CHILD HEALTH GASTROINTESTINA

The nurse is reviewing the laboratory test results for an infant suspected of having hypertrophic pyloric stenosis. The nurse should expect to note which value as the most likely laboratory finding in this infant? 1. Blood pH of 7.50 2. Blood pH of 7.30 3. Blood bicarbonate of 22 mEq/L 4. Blood bicarbonate of 19 mEq/L

1. Blood pH of 7.50

The mother of a child with an umbilical hernia calls the clinic and reports to the nurse that the child has been vomiting and is complaining of pain in the abdominal area. Which instruction to the mother is most appropriate? 1. Contact the health care provider. 2. Keep the child on clear liquids. 3. Apply an ice pack to the abdomen. 4. Administer acetaminophen (Tylenol).

1. Contact the health care provider.

A nurse has been assigned to care for a neonate just delivered who has gastroschisis. Which concern should the nurse address in the client's plan of care? 1. Infection 2. Poor body image 3. Decreased urinary elimination 4. Cracking oral mucous membranes

1. Infection

The nurse provides home care instructions to the parents of a child with celiac disease. The nurse should teach the parents to include which food item in the child's diet? 1. Rice 2. Oatmeal 3. Rye toast 4. Wheat bread

1. Rice

The nurse is caring for a 1-year-old child after cleft palate repair. On completion of feeding, the nurse should plan for which appropriate nursing action? 1. Rinsing the mouth with water 2. Cleaning the mouth with diluted hydrogen peroxide 3. Using a soft lemon and glycerin swab to clean the mouth 4. Using cotton swabs saturated with half-strength povidone-iodine (Betadine) solution to clean the mouth

1. Rinsing the mouth with water

A clinic nurse is assessing the status of jaundice in a child with hepatitis. Which anatomical area will provide the best data regarding the presence of jaundice? 1. The nail beds 2. The skin in the sacral area 3. The skin in the abdominal area 4. The membranes in the ear canal

1. The nail beds

The clinic nurse is assessing jaundice in a child with hepatitis. Which anatomical area would provide the best data regarding the presence of jaundice? 1. The nail beds 2. The skin in the sacral area 3. The skin in the abdominal area 4. The membranes in the ear canal

1. The nail beds

The nurse is providing instructions to the parents of a child with a hernia regarding measures that will promote reducing the hernia. The nurse determines that the parents understand care for their child if they make which statement? 1. "We will encourage our child to cough every few hours on a daily basis." 2. "We will make sure that our child participates in physical activity every day." 3. "We will provide comfort measures to reduce any crying periods by our child." 4. "We will be sure to give our child a Fleet enema every day to prevent constipation."

3. "We will provide comfort measures to reduce any crying periods by our child."

The nurse has provided dietary instructions to the mother of a child with celiac disease. The nurse determines that further instruction is needed if the mother states that she will include which food item in the child's nutritional plan? 1. Corn 2. Chicken 3. Oatmeal 4. Vitamin supplements

3. Oatmeal

The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which symptom of this disorder documented? 1. Watery diarrhea 2. Ribbon-like stools 3. Profuse projectile vomiting 4. Bright red blood and mucus in the stools

4. Bright red blood and mucus in the stools

A home care nurse instructs the mother of a 5-year-old child with lactose intolerance about dietary measures for her child. The nurse should tell the mother that it is necessary to provide which dietary supplement in the child's diet? 1. Fats 2. Zinc 3. Protein 4. Calcium

4. Calcium

During a home care visit, an older client complains of chronic constipation. What should the nurse tell the client to do? 1. Increase potassium in the diet. 2. Include rice and bananas in the diet. 3. Increase the intake of sugar-free products. 4. Increase fluid intake to at least eight glasses a day and increase dietary fiber.

