Deck 28: The Child with a Gastrointestinal Condition

Question 1

A child is brought to the pediatric clinic because he has been vomiting for the past 2 days. An acid-base imbalance that the nurse would expect to occur from this persistent vomiting is:

A) hyperkalemia.
B) hypernatremia.
C) acidosis.
D) alkalosis.

Answer 1

alkalosis.

Question 2

An appropriate intervention for a 3-month-old infant who has gastroesophageal reflux is to:

A) position the infant in the crib on his or her abdomen, with the head elevated.
B) administer medication as ordered to stimulate the pyloric sphincter.
C) give thin rice cereal with formula before feeding solid foods.
D) place the infant in an infant seat after feedings.

Answer 2

position the infant in the crib on his or her abdomen, with the head elevated.

Question 3

The nurse explains that the treatment of choice for a child with intussusception is:

A) a barium enema.
B) immediate surgery.
C) IV fluids until the spasms subside.
D) gastric lavage.

Answer 3

a barium enema.

Question 4

A child has been diagnosed with ascariasis (roundworm). The statement made by her mother that may suggest a cause for her condition is:

A) "I've been airing out the house on these nice breezy days."
B) "My child often goes out to the garden and pulls up a carrot to eat."
C) "She runs barefoot so much I have to wash her feet at least twice a day."
D) "We just remodeled our bathroom at home."

Question 5

The nurse would expect the stools of a child with celiac disease to have which appearance?

A) Ribbon like
B) Hard, constipated
C) Bulky, frothy
D) Loose, foul-smelling

Question 6

On the second day of hospitalization for a 3-month-old brought in for treatment for gastroenteritis, the nurse makes all of the assessments listed below. Which assessment finding indicates ineffectiveness of treatment?

A) Weight loss of 4 ounces
B) Dry mucous membranes
C) Decreased skin turgor
D) Depressed fontanelle

Question 7

A mother reports that her child has been scratching the anal area and complaining of itching. Based on this information, the nurse might suspect this child has:

A) pinworms.
B) giardiasis.
C) ringworm.
D) roundworm.

Question 8

Intussusception would be suspected when parents describe the child's stools as:

A) currant jelly.
B) black and tarry.
C) green liquid.
D) greasy and foul-smelling.

Question 9

The nurse interviewing parents of an infant with pyloric stenosis would expect the parents to report if the infant has had:

A) diarrhea.
B) projectile vomiting.
C) poor appetite.
D) constipation.

Question 10

The finding in a newborn suggestive of tracheoesophageal fistula is:

A) failure to pass meconium in 24 hours.
B) choking on the first feeding.
C) palpable mass in the sternal area.
D) visible peristalsis across abdomen.

Question 11

The nurse that is teaching a parent about pyrvinium (Povan) would include the information that the drug will cause:

A) diarrhea.
B) skin rash.
C) red stool.
D) metallic taste.

Question 12

A mother reports that her 2-year-old child experiences constipation frequently. The nurse would recommend to the mother to include what food in the child's diet?

A) Cooked vegetables
B) Pretzels
C) Whole-grain cereal
D) Yogurt

Question 13

Parents ask the nurse how their infant developed a Meckel's diverticulum. The nurse's response is based on the knowledge that this condition occurs when:

A) the yolk sac remains connected to the intestine.
B) there is inflammation of the ileocecal valve.
C) a pouch forms when the vitelline duct fails to disappear.
D) there is a weakness in the abdominal wall.

Question 14

The nurse is aware that rapid respirations are a possible cause of dehydration because they:

A) prevent the child from drinking.
B) increase circulation, thus increasing urine production.
C) cause evaporation of fluid on the mucous membranes.
D) often lead to vomiting.

Question 15

The nurse, planning a parent education program about lead poisoning prevention, would include the information that the sources of lead in the community are most likely:

A) increased lead content of air.
B) use of aluminum cookware.
C) deteriorating paint in older buildings.
D) inhaling smog.

Question 16

After reviewing dietary restrictions for celiac disease, the nurse determines that a parent understands the information when she states that a grain that can be eaten by a child with celiac disease is:

A) wheat.
B) oats.
C) barley.
D) rice.

Question 17

A child is brought to the emergency department because he ingested an unknown quantity of acetaminophen (Tylenol). After gastric lavage is completed, the nurse might expect this child to receive:

A) activated charcoal.
B) N-acetylcysteine.
C) vitamin K.
D) syrup of ipecac.

Question 18

The instruction the nurse would give to parents about preventing the spread and reinfection of pinworms is to:

A) keep children's nails short.
B) dress child in loose-fitting underwear.
C) clean the bathroom with bleach solution.
D) wash bed linens in cold water.

