Question 1

What goal has the highest priority for a child with malabsorption associated with lactose intolerance?

Accepted Answer

The child with lactose intolerance will have diarrhea and malabsorption,so a good goal would be no longer having these manifestations.A child usually has abdominal cramping pain and distention rather than spasms.The child usually has diarrhea,not constipation.One kilogram every week may or may not be appropriate depending on the child's age and how long the goal is in place for.

Question 2

Careful handwashing before and after contact can prevent the spread of which condition in daycare and school settings?

Accepted Answer

Hepatitis A is spread person to person,by the fecal-oral route,and through contaminated food or water.Good handwashing is critical in preventing its spread.The virus can survive on contaminated objects for weeks.The other conditions are not contagious.

Question 3

What is an expected outcome for a 1-month-old infant with biliary atresia?

Accepted Answer

Adequate nutrition,preventing skin breakdown,adequate growth and development,and family education and support are expected outcomes in an infant with biliary atresia.The goal of the Kasai procedure is to allow for adequate growth until a trAnswerplant can be done.It is not a curative procedure.Vitamin B₁₂supplementation is not indicated.A salt-restricted diet is appropriate.Protein intake may need to be restricted to avoid hepatic encephalopathy.

Question 4

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 indicates a correct understanding of the teaching?

Accepted Answer

Easily digested foods such as cereals,cooked vegetables,and meats should be provided for the child.Early reintroduction of nutrients is desirable.Continued feeding or reintroduction of a regular diet has no adverse effects and actually lessens the severity and duration of the illness.Clear liquids and carbonated drinks have high carbohydrate content and few electrolytes.Caffeinated beverages should be avoided because caffeine is a mild diuretic.The BRAT diet (bananas,rice,applesauce,and toast)is no longer recommended.

Question 5

Therapeutic management of the child with acute diarrhea and dehydration usually begins with

Accepted Answer

Orally administered rehydration solution is the first treatment for acute diarrhea.Clear liquids are not recommended because they contain too much sugar,which may contribute to diarrhea.The child might need an IV but would not be NPO.Antidiarrheals are not recommended because they do not get rid of pathogens.

Question 6

A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells.This is most suggestive of

Accepted Answer

Neutrophils and red blood cells in stool indicate bacterial gastroenteritis.This does not signify protein intolerance,a parasitic infection,or fat malabsorption.

Question 7

Which statement about Crohn disease is the most accurate?

Accepted Answer

Common manifestations of Crohn disease include abdominal cramping,diarrhea,and weight loss.Signs and symptoms are not usually present at birth.Edema does not accompany this disease.Symptoms do not typically disappear by adolescence.

Question 8

Which assessment finding is the most significant to report to the physician for a child with cirrhosis?

Accepted Answer

The child with cirrhosis must be assessed for encephalopathy,which is characterized by a change in level of consciousness.Encephalopathy can result from a buildup of ammonia in the blood from the incomplete breakdown of protein.One complication of cirrhosis is ascites.The child needs to be assessed for increasing abdominal girth and edema.A child who is retaining fluid will not exhibit weight loss.Biliary obstruction can lead to pruritus,which is a frequent finding.An alteration in the level of consciousness is of higher priority.Black,tarry stools may indicate blood in the stool.This needs be reported to the physician.This is not a higher priority than a change in level of consciousness.

Question 9

Which order should the nurse question when caring for a 5-year-old child after surgery for Hirschsprung disease?

Accepted Answer

Rectal temperatures should not be taken after this surgery.Rectal temperatures are generally not the route of choice for children because of the route's traumatic nature.The other interventions are all appropriate after this operation.

Question 10

Which description of a stool is characteristic of intussusception?

Accepted Answer

The characteristic stool of intussusception is described as "currant jelly." Ribbon-like stools are characteristic of Hirschsprung disease.With intussusception,passage of bloody mucous stools occurs.Stools will not be hard.Loose,foul-smelling stools may indicate infectious gastroenteritis.

