CHAPTER 38

22. The nurse is collecting data on a child who has been nutritionally deprived. The nurse notes that the child is irritable and listless. The foster caregiver reports that the child says she is not hungry and has been vomiting. It is discovered that the child has beriberi. This disease is due to a deficiency in which of the following? A) Thiamine B) Vitamin C C) Niacin D) Iron

A

32. The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of congenital aganglionic megacolon? A) A partial or complete intestinal obstruction occurs. B) A thickened, elongated muscle causes an obstruction at the end of the stomach. C) There are recurrent paroxysmal bouts of abdominal pain. D) In this disorder the sphincter that leads into the stomach is relaxed.

A

39. The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which of the following statements is the best explanation of the treatment for this diagnosis? A) "The treatment for the disorder will be a surgical procedure." B) "Your child will be treated with oral iron preparations to correct the anemia." C) "We will give enemas until clear and then teach you how to do these at home." D) "Your child will receive counseling so the underlying concerns will be addressed."

A

45. The most common source of lead poisoning in children comes from which of the following sources? A) Paint used in older homes C) Water purchased in plastic jugs B) Juice stored in glass jars D) Toys painted with spray paint

A

49. The nurse is interviewing the caregivers of a child admitted with a diagnosis of Type 1 Diabetes Mellitus. The caregiver states, "The teacher tells us that our child has to use the restroom many more times a day than other students do." The caregiver's statement indicates the child most likely has which of the following? A) Polyuria B) Pica C) Polyphagia D) Polydipsia

A

55. The nurse working with the child diagnosed with Type 2 Diabetes Mellitus recognizes that most often the disorder can be managed by which of the following? A) Taking oral hypoglycemic agents B) Increasing protein in the diet, especially in the evening C) Conserving energy with rest periods during the day D) Decreasing amounts of daily insulin

A

The caregivers of a child just diagnosed with diabetes express concern that they won't remember the different signs and symptoms of hyperglycemia and hypoglycemia. As a result, they are afraid they won't handle an emergency correctly. The best initial response by the nurse would be to A) Instruct them to treat the reaction as if it's hypoglycemia, which is more likely B) Repeat the signs and symptoms over and over until they seem to understand C) Suggest that the child wear an insulin pump for continuous insulin administration D) Give the caregivers educational pamphlets and videos about diabetes

A

The digestive process begins in which of the following organs of the gastrointestinal system? A) Mouth B) Stomach C) Small intestine D) Large intestine

A

The nurse is doing dietary teaching with the caregivers of a child diagnosed with idiopathic celiac disease. Of the following foods, which would most likely be appropriate in the child's diet? A) Bananas B) Toast C) Oatmeal D) Potatoes

A

The nurse is working with the mother of a newborn. The mother asks why a baby needs small feedings at frequent intervals. The nurse explains to the mother that this is necessary because in the infant A) The enzymes secreted by the liver and pancreas are reduced B) Food moves more slowly through the GI tract C) The pylorus has not been fully formed D) Peristaltic action is absent in the lower portion of the bowel

A

The nurse recognizes that in the disorder referred to as Rickets, the child has a lack of vitamin D. Because of the lack of vitamin D the absorption of which of the following is decreased? A) Calcium and phosphorus C) Riboflavin and niacin B) Vitamin C and thiamine D) Iron and potassium

A

. The nurse admits an infant who is nutritionally deprived. The infant is weak and seems somewhat uninterested in food. In developing the infant's plan of care, how often will the nurse most likely plan to feed this infant? A) Every hour B) Every 2 or 3 hours C) Every 4 hours D) On demand

B

24. The child who has insufficient calcium in the diet is at risk for having hypocalcemia. Which of the following may be caused by hypocalcemia? A) Cardiac arrhythmias C) Kidney failure B) Neurologic damage D) Urinary tract disorders

B

30. The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. The caregivers make the following statements. Which statement indicates a need for further teaching regarding the dietary restrictions for the child with celiac syndrome? A) "The soup we eat at our house is all made from scratch." B) "She loves hotdogs, and we always cut hers up into small pieces." C) "I have learned to make my own bread with no gluten." D) "Even though milk and pudding are good for her, we don't give her those foods."

B

33. The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of pyloric stenosis? A) A partial or complete intestinal obstruction occurs. B) A thickened, elongated muscle causes an obstruction at the end of the stomach. C) There are recurrent paroxysmal bouts of abdominal pain. D) In this disorder the sphincter that leads into the stomach is relaxed.

B

36. The nurse is caring for a child admitted with pyloric stenosis. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis? A) Explosive diarrhea C) Severe abdominal pain B) Projectile vomiting D) Frequent urination

B

43. The nurse is doing teaching with the caregivers of toddler and preschool age children. One of the caregivers tells the group that her child had diarrhea and she was told that it was caused by giardiasis. Which of the following statements made by the caregiver indicates the most likely situation in which the child contacted the disorder? A) "My son went to the mountains to fish with my husband before he got sick." B) "He attends a day care center four days a week while I am at work." C) "I won't let his sister take bubble baths but I do let him take one a few times a week." D) "My mother is in a nursing home but I always make the kids wash their hands before we leave her."