Question 19

A frightened mother calls the pediatrician's office because her child swallowed dishwashing detergent. The most appropriate action is to:

A) induce vomiting by giving the child syrup of ipecac.
B) take the child to the local emergency department.
C) give the child activated charcoal mixed with juice.
D) give the child milk to soothe affected mucous membranes.

Question 20

An infant is admitted to the hospital with severe isotonic dehydration. In planning the infant's care, the nurse is aware the infant is at risk for:

A) metabolic alkalosis.
B) hypocalcemia.
C) sepsis.
D) shock.

Question 21

When feeding a child with pyloric stenosis, what interventions will the nurse perform? Select all that apply.

A) Give a formula thinned with water.
B) Burp the infant before and during feeding.
C) Give the feeding slowly.
D) Refeed if the infant vomits.
E) Position infant on left side after feeding.

Question 22

The nurse explains that rickets, a deficiency disease that causes bony deformities, is caused by the inadequate supply of vitamin ______.

Question 23

The statement by a mother that may indicate a cause of her son's vitamin C deficiency is:

A) "We get our fruits from homemade preserves."
B) "We use milk from our own goats."
C) "We grow all our own vegetables."
D) "We're not big meat eaters."

Question 24

An infant is admitted to the hospital with severe dehydration. Laboratory results show pH 7.32, PaCO₂ 40, HCO₃- 21. The nurse interprets these values as:

A) metabolic acidosis.
B) metabolic alkalosis.
C) respiratory acidosis.
D) respiratory alkalosis.

Question 25

The nurse, speaking to the parent of a 3-year-old child who has mild diarrhea, would advise the dietary modification of:

A) soft foods with rice, bananas, toast, and applesauce.
B) small amounts of clear fluids such as gelatin.
C) an oral rehydrating solution, such as Pedialyte.
D) chicken soup because it is high in sodium.

Question 26

What assessment(s) would lead a nurse to suspect Hirschsprung's disease in a 1-month-old infant? Select all that apply.

A) Ribbon-like stools
B) Fever
C) Failure to thrive
D) Vomiting
E) Diminished peristalsis
F) None of the above

Question 27

Nursing interventions for the mother of a 10-month-old infant with nonorganic failure to thrive would include:

A) pointing out errors that the nurse observes when the mother is caring for the infant.
B) discussing negative characteristics of the infant with the mother.
C) having the nurse provide as much of the infant's care as possible.
D) teaching the mother about the developmental milestones to expect in the next few months.

Question 28

The nurse, assessing an elevated erythrocyte sedimentation rate (ESR) for an infant with gastroenteritis, recognizes that this confirms the _______________ process that is part of this disease.

Question 29

Following surgery for pyloric stenosis an infant awoke from anesthesia hungry and crying. The nurse should:

A) delay feeding the child for 6 hours.
B) offer regular formula thinned with water.
C) give small amounts of regular formula thickened with cereal.
D) allow one ounce of glucose water at frequent intervals.

Question 30

A 7-month-old infant is admitted to the hospital with a diagnosis of acute gastroenteritis. The priority goal of the infant's care is to prevent:

A) fluid and electrolyte imbalance.
B) nutritional deficiency.
C) skin breakdown.
D) malabsorption.

Question 31

The nurse instructing a mother how to administer oral nystatin suspension prescribed to treat thrush would teach her to:

A) pour the prescribed amount into a nipple and have the infant suck the medication.
B) squirt the prescribed dose into the back of the mouth and have the infant swallow.
C) give the medication mixed with a small amount of juice in a bottle.
D) use a sterile applicator to swab the medication on the oral mucosa.

Question 32

The nurse would expect a child admitted to the hospital for nonorganic failure to thrive to:

A) cry to be picked up.
B) be limp like a rag doll.
C) be responsive to cuddling.
D) weigh in the 10th percentile for age.

Question 33

One reason that infants are more vulnerable to fluid and electrolyte imbalances than adults is that:

A) they have a smaller surface area than adults in proportion to body weight.
B) water needs and losses per kilogram are lower than those for adults.
C) a greater percentage of body water in infants is extracellular.
D) infants have a lower metabolic turnover of water.

Question 34

The nurse is aware that the 18-pound child must take in _____ mL of oral fluid to make up the fluid loss from one stool of diarrhea.

A) 18
B) 36
C) 64
D) 81

Question 35

The nurse reminds parents of a child allergic to cow's milk that they should avoid foods that list ______________ as part of their contents.

Question 36

The nurse explains the medically accepted definition of constipation is fewer than _____ bowel movements in a 2-week period.

Question 37

What sign(s) indicate(s) moderate dehydration? Select all that apply.

A) 10% weight loss
B) Dry mucous membranes
C) Normal anterior fontanel
D) Increased urinary output
E) Lethargy

Question 38

The nurse explains that because _________________ beverages cause diuresis, they are not good choices for fluid replacement in a child who is dehydrated.