NCLEX - Peds Gastrointestinal

The nurse is collecting data on an infant with a diagnosis of suspected Hirschsprung's disease. Which question to the mother will most 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?"

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

The nurse is reinforcing dietary instructions to the mother of a child with celiac disease. Which statement by the mother indicates a need for further teaching? 1."I can give my child rice." 2."My child loves corn. I will be sure to include corn in the diet." 3."I will be sure to give my child vitamin supplements every day." 4."I am so pleased that I won't have to eliminate oatmeal from my child's diet."

"I am so pleased that I won't have to eliminate oatmeal from my child's diet."

The nurse reinforces home-care instructions to the parents of a child with hepatitis regarding the care of the child and the prevention of the transmission of the virus. Which statement by a parent indicates a need for further teaching? 1."Frequent hand washing is important." 2."I need to provide a well-balanced, high-fat diet to my child." 3."I need to clean contaminated household surfaces with bleach." 4."Diapers should not be changed near any surfaces that are used to prepare food."

"I need to provide a well-balanced, high-fat diet to my child."

The nurse provides instructions to the mother of an infant with cleft palate regarding feeding. Which statement by the mother indicates a need for further teaching? 1."I need to allow my infant time to swallow." 2."I need to use a nipple with a small hole to prevent choking." 3."I need to stimulate sucking by rubbing the nipple on the lower lip." 4."I need to allow my infant to rest frequently to provide time for swallowing what has been placed in the mouth."

"I need to use a nipple with a small hole to prevent choking."

The nurse reinforces home care instructions to the parents of an infant following surgical intervention for imperforate anus and tells the parents about the procedure for anal dilation. Which statement by the parents indicates the need for further teaching? 1."I need to use a water-soluble lubricant." 2."I will insert a glycerin suppository before the dilation." 3."I will insert the dilator no more than 1 to 2 cm into the anus." 4."I need to use only dilators supplied by the primary health care provider."

"I will insert a glycerin suppository before the dilation."

A child is diagnosed with lactose intolerance. The child's mother asks the nurse about the disease. Which statement is the appropriate nursing response? 1."It is the inability to tolerate sugar found in dairy products." 2."It results from the absence of ganglion cells in the rectum." 3."It results from increased bowel motility that leads to spasm and pain." 4."It is the inability to fully digest the protein part of wheat, barley, rye, and oats."

"It is the inability to tolerate sugar found in dairy products."

The nurse is reinforcing 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 these measures 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."

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

The nurse is caring for an infant with a diagnosis of Hirschsprung's disease. The nurse should check for which clinical findings that are consistent with Hirschsprung's disease? Select all that apply. 1.Fever 2.Constipation 3.Failure to thrive 4.Intolerance to wheat 5.Abdominal distention 6.Explosive, watery diarrhea

1, 2, 3, 5, 6

The nurse is preparing to feed a 1-year-old hospitalized child. The nurse prepares the amount of formula to be given to this child, knowing that generally a 1-year-old consumes approximately which amount? 1.90 mL per feeding 2.100 mL per feeding 3.175 mL per feeding 4.380 mL per feeding

175 mL per feeding

The nurse provides instructions to the parents of an infant with gastroesophageal reflux (GER) regarding proper positioning to manage reflux. The nurse should tell the parents that the infant should be maintained in which position? 1.A 30-degree angle when supine 2.A 60-degree angle when prone 3.A 60-degree angle when supine 4.A 20-degree angle when side-lying

A 60-degree angle when supine

A 1-year-old child is diagnosed with intussusception. The mother of the child asks the nurse to describe the disorder. The nurse should base the response on which description of this disorder? 1.An acute bowel obstruction 2.A condition that causes an acute inflammatory process in the bowel 3.A condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel 4.A condition in which a distal segment of the bowel prolapses into a proximal segment of the bowel

A condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel

The nurse is caring for an 18-month-old child who has been vomiting. Which is the appropriate position to place the child during naps and sleep time? 1.A supine position 2.A side-lying position 3.Prone, with the head elevated 4.Prone, with the face turned to the side

A side-lying position

The nurse is caring for a child who is scheduled for an appendectomy. When the nurse reviews the primary health care provider's preoperative prescriptions, which should be questioned? 1.Administer a Fleet enema. 2.Maintain nothing per mouth (NPO) status. 3.Maintain intravenous (IV) fluids as prescribed. 4.Administer preoperative medication on call to the operating room.

