Question 1

The pediatric nurse is caring for a child with biliary atresia who underwent a Kasai procedure.Which assessment findings indicate that the procedure has been successful? (Select all that apply.)

Accepted Answer

A Kasai procedure attempts to restore bile drainage from the liver into the intestines.The child whose procedure was successful would demonstrate improvement in symptoms,including improved skin integrity (less pruritus and itching),less jaundice,darker stools,and lighter urine.Bilious vomit is not related.

Question 2

A pediatrician diagnoses gastroesophageal reflux (GER)in an infant.Which information will the nurse provide during the teaching session to the infant's parents? (Select all that apply.)

Accepted Answer

GER is the return of gastric contents from the stomach through the lower esophageal sphincter into the esophagus.This may be "silent" or accompanied by vomiting or regurgitation.Often this is associated with apnea,congestion,irritability,or food aversion.Treatment includes lifestyle changes and/or medication.A Nissen fundoplication is used to treat severe disease or disease that is unresponsive to other treatment options.

Question 3

A pediatric clinic nurse is caring for several children with umbilical hernias.For which of the children does the nurse plan to educate the parents on surgical correction? (Select all that apply.)

Accepted Answer

Most umbilical hernias resolve on their own between the ages of 3 and 5 years.A hernia larger than 1.5 cm is less likely to close on its own and may need surgical correction.Surgery is considered for persistent hernias beyond the age of 5 years,incarcerated hernias (a hernia not able to be replaced in the abdomen),and hernias that enlarge dramatically.The 7-year-old,the child with the hernia that can't be replaced,and the 2-year-old with an enlarging hernia are the most likely candidates for surgical repair.The other two children will be managed with watchful waiting.

Question 4

A nurse is presenting information to a support group for parents of children with inflammatory bowel disease.Which information is appropriate for the nurse to provide to these parents? (Select all that apply.)

Accepted Answer

Both ulcerative colitis and Crohn's disease are inflammatory bowel disorders that have an inherited component to their etiology and have tenesmus as a common symptom.Crohn's disease is characterized by "skip"-type lesions that involve noncontiguous segments of the bowel,whereas ulcerative colitis involves a continuous segment of bowel.Surgery can provide a cure for ulcerative colitis,but not Crohn's disease.Symptoms can be seen outside the GI tract in both diseases.

Question 5

The pediatric nurse explaining cholelithiasis to a nursing student would describe which risk factors for this disease process? (Select all that apply.)

Accepted Answer

Common risk factors for cholelithiasis include hyperlipidemia,obesity,pregnancy,use of birth control pills,infection,bile stasis,congenital anomalies,use of total parenteral nutrition,and family history.Native Americans and Hispanics of both genders have the highest rate of this disease according to ethnicity.Pancreatitis is the most common complication of cholelithiasis.Smoking is not related.

Question 6

In order to prevent omphalitis in an infant,which instructions does the nurse provide to the parents prior to discharge from the hospital? (Select all that apply.)

Accepted Answer

Omphalitis is infection of the umbilical cord stump.Prevention methods include keeping the area clean and dry,cleansing the umbilical stump with the recommended solution,and positioning the baby's diaper below the level of the umbilicus.The other three interventions are not related to preventing omphalitis.

Question 7

A nurse is teaching a parent about strategies for managing colic in the infant.Which suggestions does the nurse provide to this parent? (Select all that apply.)

Accepted Answer

Management strategies for colic include supporting the parents,reassuring the parents that the child is healthy,reinforcing the parents' attempts to comfort their child,swaddling and/or rocking the baby,decreasing environmental stimulation,assessing and re-teaching feeding and burping technique if needed,and providing an opportunity for parents to express their frustrations.Changing the baby's feeding schedule and switching from breast to cow's milk are not recommended.Probiotics may be useful,but studies on their use have been inconclusive.

Question 8

The nurse on a pediatric unit is caring for a child with short bowel syndrome.When providing nutritional therapy for the child,the nurse checks for feeding intolerance by making which daily assessments? (Select all that apply.)

Accepted Answer

Assessing feeding tolerance must be included as part of nursing care for a child with short bowel syndrome.Input,output,specific gravity,and weights are also assessed daily by the nurse.Stools are tested for occult blood,pH,and reducing substances.Patients are monitored for vomiting,changes in the appearance of the stools,and abdominal distention.Stool volume is not one of the daily assessments.Vital signs are assessed on all children,but are not directly related to feeding tolerance.

Question 9

The pediatric nurse caring for children in the emergency room teaches the student nurse about the injury statistics related to abdominal trauma.Which information does the nurse provide to the student? (Select all that apply.)

Accepted Answer

The leading cause of death in children and adolescents after the first year of life is injuries.Injuries are responsible for more than 50% of all deaths in the 15- to 24-year-old age group Motor vehicle injuries are the primary cause of accidental death in the United States,with nearly 60% occurring with unrestrained children.Ten percent of incidents of serious trauma to children occur as a result of abdominal and genitourinary injury.

Question 10

The pediatric nurse is monitoring a child for signs of hepatitis.Which documented assessment findings indicate that the child is experiencing the preicteric phase of this disease process? (Select all that apply.)

Accepted Answer

Headache,anorexia,malaise,abdominal pain,nausea,and vomiting are characteristic of the preicteric phase,which lasts approximately 1 week and usually precedes the onset of clinically detectable disease.The most common symptoms of the icteric phase are jaundice and hepatomegaly,which may last several weeks.

Quiz 24: Caring for the Child With a Gastrointestinal Condition