4. Increase fluid intake to at least eight glasses a day and increase dietary fiber.

A nurse is caring for a child who was brought to the clinic complaining of severe abdominal pain and is suspected of having acute appendicitis. The child is lying on the examining table, with the knees pulled up toward the chest. The nurse assists the health care provider with further assessment of the progression of the child's pain, knowing that the health care provider will palpate the abdomen in which location? 1. Midway between the liver and the gallbladder 2. Midway between the left iliac crest and the umbilicus 3. Midway between the left inguinal area and the acetabulum 4. Midway between the right anterior superior iliac crest and the umbilicus

4. Midway between the right anterior superior iliac crest and the umbilicus

After hydrostatic reduction for intussusception, the nurse should expect to observe which client response? 1. Abdominal distention 2. Currant jelly-like stools 3. Severe colicky-type pain with vomiting 4. Passage of barium or water-soluble contrast with stools

4. Passage of barium or water-soluble contrast with stools

The nurse is initiating nasogastric tube feedings in a child. When initiating this procedure the nurse should perform which action? 1. Microwave the formula. 2. Place the child in a prone position. 3. Encourage the child to point the head downward. 4. Position the child so that the head is slightly hyperflexed.

4. Position the child so that the head is slightly hyperflexed.

A nurse is preparing to care for a newborn infant following creation of a colostomy for the treatment of imperforate anus. In the immediate postoperative period, the nurse plans to inspect the stoma and expects to note which finding in the colostomy? 1. Bleeding 2. Gray in color 3. Dark blue in color 4. Red and edematous

4. Red and edematous

A nurse is assessing a child with a diagnosis of suspected appendicitis. In assessing the intensity and progression of the pain, the nurse palpates the child at McBurney's point. In performing this assessment, the nurse understands that McBurney's point is located midway between which area? 1. Left anterior inferior iliac crest and umbilicus 2. Left anterior superior iliac crest and umbilicus 3. Right anterior inferior iliac crest and umbilicus 4. Right anterior superior iliac crest and umbilicus

4. Right anterior superior iliac crest and umbilicus

The nurse provides feeding instructions to a parent of an infant diagnosed with gastroesophageal reflux disease. Which instruction should the nurse give to the parent to assist in reducing the episodes of emesis? 1. Provide less frequent, larger feedings. 2. Burp the infant less frequently during feedings. 3. Thin the feedings by adding water to the formula. 4. Thicken the feedings by adding rice cereal to the formula.

4. Thicken the feedings by adding rice cereal to the formula.

The nurse is preparing a plan of care for an infant who will be returning from the recovery room following the surgical repair of a cleft lip located on the right side of the lip. On return from the recovery room, the nurse should plan to place the infant in which position? 1. Prone and flat 2. Supine and flat 3. On the left side 4. On the right side

3. On the left side

An infant is seen in the health care provider's office for complaints of frequent vomiting and spitting up after feedings. Findings indicate that the infant is not gaining weight and gastroesophageal reflux is suspected. Which would the nurse anticipate being prescribed initially in the care of this child? 1. Place in prone position after each feeding. 2. Administer omeprazole (Prilosec) before feeding. 3. Instruct parents to keep a log of feedings and any reflux present. 4. Change the formula to predigested formula and feed small, frequent feedings.

4. Change the formula to predigested formula and feed small, frequent feedings.

The clinic nurse reviews the record of an infant and notes that the health care provider has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which symptom most likely led the mother to seek health care for the infant? 1. Diarrhea 2. Projectile vomiting 3. Regurgitation of feedings 4. Foul-smelling ribbon-like stools

4. Foul-smelling ribbon-like stools

An emergency department nurse is performing an assessment on a child with a suspected diagnosis of intussusception. Which assessment question for the parents will elicit the most specific data related to this disorder? 1. "Does the child have any food allergies?" 2. "What do the bowel movements look like?" 3. "Has the child eaten any food in the last 24 hours?" 4. "Can you describe the type of pain that the child is experiencing?"

4. "Can you describe the type of pain that the child is experiencing?"

