Deck 46: Gastrointestinal Dysfunction

Question 1

A histamine-receptor antagonist such as cimetidine (Tagamet)or ranitidine (Zantac)is ordered for an infant with gastroesophageal reflux disease.What is the purpose of this drug?

A) It prevents reflux.
B) It prevents hematemesis.
C) It reduces gastric acid production.
D) It increases gastric acid production.

Answer 1

It reduces gastric acid production.

Question 2

A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting.What is the first step in therapeutic management for this child?

A) Intravenous fluids
B) Oral rehydration solution (ORS)
C) Clear liquids,1 to 2 ounces at a time
D) Administration of antidiarrheal medication

Answer 2

Intravenous fluids

Question 3

An infant is brought to the emergency department with poor skin turgor,weight loss,lethargy,and tachycardia.What are these signs suggestive of?

A) Overhydration
B) Dehydration
C) Sodium excess
D) Potassium excess

Answer 3

Dehydration

Question 4

What is the viral pathogen that frequently causes acute diarrhea in young children?

A) Giardia organisms
B) Shigella organisms
C) Rotavirus
D) Salmonella organisms

Question 5

What is the first treatment a nurse provides in the therapeutic management of a child with acute diarrhea and dehydration?

A) Clear liquids
B) Adsorbents such as kaolin and pectin
C) Oral rehydration solution (ORS)
D) Antidiarrheal medications such as paregoric

Question 6

When a child has which symptom would the nurse be alert for increased fluid requirements?

A) Fever
B) Mechanical ventilation
C) Heart failure
D) Increased intracranial pressure (ICP)

Question 7

The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness.What should the nurse include in her discussion?

A) Avoid carbohydrate-containing liquids.
B) Give nothing by mouth for 24 hours.
C) Brush teeth or rinse mouth after vomiting.
D) Give plain water until vomiting ceases for at least 24 hours.

Question 8

A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells.These results are most suggestive of what condition?

A) Protein intolerance
B) Parasitic infection
C) Fat malabsorption
D) Bacterial gastroenteritis

Question 9

Which statement best describes Meckel's diverticulum?

A) It is more common in females than in males.
B) It is acquired during childhood.
C) Intestinal bleeding may be mild or profuse.
D) Medical interventions are usually sufficient to treat the problem.

Question 10

What is often the cause of acute diarrhea?

A) Irritable bowel syndrome
B) Antibiotic therapy
C) Hypothyroidism
D) Hirschsprung's disease

Question 11

Which is a parasite that causes acute diarrhea?

A) Shigella organisms
B) Salmonella organisms
C) Giardia lamblia
D) Escherichia coli

Question 12

What type of dehydration results from water loss in excess of electrolyte loss?

A) Isotonic dehydration
B) Isosmotic dehydration
C) Hypotonic dehydration
D) Hypertonic dehydration

Question 13

When caring for a child with probable appendicitis,which should the nurse watch for as a sign of perforation?

A) Bradycardia
B) Anorexia
C) Sudden relief from pain
D) Decreased abdominal distension

Question 14

Which clinical manifestation indicates acute appendicitis?

A) Rebound tenderness
B) Bright red or dark red rectal bleeding
C) Abdominal pain that is relieved by eating
D) Abdominal pain that is most intense at the McBurney point

Question 15

Which high-fibre food can the nurse recommend for a 10-year-old child with chronic constipation?

A) Popcorn
B) Pancakes
C) Muffins
D) Ripe bananas

Question 16

A 4-month-old infant has gastroesophageal reflux (GER)but is thriving without other complications.What should the nurse suggest to minimize reflux?

A) Place the child in Trendelenburg position after eating.
B) Thicken formula with rice cereal.
C) Give continuous nasogastric tube feedings.
D) Give larger,less frequent feedings.

Question 17

A school-age child with diarrhea has been rehydrated.The nurse is discussing the child's diet with the family.Which statement by the parent would indicate a correct understanding of the teaching?

A) "I will keep my child on a clear liquid diet for the next 24 hours."
B) "I should encourage my child to drink carbonated drinks but avoid food for the next 24 hours."
C) "I will offer my child bananas,rice,applesauce,and toast for the next 48 hours."
D) "I should have my child eat a normal diet with easily digested foods for the next 48 hours."

Question 18

A 3-year-old child with Hirschsprung's disease is hospitalized for surgery.A temporary colostomy will be necessary.What should the nurse recognize about preparing this child psychologically for surgery?

A) It is not necessary because of child's age.
B) It is not necessary because the colostomy is temporary.
C) It is necessary because it will require the child's adjustment.
D) It is necessary because the child must deal with a negative body image.

Question 19

Constipation has recently become a problem for a school-age girl.She is healthy except for seasonal allergies,which are now being successfully treated with antihistamines.What is the most likely cause of her constipation?

