Deck 15: Gastrointestinal Disorders

Question 1

The pediatric nurse in a clinic is mentoring a newly hired nurse who has no experience in pediatrics. The new nurse is performing a physical assessment on an infant who is 1 month of age. Which observation will prompt the nurse to discuss assessment skills with the new nurse?

A)The new nurse states, "How can I hear bowel sounds when he cries?"
B)The new nurse keeps the sleeping infant covered for parts of the assessment.
C)The new nurse performs all observations before physical assessment.
D)The new nurse informs the attending parent about the assessment actions.

Answer 1

The new nurse states, "How can I hear bowel sounds when he cries?"

Question 2

The nurse is admitting an infant who is 3 months of age. The parents sought medical attention when the infant began passing pale-colored stools that are nearly white. The infant had been diagnosed with biliary atresia at birth and underwent corrective surgery. For which treatment will the nurse prepare the parents?

A)A liver transplant
B)A second corrective surgery
C)Initiating comfort care
D)Focusing on diet therapy

Answer 2

A liver transplant

Question 3

The NICU nurse is providing care for a neonate who presents with an overabundance of secretions that the neonate cannot manage. The nurse also identifies the neonate is anorectal and exhibits some limb deformity. Which assessment process will the nurse perform first?

A)Check whether there are deformities of the palate.
B)Check for choking after a feeding tube is passed.
C)Observe if cyanosis occurs during bottle feeding.
D)Determine the extent to which a feeding tube can be passed.

Answer 3

Determine the extent to which a feeding tube can be passed.

Question 4

Identify one or more choices that best complete the statement or answer the question.
A neonate is born with a 6-cm omphalocele, in which the stomach and intestines are contained within a sac of amnio, peritoneum, and Wharton's jelly outside of the abdomen. For which additional anomalies will the nurse assess? Select all that apply.

A)Neural tube defects
B)Cardiac defects
C)Rupture of the sac
D)Herniation of the brainstem
E)Exstrophy of the urinary bladder

Question 5

Identify one or more choices that best complete the statement or answer the question.
A grandmother brings a toddler to a pediatric clinic and states, "I am worried that my grandchild is not getting adequate care." The nurse is able to verify the child is underweight for height and age. Which findings will cause the nurse to initiate additional assessment? Select all that apply.

A)The grandmother cannot provide an adequate feeding history.
B)The toddler's weight for height is less than the 20th percentile.
C)The toddler repeatedly asks if the nurse will get some food.
D)The toddler's evaluation at birth indicates prematurity.
E)The mother is a single parent and lives alone with the toddler.

Question 6

Identify one or more choices that best complete the statement or answer the question.
The nurse in a pediatric clinic is performing a physical examination of a patient who is 8 years of age. The patient's weight is over the 95th percentile on the growth chart. The patient also expresses the presence of knee and abdominal pain. The patient's parent states, "He will outgrow it; all my boys start off like this." Which information does the nurse present to the parent? Select all that apply.

A)Obesity is related to the development of diabetes mellitus.
B)Being a social outcast can cause feelings of poor self-esteem.
C)Children with obesity are more likely to drop out of school.
D)There is a high risk for cardiac disease and hypertension.
E)Obesity adversely affects joint health and function.

Question 7

The nurse is providing care for an adolescent diagnosed with Crohn's disease. The nurse provides patient teaching regarding which manifestation of the condition?

A)Urgency to defecate
B)Possibility of oral aphthous ulcers
C)Episodic epigastric pain
D)Nocturnal awakening events

Question 8

A neonate is born with gastroschisis. Which action will the nurse perform immediately?

A)Prepare the mother for a serious birth defect in the neonate.
B)Promote nonnutritive sucking to fulfill the neonate's needs.
C)Protect the defect with a nonadherent sterile saline dressing.
D)Place an orogastric tube to decompress the neonate's intestines.

Question 9

The nurse is preparing teaching materials for an adolescent patient recently diagnosed with nonalcoholic fatty liver disease (NAFLD). The adolescent initially presented with right upper quadrant pain, obesity, and hepatomegaly. Which teaching will the nurse initially present?

A)Review lifestyle changes and diet modification with the adolescent.
B)Explain the care that is provided in the event acute liver failure occurs.
C)Discuss feelings the adolescent has related to the disease diagnosis.
D)Begin to introduce the probability for a liver transplant later in life.

Question 10

Identify one or more choices that best complete the statement or answer the question.
The nurse in a neonatal nursery is mentoring a newly hired nurse. The new nurse expresses uncertainty about the facts of physiological and pathological jaundice. Which information does the nurse provide? Select all that apply.