An infant born with an imperforate anus returns from surgery with a colostomy. The nurse assesses the stoma and notes that it is red and edematous. What is the best nursing action based on this finding? 1. Elevate the buttocks. 2. Document the findings. 3. Apply ice immediately. 4. Call the health care provider.

2. Document the findings

A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem? 1. Diarrhea 2. Metabolic acidosis 3. Metabolic alkalosis 4. Hyperactive bowel sounds

3. Metabolic alkalosis

A child is diagnosed with Hirschsprung's disease. The nurse is teaching the parents about the cause of the disease. Which statement, if made by the parent, supports that teaching was successful? 1. "Special cells are not present in the rectum, which caused the disease." 2. "The protein part of wheat, barley, rye, and oats is not being digested fully." 3. "The disease occurs from increased bowel motility that leads to spasm and pain." 4. "The disease occurs because of inability to tolerate sugar found in dairy products."

1. "Special cells are not present in the rectum, which caused the disease."

A nurse has provided dietary instructions to the mother of a child with celiac disease. The nurse determines that the mother understands the instructions when the mother states to include which food in the child's diet? 1. Corn 2. Wheat cereal 3. Rye crackers 4. Oatmeal biscuits

1. Corn

A nurse is assigned to care for a child who is scheduled for an appendectomy. Select the prescription(s) that the nurse anticipates will be prescribed. Select all that apply. 1. Initiate an IV line. 2. Maintain an NPO status. 3. Administer a Fleet enema. 4. Administer intravenous antibiotics. 5. Administer preoperative medications. 6. Place a heating pad on the abdomen to decrease pain.

1. Initiate an IV line. 2. Maintain an NPO status. 4. Administer intravenous antibiotics. 5. Administer preoperative medications.

The nurse is developing a plan of care for an infant after surgical intervention for imperforate anus. The nurse should include in the plan that which position is the most appropriate one for the infant in the postoperative period? 1. Prone position 2. Supine with no head elevation 3. Side-lying with the legs extended 4. Supine with the head elevated 45 degrees

1. Prone position

Which interventions should the nurse include when preparing a care plan for a child with hepatitis? Select all that apply. 1. Providing a low-fat, well-balanced diet. 2. Teaching the child effective hand-washing techniques. 3. Scheduling playtime in the playroom with other children. 4. Notifying the health care provider (HCP) if jaundice is present. 5.Instructing the parents to avoid administering medications unless prescribed. 6.Arranging for indefinite home schooling because the child will not be able to return to school.

1. Providing a low-fat, well-balanced diet. 2. Teaching the child effective hand-washing techniques. 5. Instructing the parents to avoid administering medications unless prescribed.

The clinic nurse is obtaining data about a child with a diagnosis of lactose intolerance. Which data should the nurse expect to obtain on assessment? 1. Reports of frothy stools and diarrhea 2. Reports of foul-smelling ribbon stools 3. Reports of profuse, watery diarrhea and vomiting 4. Reports of diffuse abdominal pain unrelated to meals or activity

1. Reports of frothy stools and diarrhea

The nurse in the hospital is giving at-home feeding instructions to a family whose child is being discharged after being born with a cleft lip. Which statement by the mother would indicate that further teaching is indicated? 1. "I am so glad that I am able to breast-feed my baby." 2. "I must always feed my baby with a syringe and not use a nipple." 3. "I will burp my baby very frequently so that she does not swallow a lot of air." 4. "I will feed my baby while sitting in a chair and holding her more upright."

2. "I must always feed my baby with a syringe and not use a nipple."

A nurse provides home care instructions to the mother of a child who had a cleft palate repair 4 days ago. Which statement by the mother indicates the need for further instruction? 1. "I will use a short nipple on the bottle." 2. "I need to buy some straws for drinking." 3. "I can give my child the pacifier in 2 weeks." 4. "I will give my child baby foods or baby food mixed with water." 2. "I need to buy some straws for drinking."

2. "I need to buy some straws for drinking."

