Deck 24: Caring for the Child With a Gastrointestinal Condition

Question 1

A school-age child has a diagnosis of constipation.When planning dietary teaching for the parents,what food does the nurse emphasize as a means to decrease constipation?

A) Cheese
B) Milk
C) Produce
D) Rice

Answer 1

Produce

Question 2

A pediatric nurse listens while a mother describes her toddler's eating habits.The mother states that her daughter "refuses to eat vegetables at mealtime" and "wants peanut butter sandwiches for every meal." Which action by the nurse is the most appropriate?

A) Encourage the mom to keep trying to get the child to eat vegetables.
B) Reassure the mother that this behavior is normal for a toddler.
C) Refer the mother to a pediatric dietician for unmet nutritional needs.
D) Teach the mother this behavior puts the child at risk for eating disorders.

Answer 2

Reassure the mother that this behavior is normal for a toddler.

Question 3

A nurse is preparing oral rehydration solution for a child weighing 13.7 lb (6.21 kg).How much solution should the nurse prepare for one feeding?

A) 0.5-2 mL
B) 2-4 mL
C) 6 mL
D) 10 mL

Answer 3

0.5-2 mL

Question 4

A school-age child presents with crampy lower abdominal pain,uveitis,and arthralgias.Which diagnostic test does the nurse prepare the patient and parents for based on the assessment findings?

A) Colonoscopy
B) Flat plate of the abdomen
C) Gastric biopsy
D) Nuclear medicine scan

Question 5

An adolescent is being treated with sulfasalazine (Azulfadine)for moderate Crohn's disease.How does the nurse explain the action of this medication to the patient?

A) Causes immunosuppression
B) Lessens diarrhea occurrences
C) Reduces inflammation
D) Treats crampy abdominal pain

Question 6

The student nurse studying the digestive system knows that most of the work of absorption occurs through a system of villi and folds in which gastrointestinal structure?

A) Gallbladder
B) Large intestine
C) Small intestine
D) Stomach

Question 7

A mother brings her infant to the pediatrician for a checkup.She tells the pediatric nurse that almost every afternoon her infant fusses,generally at the same time each day and usually during the late afternoon or evening.The infant pulls both legs and arms into a flexed position.Based on this description,the nurse assesses the infant further for which condition?

A) Gastric ulcers
B) Infantile colic
C) Meckel diverticulum
D) Irritable bowel syndrome

Question 8

A nurse in a community clinic assesses children for signs of failure to thrive (FTT).Which child's assessment finding is most concerning to this nurse?

A) Child's parent asking questions about feeding
B) Mother demonstrating improper burping technique
C) Weight for age and sex at the 4th percentile
D) Weight for length at 86% of ideal weight

Question 9

The registered nurse is explaining to a nursing student that which of the following is the most common cause of gastric ulcers in children?

A) Burn injury and other critical illness
B) Infection with Helicobacter pylori
C) Stress and living in poverty
D) Use of tobacco and alcohol products

Question 10

A nurse is assessing a 6-month-old baby with volvulus.The infant's vital signs are as follows: pulse: 118 beats/minute; blood pressure: 78/54 mm Hg; respirations: 42 breaths/minute.What action by the nurse is most appropriate?

A) Assess the infant's abdomen and skin.
B) Document the findings in the baby's chart.
C) Increase the rate of IV fluid administration.
D) Notify the health-care provider immediately.

Question 11

A parent calls the after-hours clinic nurse's line and describes a bulging mass in his 6-month-old son's scrotal area that used to disappear when the child was quiet.Now the mass is constantly present.What action by the nurse is the most appropriate?

A) Ask the parent to call in the morning to make an appointment.
B) Have the father withhold all feedings for 24 hours.
C) Instruct the father to take the child to an emergency department.
D) Reassure the father the condition is benign unless bloody diarrhea occurs.

Question 12

A child may have a deficiency in production of prothrombin and fibrinogen.The nurse anticipates diagnostic testing related to which organ?

A) Duodenum
B) Gallbladder
C) Liver
D) Pancreas

Question 13

A neonate is born with rectal atresia.Which action is the priority for this patient?

