CGF Unit 7 Practice Questions- Gastrointestinal Disorders

A 4-month-old is brought to the emergency department with severe dehydration. The heart rate is 198, and her blood pressure is 68/38. The infant's anterior fontanel is sunken. The nurse notes that the infant does not cry when the intravenous line is inserted. The child's parents state that she has not "held anything down" in 18 hours.The nurse obtains a finger-stick blood sugar of 94. Which would the nurse expect to do immediately? A. Administer a bolus of normal saline. B. Administer a bolus of D10W. C. Administer a bolus of normal saline with 5% dextrose added to the solution. D. Offer the child an oral rehydrating solution such as Pedialyte.

A

A 4-month-old has had vomiting and diarrhea for 24 hours. The infant is fussy, and the anterior fontanel is sunken. The nurse notes the infant does not produce tears when crying. Which task will help confirm the diagnosis of dehydration? A. Urinalysis obtained by bagged specimen. B. Urinalysis obtained by sterile catheterization. C. Analysis of serum electrolytes. D. Analysis of cerebrospinal fluid.

C

Which child may need extra fluids to prevent dehydration? Select all that apply. A: 7-day-old receiving phototherapy. B. 6-month-old with newly diagnosed pyloric stenosis. C. 2-year-old with pneumonia. D. 2-year-old with full-thickness burns to the chest, back, and abdomen. E. 13-year-old who has just started her menses

A, B, C, D

The nurse is administering Prilosec (omeprazole) to a 3-month-old with gastro -esophageal reflux (GER). The child's parents ask the nurse how the medication works. Select the nurse's best response. A. "Prilosec is a proton pump inhibitor that is commonly used for reflux in infants." B. "Prilosec decreases stomach acid, so it will not be as irritating when your child spits up." C. "Prilosec helps food move through the stomach quicker, so there will be less chance for reflux." D. "Prilosec relaxes the pressure of the lower esophageal sphincter."

B

The nurse is caring for a 7-week-old scheduled for a pyloromyotomy in 24 hours.Which would the nurse expect to find in the plan of care? A. Keep infant NPO; begin intravenous fluids at maintenance. B. Keep infant NPO; begin intravenous fluids at maintenance; place nasogastric tube(NGT) to low wall suction. C. Obtain serum electrolytes; keep infant NPO; do not attempt to pass NGT due to obstruction. D. Offer infant small frequent feedings; keep NPO 6 to 8 hours before surgery.

B

The nurse knows that Nissen fundoplication involves which of the following? A. The fundus of the stomach is wrapped around the inferior stomach, mimicking a lower esophageal sphincter. B. The fundus of the stomach is wrapped around the inferior esophagus, mimicking a cardiac sphincter. C. The fundus of the stomach is wrapped around the middle portion of the stomach,decreasing the capacity of the stomach. D. The fundus of the stomach is dilated, decreasing the likelihood of reflux.

B

The nurse is caring for a 2-year-old child who was admitted to the pediatric unit for moderate dehydration due to vomiting and diarrhea. The child is restless, with periods of irritability. The child is afebrile with a heart rate of 148 and a blood pressure of 90/42. Baseline laboratory tests reveal the following: Na 152, Cl 119, and glucose 115.The parents state that the child has not urinated in 12 hours. After establishing a saline lock, the nurse reviews the physician's orders. Which order should the nurse question? A. Administer a saline bolus of 10 mL/kg, which may be repeated if the child does not urinate. B. Recheck serum electrolytes in 12 hours. C. After the saline bolus, begin maintenance fluids of D5 1/4NS with 10 mEq KCl/L. D. Give clear liquid diet as tolerated

C

The nurse is caring for a 4-month-old with gastroesophageal reflux (GER). The infant is due to receive Zantac (rantadine). Based on the medication's mechanism of action, when should this medication be administered? A. Immediately before a feeding. B. 30 minutes after the feeding. C. 30 minutes before the feeding. D. At bedtime.

C

The nurse is caring for a 9-month-old with diarrhea secondary to rotavirus. The child has not vomited and is mildly dehydrated. Which is likely to be included in the discharge teaching? A. Administer Imodium as needed. B. Administer Kaopectate as needed. C. Continue breastfeeding per routine. D. The infant may return to day care 24 hours after antibiotics have been started

C

The nurse is caring for an 8-week-old infant being evaluated for pyloric stenosis.Which statement by the parent would be typical for a child with this diagnosis? A. "The baby is a very fussy eater and just does not want to eat." B. "The baby tends to have a very forceful vomiting episode about 30 minutes after most feedings." C. "The baby is always hungry after vomiting so I refeed." D. "The baby is happy in spite of getting really upset after spitting up."

C

The parent of a 5-year-old states that the child has been having diarrhea for 24 hours,vomited twice 2 hours ago, and now claims to be thirsty. The parent asks what to offer the child because the child is refusing Pedialyte. Select the nurse's most appropriate response. A. "You can offer clear diet soda such as Sprite and ginger ale." B. "Pedialyte is really the best thing for your child, who, if thirsty enough, will eventually drink it." C. "Pedialyte is really the best thing for your child. Allow your child some choice in the way to take it by offering small amounts in a spoon, medicine cup, or syringe." D. "It really does not matter what your child drinks as long as it is kept down. Try offering small amounts of fluids in medicine cups."

C

The nurse receives a call from the parent of a 10-month-old who has vomited three times in the past 8 hours. The parent describes the baby as playful and wanting to drink. The parent asks the nurse what to give the child. Select the nurse's best response. A. "Replace the next feeding with regular water, and see if that is better tolerated." B. "Do not allow your baby to eat any solids; give half the normal formula feeding,and see if that is better tolerated." C. "Do not let your baby eat or drink anything for 24 hours to give the stomach a chance to rest." D. "Give your child 1/2 ounce of Pedialyte every 10 minutes. If vomiting continues,wait an hour, and then repeat what you previously gave."

D

Which should the nurse include in the plan of care to decrease symptoms of gastroesophageal reflux (GER) in a 2-month-old? Select all that apply. A. Place the infant in an infant seat immediately after feedings. B. Place the infant in the prone position immediately after feeding to decrease the risk of aspiration. C. Encourage the parents not to worry because most infants outgrow GER within the first year of life. D. Encourage the parents to hold the infant in an upright position for 30 minutes following a feeding. E. Suggest that the parents burp the infant after every 1-2 ounces consumed.

D, E