The nurse is providing discharge instructions to the mother of a child who had a cleft palate repair. Which statement should the nurse make to the mother? 1. "You should use a plastic spoon to feed the child." 2. "You need to use a short nipple on the child's bottle." 3. "You can allow the child to use a pacifier but only for 30 minutes at a time." 4. "You need to monitor the child's temperature for signs of infection using an oral thermometer."

2. "You need to use a short nipple on the child's bottle."

Parents bring their child to the emergency department and tell the nurse that the child has been complaining of colicky abdominal pain located in the lower right quadrant of the abdomen. The nurse suspects that the child has which disorder? 1. Peritonitis 2. Appendicitis 3. Intussusception 4. Hirschsprung's disease

2. Appendicitis

A 2-year-old child with acute diarrhea has been diagnosed with mild dehydration. Which rehydration methods would the nurse expect the health care provider to prescribe? 1. Increase intake of water with a diet high in carbohydrates. 2. Consume oral rehydration fluid, advancing to a regular diet. 3. Begin the BRAT diet (bananas, rice, apples, and toast or tea). 4. Begin fluid replacement immediately with intravenous fluids.

2. Consume oral rehydration fluid, advancing to a regular diet.

The nurse is preparing to care for a newborn infant who will be returning from surgery with a colostomy that was created for imperforate anus. When the infant arrives, the nurse assesses the stoma and notes that it is red and edematous. Which is the most appropriate nursing intervention? 1. Elevate the buttocks. 2. Document the findings. 3. Apply ice immediately. 4. Call the health care provider.

2. Document the findings.

The nurse is writing out discharge instructions for the parents of a child diagnosed with celiac disease. The nurse should focus primarily on which aspect of care? 1. Restricting activity 2. Following a gluten-free diet 3. Following a lactose-free diet 4. Giving medication to manage the condition

2. Following a gluten-free diet

The mother of an infant diagnosed with Hirschsprung's disease asks the nurse about the disorder. What should the nurse tell the mother about the disease? 1. It is complete small intestinal obstruction. 2. It is congenital aganglionosis or megacolon. 3. It is severe inflammation of the gastrointestinal tract. 4. It is condition that causes the pyloric valve to remain open.

2. It is congenital aganglionosis or megacolon.

The nurse is reviewing the laboratory results for an infant with suspected hypertrophic pyloric stenosis. What should the nurse expect to note as the most likely finding in this infant? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

2. Metabolic alkalosis

A child admitted to the hospital with a diagnosis of gastroenteritis and dehydration weighs 17 pounds 2 ounces. The parents state that his preadmission weight was 18 pounds 4 ounces. Based on weight alone, what type of dehydration does the nurse expect? 1. Mild dehydration 2. Moderate dehydration 3. Severe dehydration 4. Acute dehydration

2. Moderate dehydration

An infant is seen in the health care provider's office for complaints of projectile vomiting after feeding. Findings indicate that the child is fussy and is gaining weight but seems to never get enough to eat. Pyloric stenosis is suspected. Which prescription would the nurse anticipate having the highest priority in the care of this child? 1. Administer predigested formula. 2. Prepare the family for surgery for the child. 3. Administer omeprazole (Prilosec) before feeding. 4. Instruct the parents to keep a log of feedings and any reflux present.

2. Prepare the family for surgery for the child.

The nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On assessment, which data would the nurse expect to obtain when asking the mother about the child's symptoms? 1. Watery diarrhea 2. Projectile vomiting 3. Increased urine output 4. Vomiting large amounts of bile

2. Projectile vomiting

The nurse is developing a plan of care for an infant being admitted with hypertrophic pyloric stenosis who is scheduled for pyloromyotomy. In the preoperative period, which position should the nurse suggest to document in the plan of care? 1. In an infant seat placed in the crib 2. Prone with the head of the bed elevated 3. Supine with the head at a 90-degree angle 4. Supine with the head of the bed at a 30-degree angle

