Question 1

The pediatric nurse examines a 14-month-old patient for bowel sounds.Which assessment finding is typical for this stage of development?

Accepted Answer

Hyperactive bowel sounds mean rapid movement through the intestines, which is typical for a 14-month-old patient. Bowel sounds occur normally every 1 to 5 seconds in infants and young children. Bruits are not typically heard upon auscultation of the bowel and hypoactive bowel sounds may indicate decreased or absent bowel motility, which would not be typical for a 14-month-old.

Question 2

A nurse educator teaches her students about the anatomy of the gastrointestinal system.Which description about the functions of these organs might be discussed?

Accepted Answer

The upper portion of the gastrointestinal system (mouth and esophagus) is responsible for nutrient intake or ingestion.

Question 3

A newborn diagnosed with an omphalocele defect is admitted to the intensive care nursery.Which nursing action is appropriate on the basis of the current data?

Accepted Answer

An omphalocele is a congenital defect in which the abdominal organs protrude through the umbilical ring into the base of the umbilical cord, and it requires immediate surgical intervention. Placing the newborn on a radiant warmer helps maintain a stable temperature and prevents hypothermia, which is a common complication of newborns with omphaloceles. Placing the newborn in an open crib or preparing the newborn for phototherapy is not appropriate for this condition. Preparing the newborn for a bottle feeding is not a priority in the immediate care of a newborn with an omphalocele.

Question 4

An adolescent client reports recurrent abdominal pain with diarrhea and bloody stools.Which type of inflammatory bowel disease does the nurse suspect on the basis of these data?

Accepted Answer

Recurrent abdominal pain, diarrhea, and bloody stools are symptoms commonly associated with ulcerative colitis. NEC is more commonly seen in premature infants and not typically associated with bloody stools. Crohn's disease can also present with similar symptoms, but recurrent abdominal pain with bloody stools is more specific to ulcerative colitis. Appendicitis usually presents with localized abdominal pain and fever.

Question 5

A neonate is born with a bilateral cleft lip that was not detected during the pregnancy.The parents are distressed about the appearance of their infant.Which nursing actions are appropriate to assist the parents in bonding with their newborn? (Select all that apply.)

Accepted Answer

Calling the newborn by the chosen name, smiling and talking to the newborn, showing before and after pictures, and discussing positive features can help the parents bond with their baby by normalizing the situation and focusing on positive aspects.

Question 6

A pediatric nurse examines the abdomen of a preschool-aged child brought to the doctor's office by the grandmother because of vomiting over the last several days.Upon inspection,the nurse observes that the child's stomach is distended.On the basis of these data,which condition does the nurse suspect?

Accepted Answer

The symptoms of vomiting and distended abdomen are highly suggestive of intestinal obstruction, which is a serious condition requiring immediate medical attention. Kidney failure would not present with these symptoms, and displaced abdominal organs or omphalitis are less likely causes.

Question 7

Which parental action observed during a home-care visit for an infant diagnosed with gastroesophageal reflux requires intervention by the nurse?

Accepted Answer

Placing the infant in a car seat immediately after feeding can contribute to gastroesophageal reflux and should be avoided. The other parental actions are appropriate for an infant with gastroesophageal reflux.

Question 8

Which statements made by the adolescent following dietary teaching for Crohn's disease indicate correct understanding of the content presented by the nurse? (Select all that apply.)

Accepted Answer

Option A is incorrect because increasing fiber may actually worsen symptoms for Crohn's disease. Options B, C, and D are correct because they promote adequate nutrition and symptom management for Crohn's disease. Option E is not a correct statement related to the teaching provided by the nurse.

Question 9

The nurse is providing care to a newborn client who presents in the pediatric clinic for a 2-week health maintenance visit.The parents of the newborn are concerned because their baby has "gas all the time." Which responses from the nurse are appropriate? (Select all that apply.)

Accepted Answer

Newborns lack certain digestive enzymes, such as amylase and lipase, which can lead to gas as their digestive systems are still maturing.

Question 10

The pediatric nurse examines a 5-week-old infant who has been observed having projectile,nonbilious vomiting.Upon palpation,the nurse feels an olive-shaped mass in the midepigastrium.On the basis of these data,which condition does the nurse suspect?

