NUR 238: Chapter 20 Practice Questions
A nurse caring for an infant born with a cleft palate, notices that the parents rarely interact with their child. The nurse overhears that mother telling her husband that she "feels like crying" every time she looks at their son. What would be the best response from the nurse? -"I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?" -"Many infants are born with this condition. Your son's palate is not nearly as bad as some cases" -"Keep in mind that your son's condition is not life-threatening and can be corrected eventually" -"Your son needs you right now. You should put your negative feelings about his condition aside for his sake"
"I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?"
The nurse is administering Prilosec (omerprazole) to a 3-month-old with gastroesophageal reflux. The child's parents ask the nurse how the medication works. Select the nurse's best response. -"Prilosec helps food move through the stomach quicker, so there will be less chance for reflux" -"Prilosec is a proton pump inhibitor that is commonly used for reflux in infants" -"Prilosec decreases stomach acid, so it will not be as irritating when your child spits up" -"Prilosec relaxes the pressure of the lower esophageal sphincter"
"Prilosec decreases stomach acid, so it will not be as irritating when your child spits up"
A group of students are reviewing information about fluid balance and losses in children in comparison to adults. The students demonstrate an understanding of fluid balance and loss when they identify which of the following. SELECT ALL THAT APPLY. -A higher metabolic rate plays a minor role in increased need for fluids -Children have a proportionately greater amount of body water than do adults -Fever plays a greater role in insensible fluid losses in infants & children -The infant's immature kidneys have a tendency to concentrate urine more
-A higher metabolic rate plays a minor role in increased need for fluids -Children have a proportionately greater amount of body water than do adults -Fever plays a greater role in insensible fluid losses in infants & children
Which should the nurses include in the plan of care to decrease symptoms of gasatroesophageal reflux (GER) in a 2-month-old? SELECT ALL THAT APPLY -Encourage the parents to hold the infant in an upright position for 30-45 minutes following a feeding -Give smaller, more frequent feedings -Suggest that the parents burp the infant after feeding 1-2 ounces -Place the infant in an infant seat or swing after feeding -Encourage the parents not to worry because most infants outgrow GER by the age of 3 years old
-Encourage the parents to hold the infant in an upright position for 30-45 minutes following a feeding -Give smaller, more frequent feedings -Suggest that the parents burp the infant after feeding 1-2 ounces
The nurse is teaching the parents of a child with celiac disease about the dietary restrictions. The nurse would explain that the most appropriate diet for their child is a diet that is free of which of the following? SELECT ALL THAT APPLY. -Rice -Oats -Wheat -Barley -Corn
-Oats -Wheat -Barley
Missing question
missing
The nurse is auscultating the bowel sounds of a 4-year-old child and documents hypoactive bowel sounds. What might this finding indicate? -Obstruction -Diarrhrea -Gastroenteritis -Infection
Obstruction
The nurse is caring for an infant who is vomiting secondary to pyloric stenosis. The mother questions why the vomitus of this child appears different from that of her other children when they have had the flu. The nurse would explain that the emesis of the infant with pyloric stenosis does not contain bile because of which of the following: -The obstruction is above the bile duct -The Gastrointestinal system is still immature in newborns and infants -The emesis is from passive regurgitation -The bile duct is obstructed
The obstruction is above the bile duct
A nurse is admitting a 5-week-old infant through an outpatient surgical unit for a laparoscopic correction of pyloric stenosis. Which manifestations should the nurse expect when asking the parents about the infant's symptoms? SELECT ALL THAT APPLY -Sweet smelling vomitus -Projectile vomiting -Absence of tears when crying -Weight loss -Hungry immediately after vomiting
-Projectile vomiting -Weight loss -Hungry immediately after vomiting
Which child/children may need extra fluids to prevent dehydration? SELECT ALL THAT APPLY -2-year-old with strep and pneumonia -2-day-old receiving phototherapy -2-month-old with newly diagnosed pyloric stenosis -13-year-old who has just started her menses -2-year-old with full-thickness burns to the chest, back, & abdomen
2-year-old with strep and pneumonia 2-day-old receiving phototherapy 2-month-old with newly diagnosed pyloric stenosis 2-year-old with full-thickness burns to the chest, back, & abdomen
A child has been diagnosed with severe dehydration. The physician has ordered the nurse to administer a bolus of 20 mL/kg of normal saline over a 2-hour period. The child weighs 63.8 lbs. At which rate of mL/hour should the nurse set the child's IV pump? (Record your answer using a whole number and only put the number)
290 mL/hr
A 2-month-old is brought to the pediatric clinic. The infant has had vomiting and diarrhea for 24 hours. The infant's anterior fontanel is sunken. The child is irritable, and the nurse notes that the infant does not produce tears when crying. Which of the following tasks will help to confirm the diagnosis of dehydration? -Urinalysis obtained by sterile catheterization -Analysis of serum electrolytes -Analysis of cerebrospinal fluid -Urinalysis obtained by bagged specimen
Analysis of serum electrolytes
The nurse is caring for a newborn that is displaying copious, frothy bubbles of mucous in the mouth and nose, and choking, as well as drooling. The nurse is concerned that the infant has what disorder? -Hiatal hernia -Omphalocele -Esophageal atresia -Gastroschisis