A)In newborns, a low level of jaundice is normal.
B)Normal jaundice usually appears within a week of birth.
C)Immaturity of the liver prevents effective metabolization of bilirubin.
D)Greatest concern is when jaundice develops before the first 24 hours.
E)High levels of bilirubin cause hyperactivity and insatiable hunger.

Question 11

The nurse is providing care for a 2-month-old infant admitted to the hospital for testing because of a persistent low-grade fever. Laboratory tests and ultrasound of the abdomen confirm the presence of gallstones. Which procedure does the nurse expect to be prescribed for this infant?

A)Immediate preparation for abdominal surgery
B)Monitoring without surgical interventions
C)Endoscopic removal of stones and gallbladder
D)Placing the infant on low-fat, soy-based formula

Question 12

A parent brings an 18-month-old toddler to the pediatric emergency department for abdominal pain and stool mixed with blood and mucus. The pain is recurring three to four times an hour. Which intervention will the nurse initiate first?

A)Assess laboratory results.
B)Initiate intravenous access.
C)Maintain strict intake and output.
D)Prepare for ultrasound studies.

Question 13

An adult female arrives in the emergency department following a spontaneous birth at home. The female indicates that no prenatal care has been received. Which assessment finding about the female causes the nurse greatest concern for the newborn?

A)A laboratory result reveals a positive hepatitis A anti-HAV-total.
B)The mother is emaciated and has indications of drug abuse.
C)The mother has no permanent address and denies having family.
D)A laboratory result reveals a positive hepatitis B e antigen (HBeAg).

Question 14

The nurse in a pediatric clinic is obtaining information about a 7-month-old infant with GI symptoms. The parent informs the nurse that bloating, flatulence, and foul-smelling stools occurred with the introduction of wheat cereal. Which additional information will cause the nurse to initiate emergency care?

A)Dental enamel defects of the teeth
B)Presence of dermatitis herpetiformis
C)Severe vomiting and diarrhea
D)Weight loss indicated by thinness of extremities

Question 15

The nurse is informing a new mother of the concern about her newborn who is 36 hours old and has not passed any meconium. The nurse shares a suspicion of Hirschsprung's disease. The mother asks the nurse multiple questions about the condition. Which information will the nurse provide?

A)Retained meconium is a source of severe infection in newborns.
B)A positive diagnosis indicates the newborn is terminally ill.
C)The absence of nerves in the colon also indicates mobility issues.
D)The condition is congenital and causes blockage of the intestines.

Question 16

The nurse in a pediatric clinic is working with a preschool patient and a parent about managing the child's functional constipation. Which is the most important information for the nurse to share?

A)The child is allowed to select a reward for having a bowel movement.
B)The child is informed of the treatments for constipation and/or impaction.
C)Parental action is required for the onset of vomiting or severe abdominal pain.
D)The parents expect the child to sit on the toilet for a period of time each day.

Question 17

The nurse in a pediatric clinic is obtaining a health history on a child who is 9 years of age. The nurse learns the child exhibits a chronic cough, midsternal discomfort, and frequent sore throats without infection. Physical assessment indicates the child is on the 50th percentile on the height chart and on the 85th percentile for weight. Which recommendation does the nurse make?

A)Serve citrus juices instead of carbonated beverages.
B)Begin an age-appropriate weight loss program.
C)Initiate a practice of no eating or drinking after dinner.
D)Encourage lying on the left side after eating a meal.

Question 18

The nurse in a pediatric clinic is assessing an infant 2 months of age. The mother states, "He always spits up, but it has become so much worse. Vomit goes everywhere." Which additional assessment will help the nurse identify a possible diagnosis for the infant?

A)A hard mass is palpated in the mid-epigastrium.
B)Vomiting occurs both before and after eating.
C)Weight is normal even with frequent vomiting.
D)Normal skin turgor is noted over the sternum.

Question 19

Identify one or more choices that best complete the statement or answer the question.
A patient who is 17 years old comes to his health-care provider for a sports physical. The nurse's visual assessment places the patient in high percentiles for both weight and height. Which additional assessments does the nurse expect to be conducted for a complete health evaluation? Select all that apply.

A)Body mass index
B)Bedtime cortisol levels
C)Glucose levels after meals
D)Lipid profile
E)Thyroid-stimulating hormone level

Question 20

Identify one or more choices that best complete the statement or answer the question.
The nurse is collecting assessment information on a pediatric patient who is 13 years of age. The patient is at the clinic for recurrent gastrointestinal distress. Which questions are appropriate for the nurse to ask the patient? Select all that apply.

A)"Can you describe the pain you are having?"
B)"Do you ever have cramping or bloating?"
C)"Is there a family history of GI problems?"
D)"Do you have a history of previous illnesses?"
E)"Are there any changes at home or school?"