Accepted Answer

Projectile, nonbilious vomiting and an olive-shaped mass in the midepigastrium are classic signs of hypertrophic pyloric stenosis. Rectal atresia would present with constipation, failure to pass meconium, and a distended abdomen. Intussusception would present with abdominal pain, vomiting, and bloody stools. Malrotation of the intestine may present with vomiting and a distended abdomen, but would not have the characteristic olive-shaped mass.

Question 11

Which gastrointestinal defects often diagnosed shortly after birth should the nurse include in the assessment process of all newborns? (Select all that apply.)

Accepted Answer

The answer of Which gastrointestinal defects often diagnosed shortly after...

Question 12

Which assessment data cause the nurse to suspect that a 3-year-old child has Hirschsprung's disease?

Accepted Answer

Chronic, progressive constipation and failure to gain weight are classic symptoms of Hirschsprung's disease due to the absence of ganglion cells in the affected segment of the colon. Clay-colored stools and dark urine are indicative of liver dysfunction, while a history of early passage of meconium in the newborn period is not specific to Hirschsprung's disease. Continual bouts of foul-smelling diarrhea are not typical of Hirschsprung's disease.

Question 13

The nurse is assessing abdominal girth for a pediatric client who presents with vomiting.Which nursing action is appropriate?

Accepted Answer

The appropriate action is to measure the abdominal girth around the widest part of the abdomen, which is typically at the level of the stomach or umbilicus, to accurately assess any distention or changes in size.

Question 14

Which parental statement at the end of a teaching session by the nurse indicates correct understanding of colostomy stoma care for the infant client?

Accepted Answer

Option C indicates correct understanding of colostomy stoma care, as it is important to watch for skin irritation around the stoma. Option A is incorrect, as changing the colostomy bag with each wet diaper is not necessary and may cause unnecessary damage to the skin. Option B is incorrect, as bleeding after cleansing the area around the stoma is not expected and should be reported to the healthcare provider. Option D is incorrect, as adhesive enhancers may not always be necessary and should be used only if prescribed by the healthcare provider.

Question 15

A pediatric nurse discusses with the parents medications prescribed for a school-aged child who is diagnosed with Crohn's disease.Which are usual pharmacological options for treatment?

Accepted Answer

The usual pharmacological options for treatment of Crohn's disease in children include antidiarrheal drugs to alleviate symptoms such as diarrhea, abdominal pain, and cramps. Antianxiety drugs, diuretic drugs, and cardiac drugs are not typically used for the treatment of Crohn's disease.

Question 16

An adolescent who is brought to the emergency department (ED)by his parents has the following symptoms: periumbilical pain that peaks at 4-hour intervals followed by right lower quadrant pain,which is followed by vomiting.On the basis of these data,which condition does the nurse suspect?

Accepted Answer

The symptoms described are classic signs of appendicitis, including periumbilical pain that migrates to the right lower quadrant, vomiting, and pain that increases in intensity over time. Meckel's diverticulum, omphalitis, and ulcerative colitis do not typically present with these specific symptoms.

Question 17

The nurse is preparing to discharge a child diagnosed with Hirschsprung's disease from the hospital.Which topic is appropriate for the nurse to include in the discharge teaching with the child's parents?

Accepted Answer

Hirschsprung's disease often requires a temporary colostomy, so it is important for the nurse to teach the parents how to care for the colostomy site and how to manage any associated complications. Options A and B are not directly related to Hirschsprung's disease, and option D is not necessary unless the child has significant malnutrition or cannot tolerate enteral nutrition.

Question 18

The pediatric nurse understands how each developmental stage contributes to the promotion of the health of the child.Which is a normal developmental attribute of the digestive system of the infant?

Accepted Answer

Infants have a built-in safeguard, such as the gag reflex, to prevent choking while swallowing and sucking, which is a normal developmental attribute of their digestive system.

Question 19

The nurse is providing care to a pediatric client diagnosed with inflammatory bowel disease who is prescribed daily prednisone.Which parental statement regarding administration of this drug indicates correct understanding of the teaching provided by the nurse?

Accepted Answer

Prednisone can cause gastrointestinal irritation, so it is best to administer it with meals to help minimize this side effect.

Question 20

The pediatric nurse is interpreting laboratory values for a patient suspected of having ulcerative colitis.Which finding does the nurse anticipate on the basis of the diagnosis?

Accepted Answer

Ulcerative colitis can cause chronic intestinal bleeding, which can lead to iron deficiency anemia and microcytic red blood cells.

Quiz 36: Child With a Gastrointestinal Condition