Question 1

A mother who intended to breastfeed has given birth to an infant with a cleft palate.Nursing interventions should include (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.

Accepted Answer

The mother who wishes to breastfeed may need encouragement and support because the defect does present some logistical issues.The nipple must be positioned and stabilized well back in the infant's oral cavity so that the tongue action facilitates milk expression.The suction required to stimulate milk,absent initially,may be useful before nursing to stimulate the let-down reflex.Because breastfeeding is an option,if the mother wishes to breastfeed,medications should not be given to suppress lactation.Because breastfeeding can usually be accomplished,gavage feedings are not indicated.

Question 2

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

Accepted Answer

Feedings are usually instituted soon after a pyloromyotomy surgery,beginning with clear liquids and advancing to formula or breast milk as tolerated.IV fluids are administered until the infant is taking and retaining adequate amounts by mouth.Appropriate analgesics should be given around the clock because pain is continuous.Ice should not be applied to the incisional area as it vasoconstricts and would reduce circulation to the incisional area and impair healing.

Question 3

The school nurse observes a child with a peanut allergy in obvious distress, wheezing and cyanotic, after ingestion of some trail mix containing peanuts. Place the interventions the nurse should implement in order of the highest priority to the lowest priority.

-Third priority
A)Call Jason's parents and notify them of the situation.
B)Call Jason's family practitioner to obtain further orders for medication.
C)Promptly administer an intramuscular (IM) dose of epinephrine.
D)Call 911 and wait for the emergency response personnel to arrive.

Accepted Answer

The answer of The school nurse observes a child with...

Question 4

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

Accepted Answer

Hepatitis A is spread person to person,by the fecal-oral route,and through contaminated food or water.Good hand washing is critical in preventing its spread.The virus can survive on contaminated objects for weeks.Irritable bowel syndrome is the result of increased intestinal motility and is not contagious.Ulcerative colitis is not infectious.Cirrhosis is not infectious.

Question 5

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

Accepted Answer

Universal vaccination for hepatitis B is now recommended for all newborns.A vaccine is available for hepatitis A,but it is not yet universally recommended.No vaccine is currently available for hepatitis C.Only hepatitis B vaccine is recommended for newborns.

Question 6

What should the nurse stress in a teaching plan for the mother of an 11-year-old boy 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

Accepted Answer

Coping with the stress of chronic illness and the clinical manifestations associated with ulcerative colitis (diarrhea,pain)are important teaching foci.Avoidance of triggers can help minimize the impact of the disease and its effect on the child.Ulcerative colitis is not infectious.Although nutritional guidance is a priority teaching focus,diarrhea is a problem with ulcerative colitis,not constipation.Daily enemas are not part of the therapeutic plan of care.

Question 7

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.

Accepted Answer

The child with hepatitis should be placed on a well-balanced,low-fat diet.Parents should be taught to not give over-the-counter medications because of impaired liver function.Hand hygiene is the most important preventive measure for the spread of hepatitis.The child will be in contact isolation in the hospital,so playtime with other hospitalized children is not scheduled.The child will be on contact isolation for a minimum of 1 week after the onset of jaundice.After that period,the child will be allowed to return to school.

Question 8

A child has a nasogastric (NG)tube to continuous low intermittent suction.The physician's prescription is to replace the previous 4-hour NG output with a normal saline piggyback over a 2-hour period.The NG output for the previous 4 hours totaled 50 mL.What milliliter/hour rate should the nurse administer to replace with a normal saline piggyback? _____ Record your answer as a whole number.

Accepted Answer

The answer of A child has a nasogastric (NG)tube to...

Question 9

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.

Accepted Answer

The vaccine elicits the formation of an antibody to the hepatitis B surface antigen,which is protective against hepatitis B.Hepatitis B can be transferred to an infant of a breastfeeding mother,especially if the mother's nipples are cracked.The onset of hepatitis B is insidious.Immunity develops after one exposure to hepatitis B.Hepatitis B can exist in a carrier state.

Question 10

An infant with pyloric stenosis experiences excessive vomiting that can result in:
A)Hyperchloremia.
B)Hypernatremia.
C)Metabolic acidosis.
D)Metabolic alkalosis.

Accepted Answer

Infants with excessive vomiting are prone to metabolic alkalosis from the loss of hydrogen ions.Chloride ions and sodium are lost with vomiting.Metabolic alkalosis,not acidosis,is likely.

Question 11

The school nurse observes a child with a peanut allergy in obvious distress, wheezing and cyanotic, after ingestion of some trail mix containing peanuts. Place the interventions the nurse should implement in order of the highest priority to the lowest priority.

