Question 1

Which assessment data would cause the nurse to suspect that a 3-year-old child has Hirschsprung disease?
A) Clay-colored stools and dark urine
B) History of early passage of meconium in the newborn period
C) History of chronic, progressive constipation and failure to gain weight
D) Continual bouts of foul-smelling diarrhea

Accepted Answer

Hirschsprung disease is characterized by chronic constipation, failure to gain weight, and possibly abdominal distension. While the child may also have diarrhea, foul-smelling or explosive stools are not typical. A history of early passage of meconium is common in infants with Hirschsprung disease, but is not as relevant in a 3-year-old. Clay-colored stools and dark urine may indicate liver dysfunction, but are not specifically associated with Hirschsprung disease.

Question 2

Which is the priority nursing action when preparing a neonate born with a gastroschisis defect for transport to a pediatric hospital for corrective surgery?
A) Covering the exposed intestines with sterile moist gauze
B) Wrapping the newborn warmly in two or three blankets
C) Providing a sterile water feeding to maintain hydration during transport
D) Allowing the parents of the newborn to see their child prior to transport

Accepted Answer

Covering the exposed intestines with sterile moist gauze is the priority nursing action when preparing a neonate born with a gastroschisis defect for transport to a pediatric hospital for corrective surgery. This helps to prevent heat and fluid loss, as well as minimize the risk of infection.

Question 3

A toddler is admitted to the surgical unit for a planned closure of a temporary colostomy. Which medical prescription should the nurse question? A) Clear liquids today. NPO tomorrow B) Type and cross-match for 1 unit of packed red blood cells. C) Rectal temperatures every 4 hours D) Start an intravenous line with D₅NS at 20 mL per hour.

Accepted Answer

Rectal temperatures should not be taken in a patient who is undergoing a temporary colostomy closure as it may cause trauma to the surgical site. The nurse should question this prescription and suggest an alternative site for temperature measurement.

Question 4

The nurse is providing care to a newborn client who presents in the pediatric clinic for a 2-week health maintenance visit. The parents of the newborn are concerned, as their baby has "gas all the time." Which responses from the nurse are appropriate? Select all that apply.
A) "Your baby has a relaxed lower esophageal sphincter, which is causing the gas."
B) "Your baby lacks the enzyme amylase, which is causing the gas."
C) "Your baby lacks the enzyme insulin, which is causing the gas."
D) "Your baby has an immature liver, which is causing the gas."
E) "Your baby lacks an enzyme that helps to digest fats, which is causing the gas."

Accepted Answer

Newborns lack certain digestive enzymes, such as amylase and lipase, which can lead to gas due to incomplete digestion of carbohydrates and fats.

Question 5

Which gastrointestinal defects, often diagnosed shortly after birth, should the nurse include in the assessment process of all newborns? Select all that apply.
A) Pyloric stenosis
B) Biliary atresia
C) Hirschsprung disease
D) Umbilical hernia
E) Diaphragmatic hernia

Accepted Answer

The answer of Which gastrointestinal defects, often diagnosed shortly after...

Question 6

Which parental statement at the end of a teaching session by the nurse indicates correct understanding of colostomy stoma care for the infant client?
A) "We will change the colostomy bag with each wet diaper."
B) "We will expect a moderate amount of bleeding after cleansing the area around the stoma."
C) "We will watch for skin irritation around the stoma."
D) "We will use adhesive enhancers when we change the bag."

Accepted Answer

Watching for skin irritation around the stoma is an important part of stoma care for an infant client with a colostomy. Option A is incorrect because changing the bag with each wet diaper is unnecessary and could lead to unnecessary expense and discomfort for the infant. Option B is incorrect because bleeding is not expected or normal during stoma care. Option D is incorrect because adhesive enhancers are not usually necessary for an infant client with a colostomy.