B

47. In treating the child with lead poisoning which of the following is used to remove the lead from the child's system? A) Diuretics B) Chelating agents C) Laxatives D) Emetics

B

50. The nurse is caring for a child admitted to the emergency center in diabetic ketoacidosis. Which of the following clinical manifestations would the nurse most likely note in this child? A) Pale and moist skin B) Red lips and fruity odor to breath C) Hyperactive and restless behavior D) Slow pulse and elevated blood pressure

B

53. The nurse is doing teaching with a group of caregivers of children diagnosed with diabetes mellitus. The nurse is explaining insulin shock and the caregivers make the following statements. Which statement indicates the best understanding of a reason an insulin reaction might occur? A) "If my child's eats as much as her older brother eats she could have an insulin reaction." B) "He measures his own medication but we watch closely to make sure he gets the correct amount so he doesn't have an insulin reaction." C) "She monitors her glucose levels because when it goes too high she has an insulin reaction." D) "On the weekends we encourage him to participate in lots of sports activities and stay busy so he doesn't have an insulin reaction."

B

The nurse has admitted a child with a diagnosis of severe gastroenteritis. To help prevent the risk of transmitting infection to other patients, the nurse should A) Wear a mask when handling articles contaminated with feces B) Follow standard precautions C) Discourage anyone from visiting D) Sterilize thermometers between patients

B

The nurse is caring for a child admitted with acute appendicitis. Prior to the child going to the operating room for emergency surgery, which of the following nursing interventions would the nurse most likely perform? A) The nurse gives the child laxatives to evacuate the colon. B) The nurse encourages the child and family to express their fears. C) The nurse administers oral fluids to prevent dehydration. D) The nurse applies a heating pad to the abdomen to manage pain.

B

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with Kwashiorkor. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of Kwashiorkor? A) "These children have a severe deficiency of vitamin D." B) "It is important to increase the intake of protein for these children." C) "The highest incidence of this disease is seen in children who are adolescents." D) "The cause of this disease can be treated very simply."

B

The school nurse notes that a child diagnosed with diabetes mellitus is experiencing an insulin reaction and is unable to eat or drink. Which of the following actions would be the most appropriate for the school nurse to do? A) Request that someone call 911 B) Administer subcutaneous glucagon C) Anticipate that the child will need intravenous glucose D) Dissolve a piece of candy in the child's mouth

B

The teeth, tongue, gallbladder, appendix, salivary glands, liver, and pancreas are referred to as accessory organs, and the purpose of these is which of the following? A) To secrete liquids that helps the food to be tasted as a person eats B) To aid in and to produce substances that aid in the digestive process C) To cushion and protect the digestive organs D) To decrease the secretion of acids in the digestive organs

B

The school nurse is working with a group of teachers who teach in classrooms of children who are nutritionally deprived. As the teachers are talking with the nurse they make the following statements. Which statement most indicates a problem related to decreased nutrition? A) "One of my students is taller than several of the other children in the class." B) "I am really glad that during this quarter the absence rate in my classroom has dropped." C) "Several of the children in my class have such a hard time concentrating." D) "The grades of the children in my class are higher than in the classroom next to me."

C

The treatment for children with a pinworm infection is to administer which of the following classifications of medications? A) Anticoagulants B) Anticonvulsants C) Anthelmintics D) Antipyretics

C

23. The nurse is discussing the disease known as pellagra. This disease is due to a deficiency in which of the following? A) Thiamine B) Vitamin C C) Niacin D) Iron

C

27. The nurse is collecting data for a child with idiopathic celiac disease. The caregiver tells the nurse that her child has bulky and greasy stools. The nurse recognizes that the child has which of the following? A) Pica B) Invagination C) Steatorrhea D) Polyuria

C

28. The nurse is collecting data for a child who is having a routine checkup. The caregiver tells the nurse that her child eats things such as laundry starch, clay, paper, and paint. The nurse recognizes that the child's behavior indicates that the child likely has which of the following? A) Pica B) Invagination C) Steatorrhea D) Polyuria

C

34. The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of colic? A) A partial or complete intestinal obstruction occurs. B) A thickened, elongated muscle causes an obstruction at the end of the stomach. C) There are recurrent paroxysmal bouts of abdominal pain. D) In this disorder the sphincter that leads into the stomach is relaxed.