Esophageal atresia
A mother brings her 6-month-old infant to the clinic. The child has been vomiting since early morning and has had diarrhea since the day before. His temperature is 38 degrees C, pulse 140, and respiratory rate 38. He has lost 6 oz since his well-child visit 4 days ago. He cries before passing a bowel movement. He will not breastfeed today. What is the priority nursing diagnosis? -Fluid volume deficit related to excessive losses and inadequate intake -Thermoregulation alteration -Alteration in nutrition, less than body requirements, related to decreased oral intake -Pain (abdominal) related to diarrhea
Fluid volume deficit related to excessive losses and inadequate intake
The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding best indicates pyloric stenosis -Perianal fissures and skin tags -Sausage-shaped mass in the upper abdomen -Hard, moveable "olive-like mass" in the upper right quadrant -Abdominal pain & irritability
Hard, moveable "olive-like mass" in the upper right quadrant
A 9-month-old girl is brought to the emergency room with what appears to have bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case? -Short-bowel syndrome -Necrotizing enterocolitis -Intussusception -Volvulus with malrotation
Intussusception
The nurse is caring for a newborn with esophageal atresia. When reviewing the mother's pregnancy history, which would the nurse expect to find? -Poor nutrition during pregnancy -Maternal polyhydramnios -Pregnancy lasting more than 38 weeks -Alcohol consumption during pregnancy
Maternal polyhydramnios
When examining the abdomen of a child, which technique would the nurse use last? -Percussion -Auscultation -Palpation -Inspection
Palpation
The parents of a newborn diagnosed with a cleft lip and palate ask the nurses when their child's lip and palate will most likely be repaired. Select the nurse's best response. -The palate and the lip are usually repaired in the first few weeks of life so that the infant can grow and gain weight -The lip is repaired in the first few months of life, but the palate is not usually repaired until the child is 3-years-old -The lip is repaired in the first few months of life, and the palate is usually repaired before 12 months of age -The palate and the lip are usually not repaired until the infant is approximately 6-months-old so that the mouth has had enough time to grow
The lip is repaired in the first few months of life, and the palate is usually repaired before 12 months of age
The nurse is caring for an infant newly diagnosed with Hirschsprung disease. Which of the following does the nurse understand about this infant's condition? -There is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention -There is a small-bowel obstruction leading to ribbon-like stools -There is inflammation throughout the large intestine, leading to accumulation of intestinal contents and abdominal distention -There is excessive peristalsis throughout the intestine, resulting in abdominal distention
There is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention
The parent of a child being evaluated for celiac disease asks the nurse why it is important to make dietary changes. What is the nurse's best response? -They body's response to gluten causes damage to special cells in the intestine and that causes the intestine to not absorb the proper nutrients -The body's response to consumption of anything containing gluten is to create special cells called villi, which leads to more diarrhea -The body's response to gluten causes the intestines to become more porous and hang on to more of the fat-soluble vitamins, and that led to vitamin toxicity. -The body's response to gluten causes damage to the mucosal cells, leading to malabsorption of water and hard, constipated stools.
They body's response to gluten causes damage to special cells in the intestine and that causes the intestine to not absorb the proper nutrients
What manifestations would the nurse expect to see in 4-week-old infant with biliary atresia? -Abdominal distention, enlarged liver, enlarged spleen, dark colored stools, and hematuria -Abdominal distention, multiple bruises, blood stools, and hematuria -No manifestations until the disease has progressed to the advanced stage -Yellow sclera and skin tones, light or white colored stools,, and enlarged liver
Yellow sclera and skin tones, light or white colored stools,, and enlarged liver
A 6-year-old is dehydrated and needs IV fluid maintenance. The child weighs 59.4 pounds. The child will receive _______ mL/24 hours. The pump rate will be ________ mL/hour (round to the nearest tenth and just put the number)
1,640 mL/24 hours 68.3 mL/hour
The nurse is caring for an infant who has been diagnosed with short bowel syndrome. The parent asks how the disease will affect the child. What is the nurse's best response? -The prognosis and course of the disease have changed because hyperalimentation is available -Because your child has shorter intestine than most children, your child will likely experience constipation and will need to be placed on a bowel regimen -Unfortunately , most children with this diagnosis do not do very well -Because your child has a shorter intestine than most children, your child will not be able to absorb all the needed nutrients and vitamins from food and will need to take vitamins
Because your child has a shorter intestine than most children, your child will not be able to absorb all the needed nutrients and vitamins from food and will need to take vitamins
Immediately after the delivery of an infant with an omphalocele, the nurses would take which priority action? -Call the blood bank for a unit of blood -Insert an orogastric tube -Weigh the infant -Cover the sac with moistened sterile gauze
Cover the sac with moistened sterile gauze