A) Diet
B) Allergies
C) Antihistamines
D) Emotional factors

Question 20

What is the primary therapeutic management for most children with Hirschsprung's disease?

A) Daily enemas
B) Low-fibre diet
C) Permanent colostomy
D) Surgical removal of affected section of bowel

Question 21

The nurse is caring for a boy with probable intussusception.He had diarrhea before admission but,while waiting for administration of air pressure to reduce the intussusception,he passes a normal brown stool.What is the most appropriate nursing action?

A) Notify the health provider.
B) Measure abdominal girth.
C) Auscultate for bowel sounds.
D) Take vital signs,including blood pressure.

Question 22

What is the most important nursing consideration when caring for a child with celiac disease?

A) Refer to a nutritionist for detailed dietary instructions and education.
B) Help the child and family understand that diet restrictions are usually only temporary.
C) Teach proper hand hygiene and standard precautions/routine practices to prevent disease transmission.
D) Suggest ways to cope more effectively with stress to minimize symptoms.

Question 23

When providing patient education to parents of a child who has just been diagnosed with Crohn's disease,which clinical manifestations will the nurse include in the discussion? Select all that apply.Express answer in small letters followed by a comma and a space-e.g. ,a,b,c

A) Rectal bleeding is common.
B) Diarrhea is usually moderate to severe.
C) Pain is usually not a symptom.
D) Anal and perianal lesions are common.
E) Fistulas and strictures are rare.
F) Growth delay may be severe.

Question 24

What is used to treat moderate to severe ulcerative colitis?

A) Antacids
B) Antibiotics
C) Corticosteroids
D) Antidiarrheal medications

Question 25

Which should be included when caring for the newborn with a cleft lip and palate before surgical repair?

A) Gastrostomy feedings
B) Keeping the infant in near-horizontal position during feedings
C) Allowing little or no sucking
D) Providing satisfaction for the infant's sucking needs

Question 26

Which statement is true about hepatitis B?

A) Hepatitis B cannot exist in a carrier state.
B) Immunity to hepatitis B does not occur after one attack.
C) Hepatitis B can be transferred to an infant from a breastfeeding mother.
D) The principal mode of transmission for hepatitis B is the fecal-oral route.

Question 27

Bismuth subsalicylate,clarithromycin,and metronidazole are prescribed for a child with a peptic ulcer for which reason?

A) It eradicates Helicobacter pylori.
B) It coats gastric mucosa.
C) It treats epigastric pain.
D) It reduces gastric acid production.

Question 28

The nurse is caring for an infant with suspected pyloric stenosis.Which clinical manifestation indicates this condition?

A) Abdominal rigidity and pain on palpation
B) Rounded abdomen and hypoactive bowel sounds
C) Visible peristalsis and weight loss
D) Distension of lower abdomen and constipation

Question 29

What disorder is characterized by a chronic inflammatory process that may involve any part of the gastrointestinal (GI)tract from mouth to anus?

A) Crohn's disease
B) Ulcerative colitis
C) Meckel's diverticulum
D) Irritable bowel syndrome

Question 30

What should the nurse do when caring for a newborn with a suspected tracheoesophageal fistula?

A) Elevate the head but give nothing by mouth.
B) Elevate the head for feedings.
C) Feed glucose water only.
D) Avoid suctioning unless the infant is cyanotic.

Question 31

Which statement best describes hepatitis A?

A) The incubation period is 6 weeks to 6 months.
B) The principal mode of transmission is through the parenteral route.
C) The onset is usually rapid and acute.
D) There is a persistent carrier state.

Question 32

What type of hernia has an impaired blood supply to the herniated organ?

A) Hiatal hernia
B) Incarcerated hernia
C) Omphalocele
D) Strangulated hernia

Question 33

What is the earliest clinical manifestation of biliary atresia?

A) Jaundice
B) Vomiting
C) Hepatomegaly
D) Absence of stooling

Question 34

An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN)and gastrostomy feedings.What should nursing care include?

A) Prepare the family for impending death.
B) Teach the family to watch for signs of central venous catheter infection.
C) Teach the family how to calculate caloric needs.
D) Secure TPN and gastrostomy tubing under the diaper,to lessen risk of dislodgment.

Question 35

A newborn was admitted to the nursery with a complete bilateral cleft lip and palate.The physician has explained the plan of therapy and its expected good results.However,the mother refuses to see or hold her baby.What should the nurse's initial therapeutic approach be to the mother?

A) Restate what the physician has told her about plastic surgery.
B) Encourage her to express her feelings.
C) Emphasize the normalcy of her baby and the baby's need for mothering.
D) Recognize that negative feelings toward the child continue throughout childhood.

Question 36

What is the best chance of survival for a child with cirrhosis?

A) Liver transplantation
B) Treatment with corticosteroids
C) Treatment with immune globulin
D) Provision of nutritional support