24) ANSWER      

D) Measure the abdominal girth.

Explanation

The first meconium stool should be passed within the first 24 hours after birth; if not, the abdominal girth should be measured to evaluate distention and the possibility of obstruction. The presence of anal fissures will not prevent the passage of a meconium stool (option 1). Notifying the physician will not provide more information (option 2). Increasing the amount of feedings will not provide more information, and if there is an obstruction, will complicate that problem (option 3). Note the key words not and first 36 hours. This tells you that there is a problem with the infant s gastrointestinal status. From there, make a selection that gathers more assessment data. Eliminate option 1 as obviously incorrect. Eliminate option 3 because increased feedings would not be given if a problem were suspected. Choose option 4 over 2 because a physician is called when there is a composite set of data, not one assessment item.