2. Prone with the head of the bed elevated

The nurse is caring for a newborn infant after surgical intervention for imperforate anus. The nurse should place the infant in which position in the postoperative period? 1. Supine with no head elevation 2. Side-lying with the legs flexed 3. Side-lying with the legs extended 4. Supine with the head elevated 30 degrees

2. Side-lying with the legs flexed

A mother brings her 5-week-old infant to the health care clinic and tells the nurse that the child has been vomiting after meals. The mother reports that the vomiting is becoming more frequent and forceful. The nurse suspects pyloric stenosis and asks the mother which assessment question to elicit data specific to this condition? 1. "Are the stools ribbon-like and is the infant eating poorly?" 2. "Does the infant suddenly become pale, begin to cry, and draw the legs up to the chest?" 3. "Does the vomit contain sour undigested food without bile, and is the infant constipated?" 4. "Does the infant cry loudly and continuously during the evening hours but nurses or takes formula well?"

3. "Does the vomit contain sour undigested food without bile, and is the infant constipated?"

A preschooler with a history of cleft palate repair comes to the clinic for a routine well-child checkup. To determine if this child is experiencing a long-term effect of cleft palate, which question should the nurse ask? 1. "Was the child recently treated for pneumonia?" 2. "Does the child play with an imaginary friend?" 3. "Is the child unresponsive when given directions?" 4. "Has the child had any difficulty swallowing food?"

3. "Is the child unresponsive when given directions?"

The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which most likely sign of this condition documented in the record? 1. Incessant crying 2. Coughing at nighttime 3. Choking with feedings 4. Severe projectile vomiting

3. Choking with feedings

The parents of a child with a cleft lip are concerned and ask the nurse when the lip will be repaired. With which statement should the nurse respond? 1. Cleft lip cannot be repaired. 2. Cleft-lip repair is usually performed by 6 months of age. 3. Cleft-lip repair is usually performed during the first weeks of life. 4. Cleft-lip repair is usually performed between 6 months and 2 years.

3. Cleft-lip repair is usually performed during the first weeks of life.

A nurse is reviewing the health care provider's documentation in the record of a child admitted with a diagnosis of intussusception. The nurse expects to note that the health care provider has documented which manifestation? 1. Scleral jaundice 2. Projectile vomiting 3. Currant jelly stools 4. Pale-colored and hard stools

3. Currant jelly stools

The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder? 1. Bile-stained fecal emesis 2. The passage of currant jelly-like stools 3. Failure to pass meconium stool in the first 24 hours after birth 4. Sausage-shaped mass palpated in the upper right abdominal quadrant

3. Failure to pass meconium stool in the first 24 hours after birth

An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time? 1. Prone position 2. On the stomach 3. Left lateral position 4. Right lateral position

3. Left lateral position

A 12-year-old girl is admitted to the hospital with suspected appendicitis. What nursing interventions should be implemented preoperatively? 1. Applying a heating pad for 5-minute intervals as prescribed 2. Administering acetaminophen (Tylenol) as needed for pain, as prescribed 3. Placing the adolescent in a fetal position, side-lying with legs drawn up to chest 4. Inserting a nasogastric tube and attaching it to low intermittent suction; measuring drainage as prescribed

3. Placing the adolescent in a fetal position, side-lying with legs drawn up to chest

A mother brings her child to the well-child clinic and expresses concern to the nurse because the child has been playing with another child diagnosed with hepatitis. The nurse performs an assessment on the child, knowing that which finding is unassociated with hepatitis? 1. Hepatomegaly 2. The presence of jaundice 3. The presence of left upper abdominal quadrant pain 4. The presence of dark-colored, frothy urine in the urine specimen

3. The presence of left upper abdominal quadrant pain

The nurse is collecting data on an infant with a diagnosis of suspected Hirschsprung's disease. Which question to the mother willmost specifically elicit information regarding this disorder? 1. "Does your infant have diarrhea?" 2. "Is your infant constantly vomiting?" 3. "Does your infant constantly spit up feedings?" 4. "Does your infant have foul-smelling, ribbon-like stools?"

