a 1 month old infant is admitted to the pediatric unit with a tentative diagnosis of hirschsprung disease congenital aganglionic megacolon what proced a 1 month old infant is admitted to the pediatric unit with a tentative diagnosis of hirschsprung disease congenital aganglionic megacolon what proced
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HESI Pediatrics Quizlet

1. How is the diagnosis of Hirschsprung disease confirmed in a 1-month-old infant admitted to the pediatric unit?

Correct answer: B

Rationale: Rectal biopsy is the definitive diagnostic procedure for Hirschsprung disease in infants. It confirms the absence of ganglion cells in the affected bowel segment, which is characteristic of Hirschsprung disease. Colonoscopy (Choice A) is not typically used for confirmation as it may not provide a definitive result. Multiple saline enemas (Choice C) are utilized in the treatment of meconium ileus, a complication of cystic fibrosis, and not in the diagnosis of Hirschsprung disease. Fiberoptic nasoenteric tube (Choice D) is not a diagnostic tool for Hirschsprung disease; it is commonly used for gastrointestinal decompression or feeding purposes but does not confirm the diagnosis.

2. A parent tells a nurse at the clinic, 'Each morning I offer my 24-month-old child juice, and all I hear is ‘No.’ What should I do because I know my child needs fluid?' What strategy should the nurse suggest?

Correct answer: A

Rationale: Offering a choice between two options allows the child to feel a sense of control while ensuring they get the necessary fluids. Providing a choice empowers the child and increases the likelihood of cooperation. Distracting the child with food or offering the glass in a firm manner may not address the underlying issue of refusal. Allowing the child to witness the parent's anger can create a negative environment and may not help in resolving the situation positively.

3. The PN is caring for an older client who was informed about the diagnosis of terminal cancer two days ago. Which intervention would be most helpful for the client's spouse at this time?

Correct answer: D

Rationale: Providing information about palliative and hospice care services can help the spouse understand the options for managing the client's symptoms and improving the quality of life. This also provides support and guidance during a difficult time. Consulting with the case manager and hospital chaplain may be beneficial for emotional support but may not address the practical aspects of care. Visiting after procedures are done to avoid seeing the client in pain may not foster open communication and support. While participating in the client's care is important, providing information about palliative and hospice care services is the most helpful intervention in this scenario.

4. After years of struggling with weight management, a middle-aged man is evaluated for gastroplasty. He has experienced difficulty managing his diabetes mellitus and hypertension, but he is approved for surgery. Which intervention is most important for the nurse to include in this client’s plan of care?

Correct answer: D

Rationale: Observing for signs of depression is crucial in this patient's plan of care as depression can impact his overall recovery and management post-surgery. Depression is common in individuals struggling with weight management, diabetes mellitus, and hypertension. Monitoring for urinary incontinence (Choice A) is not the priority in this case as the patient is undergoing gastroplasty for weight management, not a urinary issue. Applying sequential compression stockings (Choice B) is important for preventing deep vein thrombosis in immobile patients but is not the priority in this scenario. Providing a wide variety of meal choices (Choice C) is not the most crucial intervention at this stage, as post-gastroplasty dietary restrictions are essential for successful weight management.

5. What type of vaccine should a child with a history of severe allergic reactions receive?

Correct answer: B

Rationale: Children with a history of severe allergic reactions should receive inactivated vaccines because they do not contain live pathogens. Live attenuated vaccines (choice A) contain weakened live pathogens and can potentially trigger an allergic reaction in sensitive individuals. Subunit vaccines (choice C) and recombinant vaccines (choice D) may contain components that could still trigger an allergic response in individuals with a history of severe allergies. Inactivated vaccines are the safest choice for individuals with a history of severe allergic reactions as they do not pose a risk of causing an allergic reaction due to the absence of live pathogens.

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