practice questions- ch 22&26 - GI/GU Dysfunction

What is a high-fiber food that the nurse should recommend for a child with chronic constipation? 1. white rice 2. popcorn 3. fruit juice 4. ripe bananas

2

A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include? 1. Bowel cleansing 2. Dietary modification 3. Structured toilet training 4. behavior modification

1

What intervention is contraindicated in a suspected case of appendicitis? 1. Enemas 2. Palpating the abdomen 3. Administration of antibiotics 4. Administration of antipyretics for fever

1

what is the hallmark of minimal change nephrotic syndrome? 1. hyaline casts in urine 2. massive proteinuria 3. oval fat bodies in urine 4. large amts of RBCs in urine

2

A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube? 1. Prevent spread of infection. 2. Monitor electrolyte balance. 3. Prevent abdominal distention. 4. Maintain accurate record of output.

3

After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time? 1. Notify the practitioner. 2. Insert the NG tube so feedings can be given. 3. Replace the NG tube to maintain gastric decompression. 4. Leave the NG tube out because it has probably been in long enough.

1

A toddlers mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurses response should be based on which premise? 1. an emergency laparotomy is very likely 2. location needs to be confirmed by a radiographic examination 3. surgery will be necessary if not passed in the stool in 48hrs

2

An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason? 1. Wean the infant from TPN the next day 2. Stimulate adaptation of the small intestine 3. Give additional nutrients that cannot be included in the TPN 4. Provide parents with hope that the child is close to discharge

2

One of the major differences in clinical presentation between Crohn disease (CD) and ulcerative colitis (UC) is that UC is more likely to cause which clinical manifestation? 1. Pain 2. Rectal bleeding 3. Perianal lesions 4. Growth retardation

2

the nurse is caring for a 3yr old who had an appendectomy 2 days ago. the child has a fever 101.8F (38.8C) and breath sounds are slightly diminished in the right lower lobe. which action is most appropriate? 1. teach the child how to use an incentive spirometer 2. encourage the child to blow bubbles 3. obtain an order for IV antibiotics 4. obtain an order for tylenol (aceteminophen)

2

The nurse is preparing to admit a 3-year-old child with intussusception. What clinical manifestations should the nurse expect to observe? (Select all that apply.) 1. Absent bowel sounds 2. Passage of red, currant jellylike stools 3. Anorexia 4. Tender, distended abdomen 5. Hematemesis 6. Sudden acute abdominal pain

2, 4, 6

A child with minimal change nephrotic syndrome (MCNS) has generalized edema. The skin appears stretched, and areas of breakdown are noted over the bony promi-nences. The child has been receiving Lasix twice daily for several days. Which does the nurse expect to be included in the treatment plan to reduce edema? 1. An increase in the amount and frequency of Lasix. 2. Addition of a second diuretic, such as mannitol. 3. Administration of intravenous albumin. 4. Elimination of all fluids and sodium from the child's diet.

3

A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent? 1. Surgical therapy is indicated. 2. Place in prone position for sleep after feeding. 3. Thicken feedings and enlarge the nipple hole. 4. Reduce the frequency of feeding by encouraging larger volumes of formula.

3

The nurse is caring for a child admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation? 1. Place in the Trendelenburg position. 2. Apply moist heat to the abdomen. 3. Allow the child to assume a position of comfort. 4. Administer a saline enema to cleanse the bowel.

3

When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation? 1. Anorexia 2. Bradycardia 3. Sudden relief from pain 4. Decreased abdominal distention

3

a 4month old infant has had vomiting and diarrhea for 24hrs. 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? 1. U/A obtained by bagged specimen 2. U/A obtained by sterile catherization 3. analysis of serum electrolytes 4. analysis of CSF

3

a child presents with massive proteinuria, hypoalbuminemia, hyperlipidemia and edmema. which of the following conditions are these symptoms associated with? 1. UTI 2. ascites 3. nephrotic syndrome 4. acute glomerulonephritis

3

A 4-month-old male infant has been seen in the pediatrician's office several times for a distended abdomen, irritability, and constipation. A diagnosis of Hirschsprung disease (HD) is suspected, and further testing is being scheduled. The infant is scheduled for surgery in a few hours to remove the malfunctioning part of the bowel. What teaching from the nurse would best prepare the mother to know what to expect when she first sees her infant after surgery? A "Your son will have a colostomy with a bag on his abdomen and an IV." B "Your son will have an IV line, an oxygen source, a dressing, and perhaps a colostomy bag." C "He will have a colostomy with a bag, a feeding tube, and an oxygen mask." D "He will be wearing a diaper and will have an abdominal dressing and soft restraints."