4. "Does your infant have foul-smelling, ribbon-like stools?"

The nurse is providing discharge instructions to the mother of a child with herpetic gingivostomatitis. Which response by the mother indicates the need for further teaching? 1. "I will offer my child soft, bland foods." 2. "I will encourage my child to drink fluids." 3. "I will give my child frozen ice pops to assist with fluid intake." 4. "I will not give my child anything to eat for 2 days to allow the lesions to heal and crust over."

4. "I will not give my child anything to eat for 2 days to allow the lesions to heal and crust over."

The mother of a child with hepatitis A tells the home care nurse that she is concerned because the child's jaundice seems worse. Which response should the nurse make to the mother? 1. "You need to change the child's diet." 2. "The child probably is infectious again." 3. "You need to call the health care provider." 4. "In many situations, the jaundice worsens before it resolves."

4. "In many situations, the jaundice worsens before it resolves."

A 1-year-old child is diagnosed with intussusception, and the mother of the child asks the nurse to describe the disorder. Which statement is correct about intussusception? 1. "It is an acute bowel obstruction." 2. "It is a condition that causes an acute inflammatory process in the bowel." 3. "It is a condition in which a distal segment of the bowel prolapses into a proximal segment of the bowel." 4. "It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel."

4. "It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel."

The nurse is caring for an infant after repair of an inguinal hernia. Which of these assessment findings indicate that the surgical repair was effective? 1. A clean, dry incision 2. Abdominal distention 3. An adequate flow of urine 4. Absence of inguinal swelling with crying

4. Absence of inguinal swelling with crying

The mother of an 18-month-old child tells the clinic nurse that the child has been having some mild diarrhea and describes the child's stools as "mushy." The mother tells the nurse that the child is tolerating fluids and solid foods. The most appropriate suggestion regarding the child's diet would be to give the child which items? 1. Jell-O, strained cabbage, and custard 2. Fluids only until the "mushy" stools stop 3. Rice and mashed potatoes diluted with skim milk 4. Applesauce, strained bananas, and strained carrots 4. Applesauce, strained bananas, and strained carrots

4. Applesauce, strained bananas, and strained carrots

The nurse is preparing to care for an infant who has esophageal atresia with tracheoesophageal fistula (TEF). Surgery is scheduled to be performed in 1 hour. Intravenous fluids have been initiated, and a nasogastric (NG) tube has been inserted by the health care provider. The nurse plans care, knowing that which intervention is of highest priority during this preoperative period? 1. Monitor the temperature. 2. Monitor the blood pressure. 3. Irrigate the NG tube every 5 to 10 minutes. 4. Aspirate the NG tube every 5 to 10 minutes.

4. Aspirate the NG tube every 5 to 10 minutes.

A 3-year-old child is seen in the health care clinic, and a diagnosis of encopresis is made. The nurse reviews the assessment findings and expects to note documentation of which sign of this disorder? 1. Diarrhea 2. Malaise and anorexia 3. Nausea and vomiting 4. Evidence of soiled clothing

4. Evidence of soiled clothing

A child is diagnosed with intussusception. On performing an assessment of the child, the nurse keeps in mind which finding as a characteristic of this disorder? 1. The presence of fecal incontinence 2. Incomplete development of the anus 3. The infrequent and difficult passage of dry stools 4. Invagination of a section of the intestine into the distal bowel

4. Invagination of a section of the intestine into the distal bowel

The parents of a child with a cleft palate are concerned and ask the nurse when the palate will be repaired. The nurse should plan to base the response on which information about cleft palate repair? 1. Cannot be repaired 2. Repair usually is performed by age 8 weeks 3. Repair usually is performed by 2 months of age 4. Repair usually is performed between 6 months and 2 years

4. Repair usually is performed between 6 months and 2 years