Administer a Fleet enema.

The nurse prepares to administer a pancreatic enzyme powder to the child with cystic fibrosis (CF). Which food item should the nurse mix with the medication? 1.Tapioca 2.Applesauce 3.Hot oatmeal 4.Mashed potatoes

Applesauce

A 4-year-old child is hospitalized for severe gastroenteritis. The child is crying and clinging to the mother. The mother becomes very upset and is afraid to leave the child. Which nursing intervention would be most appropriate to alleviate the child's fears and the mother's anxiety? 1.Reassure the mother that the child will be fine after she leaves. 2.Ask the mother if she would like to stay overnight with the child. 3.Give the mother the telephone number of the pediatric unit, and tell the mother to call at any time. 4.Tell the mother to bring the child's favorite toys the next time she comes to the hospital to visit.

Ask the mother if she would like to stay overnight with the child.

The nurse reinforces instructions to the mother about dietary measures for a 5-year-old child with lactose intolerance. The nurse should tell the mother that which supplement will be required as a result of the need to avoid lactose in the diet? 1.Fats and vitamin A 2.Zinc and vitamin C 3.Calcium and vitamin D 4.Thiamine and vitamin B

Calcium and vitamin D

The nurse reviews the record of an infant who is seen in the clinic. The nurse notes that a diagnosis of esophageal atresia with tracheoesophageal fistula (TEF) is suspected. The nurse expects to note which most likely manifestation of this condition in the medical record? 1.Incessant crying 2.Coughing at nighttime 3.Choking with feedings 4.Severe projectile vomiting

Choking with feedings

The nurse is assigned to assist in caring for a newborn with a colostomy that was created during surgical intervention for imperforate anus. When the newborn returns from surgery, the nurse checks the stoma and notes that it is red and edematous. Which is the appropriate nursing intervention? 1.Elevate the buttocks. 2.Apply ice immediately. 3.Document the findings. 4.Notify the registered nurse immediately.

Document the findings.

The nurse is monitoring for fluid volume deficit in an infant who is vomiting and having diarrhea. The nurse weighs the infant's diaper after each voiding and stool and carefully calculates fluid volume based on which knowledge? 1.Each gram of diaper weight is equivalent to 0.5 mL of urine. 2.Each gram of diaper weight is equivalent to 1 mL of urine. 3.Each gram of diaper weight is equivalent to 2 mL of urine. 4.Each gram of diaper weight is equivalent to 2.5 mL of urine.

Each gram of diaper weight is equivalent to 1 mL of urine.

An infant returns to the nursing unit following surgery for an esophageal atresia with tracheoesophageal fistula (TEF). The infant is receiving intravenous (IV) fluids, and a gastrostomy tube is in place. The nurse assisting in caring for the infant should ensure that which action is done to the gastrostomy tube? 1.Elevated 2.Placed to gravity 3.Attached to low suction 4.Taped to the bed linens

Elevated

A nursing student is preparing to conduct a clinical conference, and the topic is hepatitis in children. The nursing instructor advises the student to further research the topic if the student plans to include which information in the discussion? 1.The child's stools will be pale and clay-colored. 2.Cases of hepatitis should be promptly reported to health care officials. 3.Vaccines are available to prevent hepatitis A (HAV) and hepatitis B (HBV). 4.Enteric precautions are necessary for hepatitis B (HBV) but not for hepatitis A (HAV).

Enteric precautions are necessary for hepatitis B (HBV) but not for hepatitis A (HAV).

