Deck 41: The Child With Gastrointestinal Dysfunction

Question 1

Nurses must be alert for increased fluid requirements when a child presents with which possible concern?

A) Fever
B) Mechanical ventilation
C) Congestive heart failure
D) Increased intracranial pressure (ICP)

Answer 1

Fever

Question 2

Therapeutic management of most children with Hirschsprung's disease is primarily:

A) daily enemas.
B) low-fiber diet.
C) permanent colostomy.
D) surgical removal of affected section of bowel.

Answer 2

surgical removal of affected section of bowel.

Question 3

The best chance of survival for a child with cirrhosis is:

A) liver transplantation.
B) treatment with corticosteroids.
C) treatment with immune globulin.
D) provision of nutritional support.

Answer 3

liver transplantation.

Question 4

What is used to treat moderate-to-severe inflammatory bowel disease?

A) Antacids
B) Antibiotics
C) Corticosteroids
D) Antidiarrheal medications

Question 5

What is the primary purpose of prescribing a histamine receptor antagonist for an infant diagnosed with gastroesophageal reflux?

A) Prevent reflux
B) Prevent hematemesis.
C) Reduce gastric acid production.
D) Increase gastric acid production.

Question 6

When caring for a child with probable appendicitis,the nurse should be alert to recognize what sign of perforation?

A) Bradycardia
B) Anorexia
C) Sudden relief from pain
D) Decreased abdominal distention

Question 7

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

A) Clear liquids
B) Adsorbents such as kaolin and pectin
C) Oral rehydration solution (ORS)
D) Antidiarrheal medications such as paregoric

Question 8

Which clinical manifestation would most suggest acute appendicitis?

A) Rebound tenderness
B) Bright red or dark red rectal bleeding
C) Abdominal pain that is relieved by eating
D) Abdominal pain that is most intense at McBurney point

Question 9

What condition is characterized by a chronic inflammatory process that may involve any part of the gastrointestinal (GI)tract from mouth to anus?

A) Crohn's disease
B) Ulcerative colitis
C) Meckel's diverticulum
D) Irritable bowel syndrome

Question 10

What is a common cause of acute diarrhea?

A) Hirschsprung's disease
B) Antibiotic therapy
C) Hypothyroidism
D) Meconium ileus

Question 11

What is the earliest clinical manifestation of biliary atresia?

A) Jaundice
B) Vomiting
C) Hepatomegaly
D) Absence of stooling

Question 12

A 4-month-old infant diagnosed with gastroesophageal reflux disease (GERD)is thriving without other complications.What should the nurse suggest to minimize reflux?

A) Place in Trendelenburg position after eating.
B) Thicken formula with rice cereal.
C) Give continuous nasogastric tube feedings.
D) Give larger, less frequent feedings.

Question 13

A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting.Therapeutic management of this child will begin with which intervention?

A) Intravenous fluids
B) Oral rehydration solution (ORS)
C) Clear liquids, 1 to 2 ounces at a time
D) Administration of antidiarrheal medication

Question 14

An infant is brought to the emergency department with poor skin turgor,sunken fontanel,lethargy,and tachycardia.This is suggestive of which condition?

A) Overhydration
B) Dehydration
C) Sodium excess
D) Calcium excess

Question 15

Bismuth subsalicylate may be prescribed for a child with a peptic ulcer to effect what result?

A) Eradicate Helicobacter pylori
B) Coat gastric mucosa
C) Treat epigastric pain
D) Reduce gastric acid production

Question 16

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

A) Protein intolerance
B) Parasitic infection
C) Fat malabsorption
D) Bacterial gastroenteritis

Question 17

Constipation has recently become a problem for a school-age child who is being treated for seasonal allergies.The nurse should focus the assessment on what possibly related factor?

A) Diet
B) Allergies
C) Antihistamines
D) Emotional factors

Question 18

The viral pathogen that frequently causes acute diarrhea in young children is:

A) Giardia organisms.
B) Shigella organisms.
C) Rotavirus.
D) Salmonella organisms.

Question 19

Which statement is most descriptive of Meckel's diverticulum?

A) It is more common in females than in males.
B) It is acquired during childhood.
C) Intestinal bleeding may be mild or profuse.
D) Medical interventions are usually sufficient to treat the problem.

Question 20

Which type of dehydration results from water loss in excess of electrolyte loss?

A) Isotonic dehydration
B) Isosmotic dehydration
C) Hypotonic dehydration
D) Hypertonic dehydration

Question 21

The nurse,caring for an infant whose cleft lip was repaired,should include which interventions into the infant's postoperative plan of care? (Select all that apply.)

A) Postural drainage
B) Petroleum jelly to the suture line
C) Elbow restraints
D) Supine and side-lying positions
E) Mouth irrigations

Question 22

What is the major focus of the therapeutic management for a child with lactose intolerance?

