Maternity and Pediatric Nursing - Third Edition Chapter 42 Nursing Care of the Child With an Alteration in Bowel Elimination / Gastrointestinal Disorder

2. The nurse is taking a health history of an 11-year-old girl with recurrent abdominal pain. Which of the following responses would lead the nurse to suspect irritable bowel syndrome?

A) "I always feel better after I have a bowel movement."

1. The nurse is teaching the mother of a 5-year-old boy with a history of impaction how to administer enemas at home. Which of the following responses from the mother indicates a need for further teaching?

A) "I should position him on his abdomen with knees bent."

3. The nurse is caring for a 3-year-old girl with short bowel syndrome as a result of trauma to the small intestine. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. How should the nurse respond?

A) "I will help you become an expert on your daughter's care."

24. A group of students are reviewing information about gallbladder disease in children. The students demonstrate a need for additional review when they identify which of the following?

A) Cholesterol gallstones are more frequently found in males.

7. A nurse is caring for a 14-year-old girl scheduled for a barium swallow/upper gastrointestinal (GI) series. Before providing instructions, which of the following would be the priority?

A) Screening the girl for pregnancy

9. The nurse is caring for a 2-month-old with a cleft palate. The child will undergo corrective surgery at age 3 months. The mother would like to continue breastfeeding the baby after surgery and wonders if it is possible. How should the nurse respond?

B) "Breastfeeding is likely to be possible, but check with the surgeon."

16. The mother of a 3-week-old infant old brings her daughter in for an evaluation. During the visit, the mother tells the nurse that her baby is spitting up after feedings. Which response by the nurse would be most appropriate?

B) "Infants this age commonly spit up."

10. The school nurse is working with a 10-year-old girl with recurrent abdominal pain. The girl's teacher has been less than understanding about the frequent absences and trips to the nurse's office. How should the nurse respond?

B) "The pain she is having is real."

13. The nurse is determining maintenance fluid requirements for a child who weighs 25 kg. How much fluid would the child need per day?

B) 1,600 mL

5. The nurse is caring for an infant with a temporary ileostomy. As part of the plan of care, the nurse monitors for skin breakdown around the stoma. If redness occurs, which of the following would be most appropriate to promote healing and prevent further skin breakdown?

B) Apply a barrier/healing cream or paste on the skin.

19. The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, which of the following would the nurse most likely find?

B) Hard, moveable, olive-shaped mass in the right upper quadrant

21. The parents of a boy diagnosed with Hirschsprung disease are anxious and fearful of the upcoming surgery. The mother states, "I'm worried about having to care for our son's ostomy." Which intervention would be most helpful for the parents?

B) Having a wound, ostomy, and continence nurse meet with them

26. A group of nursing students are reviewing information about inflammatory bowel disease in preparation for a class discussion on the topic. The students demonstrate understanding of the material when they identify which of the following as characteristic of Crohn disease? Select all answers that apply.

B) Most common between the ages of 10 to 20 years

25. After teaching the parents of a child diagnosed with celiac disease about nutrition, the nurse determines that the teaching was effective when the parents identify which foods as appropriate for their child? Select all answers that apply.

B) Peanut butter C) Carbonated drinks D) Shellfish E) Jelly

4. The nurse is conducting a physical examination of a child with suspected Crohn disease. Which of the following findings would be the most highly suspicious of Crohn disease?

B) Perianal skin tags or fissures

23. A child is scheduled for a lower endoscopy. Which of the following would the nurse include in the child's plan of care in preparation for this test?

C) Administering the prescribed bowel cleansing regimen

15. The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would document the stool's appearance most likely as which of the following?

C) Currant jelly-like

11. When examining the abdomen of a child, which technique would the nurse use last?

C) Palpation

12. Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration?

C) Sunken fontanels

6. The nurse is caring for a 4-year-old boy who has undergone an appendectomy. The child is unwilling to use the incentive spirometer. Which approach would be most appropriate to elicit the child's cooperation?

D) "Can you blow this cotton ball across the tray?"

27. After teaching the parents of a 6-year-old how to administer an enema, the nurse determines that the teaching was successful when they state that they will give how much solution to their child?

D) 500 to 1,000 mL

14. The parents of a child diagnosed with celiac disease ask the nurse what types of food they can offer their child. Which of the following would the nurse include in the teaching plan?

D) Fruit juice

8. The nurse has developed a plan of care for a 12-month-old hospitalized with dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care?

D) Maintaining the intravenous fluid rate as ordered

20. A nursing instructor is developing a class presentation about the medications used to treat peptic ulcer disease. Which drug class would the instructor be least likely to include in the presentation?

D) Prokinetics

17. A group of students are reviewing information about fluid balance and losses in children in comparison to adults. The students demonstrate a need for additional review when they identify which of the following?

D) The infant's immature kidneys have a tendency to overconcentrate urine more.

18. An 8-month-old infant is brought to the clinic for evaluation. The mother tells the nurse that she has noticed some white patches on the infant's tongue that look like curdled milk after breastfeeding. The nurse suspects oral candidiasis (thrush). Which question would the nurse use to help confirm this suspicion?

A) "Are you having breast pain when you nurse the baby?"

22. The nurse is providing care to a child with pancreatitis. When reviewing the child's laboratory test results, which of the following would the nurse expect to find? Select all answers that apply.

A) Leukocytosis C) Elevated serum amylase levels