A) Assist with immediate intubation.
B) Obtain informed consent for surgery.
C) Place the child in protective isolation.
D) Teach the parents colostomy care.

Question 14

A child is taking azathioprine (Imuran)for moderate Crohn's disease.Which assessment finding best indicates that an important goal related to this medication has been met?

A) The child has not developed seasonal illnesses.
B) Edema and fluid retention have been eliminated.
C) Stools are more solid and passed less often.
D) Weight gain has been consistent at each visit.

Question 15

A nurse is caring for an infant waiting for surgical correction of intussusception.The child passes a diarrheal stool.Which action by the nurse is the most appropriate?

A) Document the findings.
B) Increase the IV fluid rate.
C) Notify the physician.
D) Weigh the child's diaper.

Question 16

In providing anticipatory guidance,what does the nurse teach parents about nutrition in their 4-year-old child?

A) Food jags are common in this age group.
B) Give the child a wide variety of foods.
C) Introduce foods slowly and carefully.
D) Provide 108 kcal/kg (50 kcal/lb).

Question 17

During a well-child visit,the pediatric nurse performs a physical assessment on a 2-year-old patient.Which of the following developmental characteristics would the nurse expect to be the case for a child of 2 years?

A) Average weight gain is 10 to 12 lb/year.
B) The digestive system grows rapidly, increasing caloric needs.
C) The salivary glands reach adult size.
D) Stomach capacity increases to about 200 mL.

Question 18

A pediatric nurse is caring for a 10-year-old patient on the pediatric unit who has been vomiting upon arising in the morning for the past 2 days.The nurse knows that this symptom is often associated with which condition?

A) Bowel blockage
B) Neurological involvement
C) Stomach cancer
D) Ulcerative colitis

Question 19

A child is being discharged from the hospital after a pyloromyotomy.Which discharge instruction does the nurse provide for the parents?

A) Keep child NPO for 48 hours.
B) Monitor the skin around the colostomy.
C) No pain control should be needed.
D) Report vomiting after 48 hours.

Question 20

A parent calls the pediatric clinic about his child who was diagnosed with gastric ulcer disease and placed on omeprazole (Prilosec)8 days ago.The parent states that the child has not had relief of symptoms.Which action by the nurse is the most appropriate?

A) Advise the parent to bring the child in today.
B) Encourage the parent to serve milk at each meal.
C) Inform the provider that the child needs a different medication.
D) Reassure the parent that relief may take 4-8 weeks.

Question 21

A father brings his son to the emergency department complaining that the child has a fever and severe,foul-smelling diarrhea.The child's only previous health complaint was constipation.The nurse notes abdominal distention and firmness on palpation.Which nursing action takes priority?

A) Have the father sign a consent for emergency surgery.
B) Place the child on NPO status and insert an NG tube.
C) Prepare to administer intravenous antibiotics.
D) Start an IV and provide maintenance and replacement fluids.

Question 22

A child in the emergency department has a suspected Meckel diverticulum.What diagnostic testing is most important for the nurse to facilitate?

A) Abdominal ultrasound
B) Complete blood count
C) Non-contrast CT scan
D) Radionuclide scintigraphy

Question 23

A mother is distraught after learning that her son has Hirschsprung disease.She asks the nurse how she could have prevented this from occurring.Which response by the nurse is most appropriate?

A) "Did you use recreational drugs during pregnancy?"
B) "How much alcohol did you consume while pregnant?"
C) "Nothing; this disease seems to be familial in origin."
D) "You probably did not get enough folic acid in your diet."

Question 24

A school-age child is being discharged after a laparoscopic appendectomy.Which discharge teaching does the nurse provide to the child and family?

A) Allow activity as the child desires.
B) Call the surgeon for reports of pain.
C) Empty the drains twice a day.
D) Report redness or heat at the incision sites.

Question 25

A new nurse is caring for a toddler with failure to thrive (FTT).Which action by the new nurse would cause the preceptor nurse to intervene?