A) Compliance with the medication regimen
B) Providing emotional support to family members
C) Teaching dietary modifications
D) Administration of daily normal saline enemas

Question 23

What is the most appropriate nursing action when a child with a probable intussusception has a normal,brown stool?

A) Notify the practitioner
B) Measure abdominal girth
C) Auscultate for bowel sounds
D) Take vital signs, including blood pressure

Question 24

The nurse is caring for an infant with suspected pyloric stenosis.Which clinical manifestation would indicate pyloric stenosis?

A) Abdominal rigidity and pain on palpation
B) Rounded abdomen and hypoactive bowel sounds
C) Visible peristalsis and weight loss
D) Distention of lower abdomen and constipation

Question 25

The nurse,caring for a neonate with a suspected tracheoesophageal fistula,should include what intervention into the plan of care?

A) Elevating the head to facilitate secrete drainage.
B) Elevating the head for feedings only.
C) Feeding glucose water only.
D) Avoiding suctioning unless the infant is cyanotic.

Question 26

Careful hand washing before and after contact can prevent the spread of which condition in day care and school settings?

A) Irritable bowel syndrome
B) Ulcerative colitis
C) Hepatic cirrhosis
D) Hepatitis A

Question 27

Which description of a stool is characteristic of intussusception?

A) Ribbon-like stools
B) Hard stools positive for guaiac
C) "Currant jelly" stools
D) Loose, foul-smelling stools

Question 28

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

A) Preventing the spread of illness to others
B) Nutritional guidance and preventing constipation
C) Teaching daily use of enemas
D) Coping with stress and avoiding triggers

Question 29

What food choice by the parent of a 2-year-old child with celiac disease indicates a need for further teaching?

A) Oatmeal
B) Rice cake
C) Corn muffin
D) Meat patty

Question 30

Which statements regarding hepatitis B are correct? (Select all that apply.)

A) Hepatitis B cannot exist in a carrier state.
B) Hepatitis B can be prevented by hepatitis B virus vaccine.
C) Hepatitis B can be transferred to an infant of a breastfeeding mother.
D) The onset of hepatitis B is insidious.
E) Immunity to hepatitis B occurs after one attack.

Question 31

Which interventions should a nurse implement when caring for a child with hepatitis? (Select all that apply.)

A) Provide a well-balanced, low-fat diet.
B) Schedule playtime in the playroom with other children.
C) Teach parents not to administer any over-the-counter medications.
D) Arrange for home schooling because the child will not be able to return to school.
E) Instruct parents on the importance of good hand washing.

Question 32

A nurse is conducting dietary teaching on high-fiber foods for parents of a child with constipation.Which foods should the nurse include as being high in fiber? (Select all that apply.)

A) White rice
B) Avocados
C) Whole grain breads
D) Bran pancakes
E) Raw carrots

Question 33

Which type of hernia has an impaired blood supply to the herniated organ?

A) Hiatal hernia
B) Incarcerated hernia
C) Omphalocele
D) Strangulated hernia

Question 34

An important nursing consideration in the care of a child with celiac disease is to facilitate which intervention?

A) Refer to a nutritionist for detailed dietary instructions and education.
B) Help the child and family understand that diet restrictions are usually only temporary.
C) Teach proper hand washing and Standard Precautions to prevent disease transmission.
D) Suggest ways to cope more effectively with stress to minimize symptoms.

Question 35

A mother shares with the clinic nurse that she has been giving her 4 year old the antidiarrheal drug loperamide.What conclusion should the nurse arrive at based on knowledge of this classification of drugs?

A) Not indicated
B) Indicated because it slows intestinal motility
C) Indicated because it decreases diarrhea
D) Indicated because it decreases fluid and electrolyte losses

Question 36

The nurse is preparing to care for an infant returning from pyloromyotomy surgery.Which prescribed orders should the nurse anticipate implementing? (Select all that apply.)

A) Nothing by mouth for 24 hours
B) Administration of analgesics for pain
C) Ice bag to the incisional area
D) Intravenous (IV) fluids continued until tolerating fluids by mouth
E) Clear liquids as the first feeding

Question 37

An infant diagnosed with pyloric stenosis experiences excessive vomiting that can result in which condition?

A) Hyperchloremia
B) Hypernatremia
C) Metabolic acidosis
D) Metabolic alkalosis

Question 38

A mother who intended to breastfeed has given birth to an infant with a cleft palate.Which nursing interventions should be included in the plan of care? (Select all that apply.)

A) Giving medication to suppress lactation.
B) Encouraging and helping mother to breastfeed.
C) Teaching mother to feed breast milk by gavage.
D) Recommending use of a breast pump to maintain lactation until infant can suck.

Question 39

Which vaccine is now recommended for the immunization of all newborns?

A) Hepatitis A vaccine
B) Hepatitis B vaccine
C) Hepatitis C vaccine
D) Hepatitis A, B, and C vaccines