-Fourth priority
A)Call Jason's parents and notify them of the situation.
B)Call Jason's family practitioner to obtain further orders for medication.
C)Promptly administer an intramuscular (IM) dose of epinephrine.
D)Call 911 and wait for the emergency response personnel to arrive.

Accepted Answer

The fourth priority is to call Jason's parents and notify them of the situation, as the immediate medical interventions and emergency response are more critical.

Question 12

A mother calls the clinic nurse about her 4-year-old son who has acute diarrhea.She has been giving him the antidiarrheal drug loperamide (Imodium A-D).The nurse's response should be based on knowledge that this drug is:
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.

Accepted Answer

Antidiarrheal medications are not recommended for the treatment of acute infectious diarrhea.These medications have adverse effects and toxicity,such as worsening of the diarrhea because of slowing of motility and ileus,or a decrease in diarrhea with continuing fluid losses and dehydration.Antidiarrheal medications are not recommended in infants and small children.

Question 13

During the first few days after surgery for cleft lip,which intervention should the nurse do?
A)Leave infant in crib at all times to prevent suture strain.
B)Keep infant heavily sedated to prevent suture strain.
C)Remove restraints periodically to cuddle infant.
D)Alternate position from prone to side-lying to supine.

Accepted Answer

The nurse should remove restraints periodically,while supervising the infant,to allow him or her to exercise arms and to provide cuddling and tactile stimulation.The infant should not be left in the crib,but should be removed for appropriate holding and stimulation.Analgesia and sedation are administered for pain.Heavy sedation is not indicated.The child should not be placed in the prone position.

Question 14

The school nurse observes a child with a peanut allergy in obvious distress, wheezing and cyanotic, after ingestion of some trail mix containing peanuts. Place the interventions the nurse should implement in order of the highest priority to the lowest priority.

-First priority
A)Call Jason's parents and notify them of the situation.
B)Call Jason's family practitioner to obtain further orders for medication.
C)Promptly administer an intramuscular (IM) dose of epinephrine.
D)Call 911 and wait for the emergency response personnel to arrive.

Accepted Answer

The prompt administration of an IM dose of epinephrine is the highest priority intervention for a child experiencing an anaphylactic reaction to a food allergen.

Answer: D
 Calling 911 and waiting for emergency response personnel to arrive is important, but it is a secondary priority after administering epinephrine.

Answer: A
 Calling Jason's parents to notify them of the situation is important but it can be done after addressing the child's immediate medical needs.

Answer: B
 Calling Jason's family practitioner to obtain orders for medication is also important but less urgent than administering epinephrine and calling 911.

Question 15

The school nurse observes a child with a peanut allergy in obvious distress, wheezing and cyanotic, after ingestion of some trail mix containing peanuts. Place the interventions the nurse should implement in order of the highest priority to the lowest priority.

-Second priority
A)Call Jason's parents and notify them of the situation.
B)Call Jason's family practitioner to obtain further orders for medication.
C)Promptly administer an intramuscular (IM) dose of epinephrine.
D)Call 911 and wait for the emergency response personnel to arrive.

Accepted Answer

The answer of The school nurse observes a child with...

Question 16

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

Accepted Answer

High-fiber foods include whole grain breads,bran pancakes,and raw carrots.Unrefined (brown)rice is high in fiber but white rice is not.Raw fruits,especially those with skins or seeds,other than ripe banana or avocados are high in fiber.

Quiz 41: Gastrointestinal Dysfunction

A mother who intended to breastfeed has given birth to an infant with a cleft palate.Nursing interventions should include (Select all that apply) :

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) ?

The school nurse observes a child with a peanut allergy in obvious distress, wheezing and cyanotic, after ingestion of some trail mix containing peanuts. Place the interventions the nurse should implement in order of the highest priority to the lowest priority. -Third priority

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

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

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

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

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

An infant with pyloric stenosis experiences excessive vomiting that can result in:

The school nurse observes a child with a peanut allergy in obvious distress, wheezing and cyanotic, after ingestion of some trail mix containing peanuts. Place the interventions the nurse should implement in order of the highest priority to the lowest priority. -Fourth priority

A mother calls the clinic nurse about her 4-year-old son who has acute diarrhea.She has been giving him the antidiarrheal drug loperamide (Imodium A-D) .The nurse's response should be based on knowledge that this drug is:

During the first few days after surgery for cleft lip,which intervention should the nurse do?

The school nurse observes a child with a peanut allergy in obvious distress, wheezing and cyanotic, after ingestion of some trail mix containing peanuts. Place the interventions the nurse should implement in order of the highest priority to the lowest priority. -First priority

The school nurse observes a child with a peanut allergy in obvious distress, wheezing and cyanotic, after ingestion of some trail mix containing peanuts. Place the interventions the nurse should implement in order of the highest priority to the lowest priority. -Second priority

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) ?