Question 11

What is a priority concern for a 14-year-old child with inflammatory bowel disease?

Accepted Answer

Embarrassment and stress from chronic diarrhea are real concerns for the adolescent with inflammatory bowel disease.Antidiarrheal medications are not typically ordered for a child with inflammatory bowel disease.Long-term complications are not a priority concern for the adolescent with inflammatory bowel disease.Exacerbations may interfere with school attendance,but home schooling is not a usual consideration for the adolescent with inflammatory bowel disease.

Question 12

Therapeutic management of most children with Hirschsprung disease is primarily

Accepted Answer

Most children with Hirschsprung disease require surgical rather than medical management.Surgery is done to remove the aganglionic portion of the bowel,relieve obstruction,and restore normal bowel motility and function of the internal anal sphincter.Preoperative management may include enemas and a low-fiber,high-calorie,high-protein diet,until the child is physically ready for surgery.The colostomy that is created in Hirschsprung disease is usually temporary.

Question 13

Which nursing diagnosis has the highest priority for the toddler with celiac disease?

Accepted Answer

Imbalanced Nutrition: Less than Body Requirements is the highest priority nursing diagnosis because celiac disease causes gluten enteropathy,a malabsorption condition.A psychosocial diagnosis (Disturbed Body Image)would not take priority over a physical diagnosis.Celiac disease causes disproportionate growth and development associated with malnutrition,not obesity.Celiac crisis causes deficient fluid volume.

Question 14

The nurse caring for a child with suspected appendicitis should question which order from the physician?

Accepted Answer

A K-pad (moist heat device)is contraindicated for suspected appendicitis because it may contribute to the rupture of the appendix.NPO status,an IV,and a CBC are all appropriate for this child.

Question 15

A baby is scheduled for abdominal surgery for hypertrophic pyloric stenosis and has an NG tube to intermittent suction.When the family asks why the child has the tube,what response by the nurse is best?

Accepted Answer

The nasogastric tube provides decompression and decreases vomiting.A nursing responsibility when a patient has a nasogastric tube is measurement of accurate intake and output,but this is not why nasogastric tubes are inserted.Nasogastric tube placement does not decrease diarrhea.The presence of a nasogastric tube can be perceived as a discomfort by the patient.

Question 16

What should the nurse stress in a teaching plan for the mother of an 11-year-old boy with ulcerative colitis?

Accepted Answer

Coping with the stress of chronic illness and the clinical manifestations associated with ulcerative colitis (diarrhea,pain)are important teaching foci.Avoidance of triggers can help minimize the impact of the disease and its effect on the child.Ulcerative colitis is not infectious.Enemas are not used in this disease.

Question 17

The nurse notes on assessment that a 1-year-old child is underweight,with abdominal distention,thin legs and arms,and foul-smelling stools.The nurse suspects failure to thrive is associated with

Accepted Answer

These are classic symptoms of celiac disease.They are not related to intussusception,irritable bowel syndrome,or an imperforate anus.

Question 18

Which parasite causes acute diarrhea?

Accepted Answer

Giardiasis a parasite that represents 15% of nondysenteric illness in the United States.The other organisms are bacterial.

Question 19

Which viral pathogen frequently causes acute diarrhea in young children?

Accepted Answer

Rotavirus is the most frequent viral pathogen that causes diarrhea in young children.The other organisms are bacterial.

Question 20

What is the most important action to prevent the spread of gastroenteritis in a daycare setting?

Accepted Answer

Handwashing is the most the important measure to prevent the spread of infectious diarrhea.Prophylactic medications are not helpful in preventing gastroenteritis.Bringing food from home will not prevent the spread of infectious diarrhea.Gloves should be worn when changing diapers,soiled clothing,or linens.They do not need to be worn for interactions that do not involve contact with secretions.Handwashing after contact is indicated.

Quiz 43: The Child with a Gastrointestinal Alteration