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

Evidence of soiled clothing

The nurse is admitting a child with a diagnosis of lactose intolerance. Which finding does the nurse expect to note? 1.Frothy stools 2.Foul-smelling ribbon stools 3.Profuse, watery diarrhea and vomiting 4.Diffuse abdominal pain unrelated to meals or activity

Frothy stools

A newborn infant is diagnosed with gastroesophageal reflux (GER). The mother of the infant asks the nurse to explain the diagnosis. The nurse plans to base the response on which description of this disorder? 1.Gastric contents regurgitate back into the esophagus. 2.The esophagus terminates before it reaches the stomach. 3.Abdominal contents herniate through an opening of the diaphragm. 4.A portion of the stomach protrudes through the esophageal hiatus of the diaphragm.

Gastric contents regurgitate back into the esophagus.

The nurse is reviewing the health record of an infant with a diagnosis of gastroesophageal reflux. Which signs/symptoms of this disorder should the nurse expect to note documented in the record? 1.Excessive oral secretions 2.Bowel sounds heard over the chest 3.Hiccupping and spitting up after a meal 4.Coughing, wheezing, and short periods of apnea

Hiccupping and spitting up after a meal

A child is diagnosed with intussusception. The nurse collects data on the child, knowing that which is 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

Invagination of a section of the intestine into the distal bowel

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

It is a congenital aganglionosis or megacolon.

The nurse is reviewing the laboratory results of an infant suspected of having hypertrophic pyloric stenosis. Which acid-base disorder would the nurse expect to note in the infant? 1.Metabolic acidosis 2.Metabolic alkalosis 3.Respiratory acidosis 4.Respiratory alkalosis

Metabolic alkalosis

A mother brings her 5-month-old daughter into the pediatrician's office with complaints that the child has been vomiting during feedings. The mother also states that the child is sometimes very fussy. Which should be the nurse's initial action? 1.Assess the child's growth status. 2.Obtain a complete history of the child's feeding habits. 3.Assess whether any other children in the family have had the same problem. 4.Explain to the mother that the primary health care provider will prescribe a barium swallow and upper gastrointestinal (GI) series.

Obtain a complete history of the child's feeding habits.

An infant returns to the nursing unit after the surgical repair of a cleft lip located on the right side of the lip. Which is the best position to place this infant at this time? 1.A flat position 2.A prone position 3.On his or her left side 4.On his or her right side

On his or her left side

A child with a diagnosis of a hernia has been scheduled for a surgical repair in 2 weeks. The nurse reinforces instructions to the parents about the signs of possible incarcerated hernia. The nurse tells the parents that which manifestation requires primary health care provider (PHCP) notification by the parents? 1.Pain 2.Diarrhea 3.Constipation 4.Increased flatus

Pain

The nurse is assisting a primary health care provider with an assessment of a child with a diagnosis of suspected appendicitis. In assessing the intensity and progression of the pain, the primary health care provider palpates the child at McBurney's point. What response does the nurse expect the child to have during the examination? 1.Pain in the upper right side 2.Pain when extending the leg 3.Pain when the right thigh is drawn up 4.Pain in the lower right side between the umbilicus and the iliac crest

Pain in the lower right side between the umbilicus and the iliac crest

The nurse is reviewing the health record of a child with a diagnosis of celiac disease. Which clinical manifestation should the nurse expect to note documented in the health record? 1.Frothy diarrhea 2.Foul-smelling ribbon stools 3.Profuse watery diarrhea and vomiting 4.Diffuse abdominal pain unrelated to meals or activity

Profuse watery diarrhea and vomiting

The nurse reviews the record of a 1-year-old child seen in the clinic and notes that the primary health care provider has documented a diagnosis of celiac crisis. Which symptom should the nurse expect to note in this condition? 1.Anorexia 2.Joint pain 3.Constipation 4.Profuse, watery diarrhea

Profuse, watery diarrhea

The nurse is monitoring for signs of dehydration in a 1-year-old child who has been hospitalized for diarrhea and prepares to take the child's temperature. Which method of temperature measurement should be avoided? 1.Rectal 2.Axillary 3.Electronic 4.Tympanic

Rectal

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

Rice

The nurse is assisting in admitting to the hospital a 4-month-old infant with a diagnosis of vomiting and dehydration. The nurse assists in developing a plan of care for the infant and suggests which position for the infant? 1.Prone position 2.Side-lying position 3.Modified Trendelenburg's position 4.Infant car seat with the head of the seat in a flat position

