Deck 47: Gastrointestinal Dysfunction

Question 1

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:

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

Answer 1

Intravenous fluids.

Question 2

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

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

Answer 2

Oral rehydration solution (ORS).

Question 3

A parasite that causes acute diarrhea is:

A)Shigella organisms.
B)Salmonella organisms.
C)Giardia lamblia.
D)Escherichia coli.

Answer 3

Giardia lamblia.

Question 4

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

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

Question 5

A histamine-receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with gastroesophageal reflux. The purpose of this is to:

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

Question 6

Nurses must be alert for increased fluid requirements when a child has:

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

Question 7

Acute diarrhea is often caused by:

A)Celiac disease.
B)Antibiotic therapy.
C)Immunodeficiency.
D)Protein malnutrition.

Question 8

The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. The nurse should include:

A)Avoiding carbohydrate-containing liquids.
B)Giving nothing by mouth for 24 hours.
C)Brushing teeth or rinsing mouth after vomiting.
D)Giving plain water until vomiting ceases for at least 24 hours.

Question 9

When caring for a child with probable appendicitis,the nurse should be alert to recognize that a sign of perforation is:

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

Question 10

A 3-year-old child with Hirschsprung's disease is hospitalized for surgery. A temporary colostomy will be necessary. The nurse should recognize that preparing this child psychologically is:

A)Not necessary because of child's age.
B)Not necessary because the colostomy is temporary.
C)Necessary because it will be an adjustment.
D)Necessary because the child must deal with a negative body image.

Question 11

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.

Question 12

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 13

A high-fiber food that the nurse could recommend for a child with chronic constipation is:

A)Popcorn.
B)Pancakes.
C)Muffins.
D)Ripe bananas.

Question 14

A 4-month-old infant has gastroesophageal reflux disease (GERD) but 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 15

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 would indicate a correct understanding of the teaching?

A)"I will keep my child on a clear liquid diet for the next 24 hours."
B)"I should encourage my child to drink carbonated drinks but avoid food for the next 24 hours."
C)"I will offer my child bananas,rice,applesauce,and toast for the next 48 hours."
D)"I should have my child eat a normal diet with easily digested foods for the next 48 hours."

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

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 18

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 19

An infant is brought to the emergency department with poor skin turgor,weight loss,lethargy,and tachycardia. This is suggestive of:

A)Overhydration.
B)Dehydration.
C)Sodium excess.
D)Potassium excess.

Question 20

Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies,which are now being successfully treated with antihistamines. The nurse should suspect that the constipation is most likely caused by:

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

Question 21

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 22

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include:

A)Elevating the head but giving nothing by mouth.
B)Elevating the head for feedings.
C)Feeding glucose water only.
D)Avoiding suctioning unless the infant is cyanotic.

Question 23

Bismuth subsalicylate,clarithromycin,and metronidazole are prescribed for a child with a peptic ulcer to:

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

Question 24

The earliest clinical manifestation of biliary atresia is:

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

Question 25

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.

Question 26

What is true concerning hepatitis B? Choose 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)The principal mode of transmission for hepatitis B is the fecal-oral route.
F)Immunity to hepatitis B occurs after one attack.

Question 27

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 28

What 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 29

A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However,the mother refuses to see or hold her baby. Initial therapeutic approach to the mother should be to:

A)Restate what the physician has told her about plastic surgery.
B)Encourage her to express her feelings.
C)Emphasize the normalcy of her baby and the baby's need for mothering.
D)Recognize that negative feelings toward the child continue throughout childhood.

Question 30

An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include:

A)Preparing the family for impending death.
B)Teaching the family signs of central venous catheter infection.
C)Teaching the family how to calculate caloric needs.
D)Securing TPN and gastrostomy tubing under diaper to lessen risk of dislodgment.

Question 31

An important nursing consideration in the care of a child with celiac disease is to:

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 handwashing and Standard Precautions to prevent disease transmission.
D)Suggest ways to cope more effectively with stress to minimize symptoms.

Question 32

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

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

Question 33

The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infant's postoperative care include:

A)Arm restraints,postural drainage,mouth irrigations.
B)Cleansing suture line,supine and side-lying positions,arm restraints.
C)Mouth irrigations,prone position,cleansing suture line.
D)Supine and side-lying positions,postural drainage,arm restraints.

Question 34

A family who excludes meat from their diet but consumes dairy products would be referred to as ________________________ vegetarians.

Question 35

Which statement best characterizes hepatitis A?

A)The incubation period is 6 weeks to 6 months.
B)The principal mode of transmission is through the parenteral route.
C)Onset is usually rapid and acute.
D)There is a persistent carrier state.

Question 36

The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but,while waiting for administration of air pressure to reduce the intussusception,he passes a normal brown stool. The most appropriate nursing action is to:

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

Question 37

Caring for the newborn with a cleft lip and palate before surgical repair includes:

A)Gastrostomy feedings.
B)Keeping the infant in near-horizontal position during feedings.
C)Allowing little or no sucking.
D)Providing satisfaction of sucking needs.