Question 7

A newborn diagnosed with an omphalocele defect is admitted to the intensive care nursery. Which nursing action is appropriate based on the current data?
A) Placing the newborn on a radiant warmer
B) Placing the newborn in an open crib
C) Preparing the newborn for phototherapy
D) Preparing the newborn for a bottlefeeding

Accepted Answer

Omphalocele is a congenital defect where the abdominal organs protrude through an opening in the abdominal wall. The newborn requires immediate stabilization and should be placed on a radiant warmer to maintain a stable body temperature. B is not appropriate as an open crib may not maintain body temperature. C is not appropriate as phototherapy is not related to omphalocele. D is not appropriate as the baby with this defect may require tube feeding or intravenous fluids.

Question 8

The nurse is unsuccessful in inserting a nasogastric tube for a newborn client. The nurse suspects the newborn has esophageal atresia/tracheoesophageal (EA/TE) fistula. Which nursing action is appropriate while waiting for the healthcare provider to further assess the neonate?
A) Position the newborn in semi-Fowler position.
B) Allow the newborn to be taken to the mother's room for bonding.
C) Offer the newborn formula feeding instead of breastfeeding.
D) Wrap the newborn in blankets and place in a crib by the viewing window.

Accepted Answer

Positioning the newborn in semi-Fowler position can help prevent aspiration from any oral secretions or emesis due to the suspected EA/TE fistula. Allowing the newborn to be taken to the mother's room for bonding or offering formula feeding instead of breastfeeding may not be safe until the EA/TE fistula is further assessed and managed by the healthcare provider. Placing the newborn in a crib by the viewing window is not a priority nursing action and does not address the suspected EA/TE fistula.

Question 9

A nasogastric tube to suction is ordered for a neonate diagnosed with a diaphragmatic hernia. Which complication related to gastric drainage is the priority when planning care for this neonate?
A) Weight loss
B) Metabolic alkalosis
C) Dehydration
D) Hyperbilirubinemia

Accepted Answer

Gastric drainage can lead to loss of hydrochloric acid and subsequent metabolic alkalosis in neonates with diaphragmatic hernia due to reduced gastric perfusion and peristalsis. Priority should be given to maintain acid-base balance and electrolyte levels, and prevent metabolic alkalosis. Options A, C, and D may occur as secondary complications, but are not the priority concern in this scenario.

Question 10

Which statements should the nurse include in a presentation related to the general function of the gastrointestinal (GI) system for parents of pediatric clients? Select all that apply.
A) "The GI tract is responsible for the ingestion and absorption of food."
B) "Newborns have smaller stomachs but increased peristalsis."
C) "All children require smaller, more frequent feedings."
D) "Infants lack certain digestive enzymes which increases the risk for regurgitation."
E) "By the second year of life a child is able to accommodate three meals each day."

Accepted Answer

The answer of Which statements should the nurse include in...

Question 11

A child returns from exploratory surgery following a gunshot wound to the abdomen. Which nursing intervention should be excluded for the plan of care?
A) Immediate initiation of oral feedings
B) Assessment of the surgical site
C) Administration of opioid narcotics for pain management
D) Visitation at the bedside

Accepted Answer

Immediate initiation of oral feedings would not be appropriate for a child who has just undergone exploratory surgery for a gunshot wound to the abdomen. The child's gastrointestinal tract needs time to recover and heal before being able to tolerate oral feedings again. Gradual introduction of clear liquids and soft, bland foods would be a more appropriate approach. Assessment of the surgical site, administration of opioid narcotics for pain management, and visitation at the bedside are all important components of the plan of care.

Question 12

An adolescent client reports recurrent abdominal pain with diarrhea and bloody stools. Which type of inflammatory bowel disease does the nurse suspect based on these data?
A) Necrotizing enterocolitis (NEC)
B) Ulcerative colitis (UC)
C) Crohn disease
D) Appendicitis

Accepted Answer

Recurrent abdominal pain with diarrhea and bloody stools are classic symptoms of ulcerative colitis, which is one type of inflammatory bowel disease. Necrotizing enterocolitis is typically seen in premature infants, while Crohn's disease may also present with abdominal pain and diarrhea, but bloody stools are less common. Appendicitis is not a type of inflammatory bowel disease.

