infectious and could expose the child with leukemia to gastrointestinal pathogens.
D. A child with rheumatic fever does not have a contagious illness, but the specific needs of the child with leukemia and the potential for complications from infections make it less ideal compared to a non-infectious condition like nephrotic syndrome.
Correct Answer is A
Explanation
Rationale:
A. If NSAIDs (nonsteroidal anti-inflammatory drugs) are ineffective in managing symptoms of JIA, the healthcare provider needs to be notified as other treatments, such as disease-modifying antirheumatic drugs (DMARDs) or biologics, may be necessary.
B. Warm compresses, rather than cool compresses, are typically recommended to relieve joint pain and stiffness in JIA.
C. While rest is important, excessive napping can lead to stiffness and decreased mobility. Regular, gentle activity is encouraged to maintain joint function.
D. High-impact exercises like running may be too strenuous for children with JIA and can exacerbate joint pain. Low-impact activities such as swimming or cycling are generally recommended to promote range of motion without putting undue stress on the joints.