Side-lying position

The nurse is caring for a 1-year-old child following a cleft palate repair. Which solution should the nurse use after feedings to cleanse the child's mouth? 1.Sterile water 2.Diluted hydrogen peroxide 3.A soft lemon glycerin swab 4.Half-strength povidone-iodine solution

Sterile water

A 2-year-old child is diagnosed with constipation due to encopresis. Which description is a characteristic of this disorder? 1.Anorexia in the evening 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

The infrequent and difficult passage of dry stools

The nurse is checking the status of jaundice in a child with hepatitis. Which location should the nurse check to ascertain if the child is jaundiced? 1.The mucous membranes 2.The skin in the sacral area 3.The skin in the abdominal area 4.The membranes in the ear canal

The mucous membranes

The nurse is monitoring a newborn with a suspected diagnosis of imperforate anus. Which assessment finding is unassociated with this diagnosis? 1.The presence of stool in the urine 2.Failure to pass a rectal thermometer 3.The passage of currant jelly-like stool 4.Failure to pass meconium in the first 24 hours after birth

The passage of currant jelly-like stool

The nurse provides feeding instructions to a mother of an infant diagnosed with gastroesophageal reflux (GER). To assist in reducing the episodes of emesis, which instruction should the nurse provide the mother? 1.Provide less frequent, larger feedings. 2.Burp 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.

Thicken the feedings by adding rice cereal to the formula.

The nurse has reinforced dietary instructions to the mother of a child with celiac disease. The nurse determines that the mother understands the dietary instructions if she indicates eliminating which products? Select all that apply. 1.Rice 2.Corn 3.Millet 4.Oatmeal 5.Rye crackers 6.Wheat bread

4, 5, 6

The nurse is reviewing the record of a child with a diagnosis of pyloric stenosis. Which data should the nurse expect to note as having been documented in the child's record? 1.Watery diarrhea 2.Projectile vomiting 3.Increased urine output 4.Vomiting large amounts of bile

Projectile vomiting

The nurse is assigned to care for a child with hypertrophic pyloric stenosis scheduled for a pyloromyotomy. In which position should the nurse place the child during the preoperative period? 1.Prone with the head of the bed elevated 2.Supine with the head of the bed at a 30-degree angle 3.Supine with the head of the bed at a 45-degree angle 4.Prone with the head of the bed lowered to promote drainage

Prone with the head of the bed elevated

The nurse is assigned to care for a child who is scheduled for an appendectomy. Which prescriptions should the nurse anticipate to be prescribed? Select all that apply. 1.Administer a Fleet enema. 2.Initiate an intravenous line. 3.Maintain nothing-by-mouth status. 4.Administer intravenous antibiotics. 5.Administer preoperative medications. 6.Place a heating pad on the abdomen to decrease pain.

2, 3, 4, 5

Which interventions should the nurse include when preparing a plan of care 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.Notifying the primary health care provider if jaundice is present 4.Scheduling play time in the playroom with other children 5.Instructing the parents about the risks associated with taking medications 6.Arranging for indefinite home schooling because the child will not be able to return to school

1, 2, 5

A mother of a child with a diagnosis of intussusception calls the nurse into the hospital room because the child is screaming in pain. Which manifestations of perforation should the nurse report immediately? Select all that apply. 1.Fever 2.Ribbon-like stools 3.Increased heart rate 4.Hypoactive bowel sounds 5.Profuse projectile vomiting 6.Change in the level of consciousness

1, 3, 6

The nurse is reviewing the postoperative primary health care provider's (PHCP'S) prescriptions for a 3-week-old infant with Hirschsprung's disease admitted to the hospital for surgery. Which prescriptions documented in the child's record should the nurse question? Select all that apply. 1.Measure abdominal girth daily. 2.Monitor strict intake and output. 3.Take temperature measurements rectally. 4.Start clear liquid diet after 8 hours postoperative. 5.Maintain IV fluids until the child tolerates oral intake. 6.Monitor the surgical site for redness, swelling, and drainage.

3, 4