A) Collaborating with laboratory to schedule blood draws well before mealtime
B) Hiding needed medication and supplements in child's favorite food
C) Teaching parents how a child's nutrition needs differ from an adult's
D) Weighing the child at the same time each day on the same scale

Question 26

A nurse is performing a focused abdominal assessment on a child complaining of stomach pain.Which assessment finding warrants immediate action by the nurse?

A) Complains of pain of 4 on 1-10 scale
B) Lack of rebound tenderness
C) Negative obturator sign
D) Positive heel-drop jarring test

Question 27

A nurse notes that a patient has a bluish discoloration of the periumbilical area.Which term will the nurse use when documenting this finding in the medical record?

A) Cullen's sign
B) Grey Turner's sign
C) Kernig's sign
D) Psoas sign

Question 28

A nurse is teaching a group of day-care providers about infection control.Which action does the nurse explain is the best way to prevent children from contracting diarrhea?

A) Good hand-washing practices
B) Limiting toy sharing to small groups
C) Providing less juice with sugar
D) Wearing gloves to change diapers

Question 29

The pediatric nurse is caring for a hospitalized child with cirrhosis who has 4+ pitting edema.Which laboratory value would the nurse correlate with the edema?

A) Albumin: low
B) Cholesterol: low
C) Prothrombin time: high
D) White blood cell count: high

Question 30

A patient has pancreatitis.Which daily laboratory test will the nurse review as a priority for this patient?

A) Amylase
B) C-reactive protein
C) Lipase
D) White blood cell count

Question 31

A pediatric clinic nurse is educating parents about an important primary prevention measure for hepatitis A. Which topic does the nurse include in the teaching session?

A) Genetic counseling
B) Immune globulin
C) Immunization
D) Oatmeal baths

Question 32

A pediatric nurse is teaching the family of a child with celiac disease about necessary dietary modifications to manage the disease.Which information does the nurse include in the teaching session?

A) Eliminate all sources of corn.
B) High-calorie, high-protein foods are preferred.
C) Lactose restriction may be needed.
D) Rye and wheat must be avoided.
E) Watch for hidden sources of gluten.

Question 33

A nurse is conducting prenatal classes and teaches about common congenital defects.A pregnant woman asks how to prevent Meckel diverticulum,which she had when she was born.What information does the nurse provide to this pregnant woman?

A) Adequate intake of folic acid will prevent this condition from developing.
B) Avoid second-hand smoke, pollution, and exposure to heavy metals.
C) Early initiation of breastfeeding after birth is a preventative measure.
D) This condition is not preventable, but good prenatal care is still important.

Question 34

After surgical correction of a Meckel diverticulum,what nursing action is the most important?

A) Administration of total parenteral nutrition
B) Care of a nasogastric tube and oral care
C) Referral to a dietician for low-residue diet
D) Teaching parents and child colostomy care

Question 35

A child has been admitted to the hospital with acute diarrhea.Which assessment finding by the nurse would indicate that goals for the priority nursing diagnosis have been met?

A) No stooling for 4 hours
B) Perineal skin intact
C) Stable weight for 2 days
D) White blood cell count normal

Question 36

The nurse explains to the nursing student that lactose is hydrolyzed into glucose and galactose in which organ?

A) Gallbladder
B) Large intestine
C) Small intestine
D) Stomach

Question 37

A nurse has been working with a teenager who has celiac disease.Which statement by the patient indicates that goals for an important diagnosis have been met?

A) "Gluten is obvious and easy to find in food products."
B) "I am gaining weight and I have more energy."
C) "Rice was my favorite; I hated to give that up."
D) "When my symptoms go away I can eat wheat again."

Question 38

A parent calls the pediatric clinic to make an appointment for her child who complains of periumbilical pain that has progressed to right lower quadrant pain.Later the parent calls to cancel the appointment,stating that the pain went away spontaneously after the child used a heating pad.What action by the nurse is most appropriate?

A) Ask the parent if the child has diarrhea or a fever.
B) Encourage the parent to keep the appointment anyway.
C) Instruct the parent to take the child to an emergency department.
D) Reassure the parent she can bring the child in if the pain returns.

Question 39

A nurse is caring for a child with irritable bowel syndrome (IBS)who has severe abdominal cramping.Which medication would the nurse question for this child?

