HESI Registered Nurse EXIT Practice Exam

Which parent's comment about a newborn most likely suggests pyloric stenosis?

1. I noticed a little lump a little above the belly button.

2. The baby seems hungry all the time.

3. Mild vomiting that progressed to vomiting shooting across the room.

4. Irritation and spitting up immediately after feedings.

The correct answer is: Mild vomiting that progressed to vomiting shooting across the room.

The comment about mild vomiting that progressed to vomiting shooting across the room strongly suggests pyloric stenosis. This condition involves the narrowing of the pylorus, which is the passage between the stomach and the small intestine. As a result, the stomach’s contents are unable to pass into the intestine effectively. One of the hallmark signs of pyloric stenosis is projectile vomiting, which typically occurs after feeding and is often described as occurring with significant force, sometimes described as "shooting across the room." This symptom helps differentiate pyloric stenosis from other forms of vomiting that may be more common in newborns. Other comments, such as noticing a lump above the belly button or that the baby seems constantly hungry, may indicate feeding issues or potential gastrointestinal conditions but do not specifically point toward pyloric stenosis like the description of projectile vomiting does. Likewise, irritation and spitting up immediately after feedings can occur due to a variety of benign reasons, such as overfeeding or reflux, and do not carry the same implications for pyloric stenosis as the concerned comment about severe vomiting does.