Question 13

Which parental action, observed during a home care visit for an infant diagnosed with gastroesophageal reflux, requires intervention by the nurse?
A) The infant's formula has rice cereal added.
B) The mother holds the infant in a high Fowler position while feeding.
C) After feeding, the infant is placed in a car seat.
D) The mother draws up the ranitidine (Zantac) in a syringe for oral administration.

Accepted Answer

Placing the infant in a car seat after feeding can exacerbate gastroesophageal reflux by allowing stomach contents to flow back up into the esophagus. The nurse should educate the mother on proper positioning and recommend keeping the infant in an upright position for at least 30 minutes after feeding. Adding rice cereal to the formula may actually help reduce reflux by thickening the contents of the stomach, and holding the infant in a high Fowler position during feeding can also help prevent reflux. Drawing up medication in a syringe for oral administration is a standard method of delivering medication and does not require intervention.

Question 14

A neonate is born with a bilateral cleft lip that was not detected during the pregnancy. The parents are distressed about the appearance of their infant. Which nursing actions are appropriate to assist the parents to bond with their newborn? Select all that apply.
A) Calling the newborn by the chosen name
B) Keeping the newborn's lower face covered with the blanket
C) Smiling and talking to the newborn in the parents' presence
D) Showing the parents before and after pictures of other children with cleft lips
E) Discussing positive features of the baby

Accepted Answer

The answer of A neonate is born with a bilateral...

Question 15

Which statements, made by the adolescent following dietary teaching for Crohn disease, indicate correct understanding of the content presented by the nurse? Select all that apply.
A) "I can promote solid stools by increasing fiber in my diet."
B) "Small, frequent meals are preferred over three meals a day."
C) "I should identify foods that cause distress and eliminate them from my diet."
D) "High-calorie dietary supplement shakes can help me to meet my nutritional requirements."
E) "Socialization during my meal times is important even if my parents do not agree with my food choices."

Accepted Answer

Option B is correct as small, frequent meals are recommended as they are easier to digest and can help in reducing inflammation. Option C is correct as identifying and eliminating foods that cause distress can help reduce symptoms. Option D is correct as patients with Crohn's disease often have difficulty meeting their nutritional requirements and high-calorie dietary supplement shakes can help in meeting those requirements. Option A is incorrect as increasing fiber can aggravate symptoms in some individuals. Option E is incorrect as socialization during meal times may not be important if the individual is experiencing symptoms or having trouble with their diet, and it is not necessary to prioritize socialization over symptom management.

Question 16

Which is the priority nursing diagnosis when planning care for a newborn who is born with esophageal atresia and tracheoesophageal fistula?
A) Ineffective Tissue Perfusion
B) Ineffective Infant Feeding Pattern
C) Acute Pain
D) Risk for Aspiration

Accepted Answer

Risk for Aspiration is the priority nursing diagnosis for a newborn with esophageal atresia and tracheoesophageal fistula because the abnormal connection between the esophagus and the trachea increases the risk of food and fluids entering the lungs, leading to aspiration pneumonia.

Question 17

A nurse is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment should the nurse have on hand for the delivery?
A) Bag-valve-mask system
B) Sterile gauze and saline
C) Soft arm restraints
D) Endotracheal tube

Accepted Answer

An endotracheal tube is necessary because infants with a diaphragmatic hernia often have respiratory distress and require immediate intubation to secure the airway and provide adequate ventilation.

Question 18

The nurse is planning care for a school-age client who is postoperative for the surgical removal of the appendix. In addition to pharmacologic pain management, which should the nurse include in the plan of care to address pain?
A) Applying a warm, moist pack every 4 hours
B) Applying EMLA cream to the incision site prior to ambulation
C) Applying a cold, moist pack every 2 hours
D) Applying a pillow against the abdomen to splint the incision site when coughing

Accepted Answer

Applying a pillow against the abdomen to splint the incision site when coughing can help to decrease pain by providing support to the incision site, reducing tension on the incision, and avoiding excessive movement. Applying heat or cold may not be effective or appropriate for pain management in this case. EMLA cream is a local anesthetic and may not be necessary for pain management in a postoperative client.