A) Bisacodyl (Dulcolax)
B) Hyoscyamine (Levsin)
C) Phenobarbital (Donnatal)
D) Scopolomine (Isopto)

Question 40

A 13-year-old child has been admitted for acute pancreatitis.The parents want to know how the child contracted this disease.Which response by the nurse is the most appropriate?

A) "Has your child been exposed to pancreatitis?"
B) "In most cases we don't find the cause."
C) "Microliths are a common causative factor."
D) "Your child is probably drinking alcohol."

Question 41

The pediatric nurse is caring for a child with biliary atresia who underwent a Kasai procedure.Which assessment findings indicate that the procedure has been successful?

A) Improved skin integrity
B) Lessened jaundice in sclera
C) Stools that are lighter in color
D) Urine that becomes lighter in color
E) Vomitus that no longer contains bile

Question 42

In order to prevent omphalitis in an infant,which instructions does the nurse provide to the parents prior to discharge from the hospital?

A) Administration of prophylactic antibiotics
B) How to position a baby for diaper changes
C) Importance of monitoring stool frequency
D) Positioning of baby's diaper below the umbilicus
E) Stump cleaning with recommended solution

Question 43

The pediatric nurse is monitoring a child for signs of hepatitis.Which documented assessment findings indicate that the child is experiencing the preicteric phase of this disease process?

A) Anorexia
B) Hepatomegaly
C) Jaundice
D) Nausea
E) Spleenomegaly

Question 44

The pediatric nurse explaining cholelithiasis to a nursing student would describe which risk factors for this disease process?

A) Asian descent
B) Hyperlipidemia
C) Obesity
D) Pancreatitis
E) Smoking

Question 45

The pediatric nurse caring for children in the emergency room teaches the student nurse about the injury statistics related to abdominal trauma.Which information does the nurse provide to the student?

A) Injuries are responsible for more than 70% of all deaths in the 15- to 24-year-old age group.
B) Injuries are the leading cause of death in children and adolescents after their first year.
C) Injuries from motor vehicle crashes are the main cause of accidental death in the United States.
D) Injuries to the abdomen and genitourinary system are usually caused by abuse.
E) Injuries to the abdominal and genitourinary area account for 10% of serious trauma.

Question 46

The nurse on a pediatric unit is caring for a child with short bowel syndrome.When providing nutritional therapy for the child,the nurse checks for feeding intolerance by making which daily assessments?

A) Intake and output
B) Stool volume
C) Specific gravity
D) Vital signs
E) Weight

Question 47

A pediatric clinic nurse is caring for several children with umbilical hernias.For which of the children does the nurse plan to educate the parents on surgical correction?

A) 7-year-old child with 1-cm hernia
B) Child with hernia that can't be replaced
C) Enlarging hernia in a 2-year-old
D) 1-year-old with 0.5-cm hernia
E) 3-year-old with 2-cm hernia

Question 48

A nurse is presenting information to a support group for parents of children with inflammatory bowel disease.Which information is appropriate for the nurse to provide to these parents?

A) Both diseases seem to have an inherited or genetic aspect.
B) Surgery can provide a cure for patients with Crohn's disease.
C) Symptoms outside the gastrointestinal tract only occur in Crohn's disease.
D) Tenesmus is a symptom commonly seen in both disorders.
E) Ulcerative colitis involves a continuous segment of bowel.

Question 49

A nurse is teaching a parent about strategies for managing colic in the infant.Which suggestions does the nurse provide to this parent?

A) Change the baby's feeding schedule.
B) Encourage daily use of probiotics.
C) Provide a peaceful environment.
D) Swaddle and rock the child when fussy.
E) Switch from breast milk to formula .

Question 50

A pediatrician diagnoses gastroesophageal reflux (GER)in an infant.Which information will the nurse provide during the teaching session to the infant's parents?

A) Causes the infant to refuse feedings because of discomfort
B) Includes the return of gastric contents from the stomach
C) Includes symptoms such as vomiting and regurgitation
D) Results in an infant who is often fussy and irritable
E) Usual treatment is a Nissen fundoplication