C

38. The nurse is caring for a child admitted with congenital aganglionic megacolon. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis? A) Prolonged bleeding C) Persistent constipation B) Chronic cough D) Irregular breathing

C

48. The nurse is interviewing the caregivers of a child admitted with a diagnosis of Type 1 Diabetes Mellitus. The caregiver states, "She is hungry all the time and eats everything, but she is losing weight." The caregiver's statement indicates the child most likely has which of the following? A) Polyuria B) Pica C) Polyphagia D) Polydipsia

C

52. The nurse is caring for a 3-year-old diagnosed with diabetes mellitus. The child's eating patterns are unpredictable. One day the child will eat almost nothing, the next day the child eats everything on her tray. The nurse recognizes that which of the following types of insulin would most likely be used in treating this child? A) Long-acting insulin C) Rapid-acting insulin B) Regular insulin D) Intermediate-acting insulin

C

A young child has been admitted with a diagnosis of enterobiasis (pinworm infection). This child will most likely have a history of which of the following? A) Bedwetting B) Restlessness C) Perianal itching D) Malnutrition

C

In understanding the disease of Marasmus when seen in children, the nurse recognizes that the disease is caused because of which of the following? A) Deficiency of vitamin C and iron C) Deficiency of protein and calories B) Excess of vitamin C and iron D) Excess of protein and calories

C

The incidence of vitamin D deficiency in the United States is less than in many countries. The most likely reason for this is because of which of the following? A) Many children in the US take daily vitamin supplements B) The water in many towns and cities in the US has vitamin D added C) Some foods in the US have been fortified with vitamin D D) The amount of ultraviolet sunlight each day in the US is adequate to provide needed vitamin D.

C

The nurse admits a 9-year-old who is complaining of pain in the lower right quadrant of the abdomen, nausea, and constipation. She also has a fever of 101 degrees Fahrenheit. Of the following nursing actions, which will most likely be done at this time for this child? The nurse will A) Give a laxative to alleviate constipation B) Place a heating pad or hot water bottle on her abdomen C) Help her find a comfortable position D) Give her an analgesic such as acetaminophen

C

The nurse is caring for a 7-year-old diagnosed with pinworms. The nurse talks with the child's caregiver about proper treatment and prevention of future infections. Which of the following statements made by the caregiver indicates a need for further teaching? A) "I always have to remind him to wash his hands before eating." B) "We just bought a washer and dryer, and the hot water works well." C) "Thank goodness my other children and I are not sick too." D) "He hates having his nails trimmed but I will insist they are kept short."

C

Which of the following is most correct regarding the gastrointestinal system of the child? A) The child's gastrointestinal system is fully matured when the child is born. B) The enzymes secreted by the child's liver and pancreas are much greater in amount than in the adult. C) The child cannot break down and use complex carbohydrates in the same way the adult can. D) The speed with which food passes through the gastrointestinal tract in the child is much slower than in the adult.

C

31. The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux? A) A partial or complete intestinal obstruction occurs. B) A thickened, elongated muscle causes an obstruction at the end of the stomach. C) There are recurrent paroxysmal bouts of abdominal pain. D) In this disorder the sphincter that leads into the stomach is relaxed.

D

35. The nurse is collecting data on a 2 ½ year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which of the following questions would be most important for the nurse to ask? A) "How many times a day does your child urinate?" B) "How long has your child been toilet trained?" C) "Tell me about the types of stools you child has been having." D) "What foods has your child eaten during the last few days."

D

37. The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. Which of the following goal has the highest priority at this time? A) Preparing family for home care C) Maintaining skin integrity B) Promoting comfort D) Improving hydration

D

40. The nurse is discussing the diagnosis of intussuseption with a group of peers. Which of the following is an accurate statement regarding this disorder? A) There is a telescoping of the lower part of the bowel up over the upper part of the bowel. B) The disorder is seen most often in female infants under the age of 3 months. C) The infant is pale, cries weakly, and has spasms of pain continuously. D) The stools of the infant are called currant jelly stools and consist of blood and mucuous.

D

5. The major role of the endocrine system is to do which of the following? A) Regulate insulin C) Absorb nutrients B) Produce enzymes D) Secrete hormones

D

51. When collecting data on a child diagnosed with diabetes mellitus, the nurse notes that the child has had weight loss and other symptoms of the disease. The nurse would anticipate which of the following findings in the child's fasting glucose levels? A) 60 mg/dL B) 120 mg/dL C) 180 mg/dL D) 240 mg/dL

D

A nurse stops at her friend's house one evening to visit. Her friend isn't home but a teenager watching TV says she is baby-sitting for the family's three children. The nurse notices that one of the children is chewing several pieces of something white. He is also drooling and crying. A container that looks like an empty pill bottle is on the floor. The first action by the nurse would be to A) Call 911 for emergency help B) Ask the poison control center about an antidote C) Give the child syrup of ipecac to induce vomiting D) Remove the substance from the child's mouth

D

In understanding the gastrointestinal system, the nurse recognizes that this system includes the stomach and intestines as well as which of the following? A) A protective cushion lining the organs B) Nerves throughout the abdomen C) The brain and spinal cord D) The pharynx and esopagus

D

The nurse is caring for an infant immediately after a pyloromyotomy surgery has been performed to treat pyloric stenosis. The infant's parents are understandably anxious about their child. Given the situation, what is the most appropriate way for the nurse to position the infant during the anesthesia recovery period? The nurse should A) Allow the parents to hold him B) Place the infant on his back C) Lay the infant on his stomach D) Support him and place him on his side

D

The nurse is collecting data from the caregivers of a child who is suspected of having a food allergy. Which of the following clinical manifestations would likely have been noted in this child? A) Restlessness and irritability C) Nasal discharge and sneezing B) Blinking and twitching of the mouth D) Urticaria and pruritus

D