Question 19

The nurse is assessing abdominal girth for a pediatric client who presents with abdominal distension. Which nursing action is appropriate?
A) Measuring the girth just below the umbilicus
B) Measuring the girth just below the sternum
C) Measuring the girth just above the pubic bone
D) Measuring the girth around the portion of the stomach

Accepted Answer

The answer of The nurse is assessing abdominal girth for...

Question 20

The nurse is providing care to a pediatric client, diagnosed with inflammatory bowel disease, who is prescribed daily prednisone. Which parental statement regarding administration of this drug indicates correct understanding of the teaching provided by the nurse?
A) "I will administer this medication between meals."
B) "I will administer this medication at bedtime."
C) "I will administer this medication one hour before meals."
D) "I will administer this medication with meals."

Accepted Answer

Prednisone is a corticosteroid that can cause stomach upset, nausea, and vomiting, so it is best to administer it with meals to minimize these side effects. Administering it between meals, at bedtime, or one hour before meals is not necessary and may not provide as much relief from gastrointestinal side effects.

Quiz 51: The Child With Alterations in Gastrointestinal Function

Which assessment data would cause the nurse to suspect that a 3-year-old child has Hirschsprung disease?

Which is the priority nursing action when preparing a neonate born with a gastroschisis defect for transport to a pediatric hospital for corrective surgery?

A toddler is admitted to the surgical unit for a planned closure of a temporary colostomy. Which medical prescription should the nurse question?

The nurse is providing care to a newborn client who presents in the pediatric clinic for a 2-week health maintenance visit. The parents of the newborn are concerned, as their baby has "gas all the time." Which responses from the nurse are appropriate? Select all that apply.

Which gastrointestinal defects, often diagnosed shortly after birth, should the nurse include in the assessment process of all newborns? Select all that apply.

Which parental statement at the end of a teaching session by the nurse indicates correct understanding of colostomy stoma care for the infant client?

A newborn diagnosed with an omphalocele defect is admitted to the intensive care nursery. Which nursing action is appropriate based on the current data?

The nurse is unsuccessful in inserting a nasogastric tube for a newborn client. The nurse suspects the newborn has esophageal atresia/tracheoesophageal (EA/TE) fistula. Which nursing action is appropriate while waiting for the healthcare provider to further assess the neonate?

A nasogastric tube to suction is ordered for a neonate diagnosed with a diaphragmatic hernia. Which complication related to gastric drainage is the priority when planning care for this neonate?

Which statements should the nurse include in a presentation related to the general function of the gastrointestinal (GI) system for parents of pediatric clients? Select all that apply.

A child returns from exploratory surgery following a gunshot wound to the abdomen. Which nursing intervention should be excluded for the plan of care?

An adolescent client reports recurrent abdominal pain with diarrhea and bloody stools. Which type of inflammatory bowel disease does the nurse suspect based on these data?

Which parental action, observed during a home care visit for an infant diagnosed with gastroesophageal reflux, requires intervention by the nurse?

A neonate is born with a bilateral cleft lip that was not detected during the pregnancy. The parents are distressed about the appearance of their infant. Which nursing actions are appropriate to assist the parents to bond with their newborn? Select all that apply.

Which statements, made by the adolescent following dietary teaching for Crohn disease, indicate correct understanding of the content presented by the nurse? Select all that apply.

Which is the priority nursing diagnosis when planning care for a newborn who is born with esophageal atresia and tracheoesophageal fistula?

A nurse is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment should the nurse have on hand for the delivery?

The nurse is planning care for a school-age client who is postoperative for the surgical removal of the appendix. In addition to pharmacologic pain management, which should the nurse include in the plan of care to address pain?

The nurse is assessing abdominal girth for a pediatric client who presents with abdominal distension. Which nursing action is appropriate?

The nurse is providing care to a pediatric client, diagnosed with inflammatory bowel disease, who is prescribed daily prednisone. Which parental statement regarding administration of this drug indicates correct understanding of the teaching provided by the nurse?