B

A 4-month-old male infant has been seen in the pediatrician's office several times for a distended abdomen, irritability, and constipation. A diagnosis of Hirschsprung disease (HD) is suspected, and further testing is being scheduled. The nurse is obtaining a history about the infant's early months. What question is most critical for the nurse to ask to aid in the diagnosis of HD? A "Did your son urinate immediately after delivery?" B "When did your son have his first bowel movement?" C "Did you breastfeed or bottle-feed your son?" D "Did your son experience any colic?"

B

A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child? 1. It is unnecessary because of childs age. 2. It is essential because it will be an adjustment. 3. Preparation is not needed because the colostomy is temporary. 4. Preparation is important because the child needs to deal with negative body image.

2

A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include? 1. Dilating the stoma 2. Assessing bowel function 3. Limitation of physical activities 4. Measures to prevent prolapse of the rectum

2

what organism is the most common uropathogen for UTIs in children? 1. pseudomonas aeruginosa 2. escherichia coli 3. klebsiella 4. proteus mirabilis

2

The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs? 1. Gastrointestinal perforation may have occurred. 2. The object may have been aspirated. 3. The object may be lodged in the esophagus. 4. The object may be embedded in stomach wall.

3

A 4-month-old male infant has been seen in the pediatrician's office several times for a distended abdomen, irritability, and constipation. A diagnosis of Hirschsprung disease (HD) is suspected, and further testing is being scheduled. The infant's mother asks about the testing her little son needs to undergo. She is very worried because she does not understand what testing is involved even after the pediatrician has explained it. What response from the nurse would be most appropriate? A "What are your concerns?" B "It's too soon for us to be discussing the tests." C "Every mother is scared when her baby is ill." D "There are several tests, including x-rays and a rectal biopsy, but we will keep your son comfortable."

D

Which type of dialysis is preferred to preserve the child's independence? 1. hemodialysis 2. cycling dialysis 3. hemofiltration 4. peritoneal dialysis

4

which of the following is the baseline treatment of poor perfusion resulting from dehydration? 1. blood transfusion 2. sodium restricted diet 3. fluid overload 4. volume restoration

4

which of the following symptoms are commonly associated with acute poststreptococcal glomerulonephritis? 1. oliguria, edema, hypotension and circulatory congestion, hematuria and proteinuria 2. oliguria, edema, hypertension and circulatory congestion, ascites and proteinuria 3. oliguria, edema, hypotension and circulatory congestion, ascites and proteinuria 4. oliguria, edema, hypertension and circulatory congestion, hematuria and proteinuria

4

What clinical manifestation should be the most suggestive of acute appendicitis? 1. Rebound tenderness 2. Bright red or dark red rectal bleeding 3. Abdominal pain that is relieved by eating 4. Colicky, cramping, abdominal pain around the umbilicus

4

What term describes invagination of one segment of bowel within another? 1. Atresia 2. Stenosis 3. Herniation 4. Intussusception

4

_________________ is the most effective means, short of dialysis, for reducing the quantity of materials that require renal excretion. 1. fluid restriction 2. routine dialysis 3. daily labs 4. diet regulation

4

What test is used to screen for carbohydrate malabsorption? 1. Stool pH 2. Urine ketones 3. urea breath test 4. ELISA stool assay

1

wht is the principal feature of acute renal failure? 1. polyuria 2. dysuria 3. oliguria 4. hematuria

3

the nurse is assisting a child with celiac disease to select foods from a menu. What foods should the nurse suggest? 1. Hamburger on a bun 2. Spaghetti with meat sauce 3. Corn on the cob with butter 4. Peanut butter and crackers

3

what is the most immediate threat to a child in acute renal failure? 1. hyperkalemia 2. hypercalcemia 3. hypernatremia 4. hypertension

1

the nurse is caring for a 9month old with diarrhea secondary to a virus. the child has no vomited and is mildly dehydrated. which is likely to be included in the discharge teaching? 1. adm imodium as needed 2. admin kaopectate as needed 3. continue breastfeeding per routine 4. infant may return to day care after 24hours of antibiotic therapy initiation

3

a nurse caring for an 8 year old boy on dialysis and notes color of the dialysate is cloudy. what is the next step the nurse should take? 1. nothing. this is a normal and expected finding 2. report this to the physician immediately 3. remove the dialysate and start over 4. check again in 4 hours, if still cloudy, report the findings to the physician

2

What immunization is recommended for all newborns? 1. Hepatitis A vaccine 2. Hepatitis B vaccine 3. Hepatitis C vaccine 4. Hepatitis A, B, and C vaccines

2

. The nurse is evaluating the laboratory results of a stool sample. What is a normal finding? 1. The laboratory reports a stool pH of 5.0. 2. The laboratory reports a negative guaiac. 3. The laboratory reports low levels of enzymes. 4. The laboratory reports reducing substances present.

2

A child had a tonsillectomy 6 days ago and was seen in the emergency room 4 hours ago due to post-operative hemorrhage. The parent noted that her child was "swal-lowing a lot and finally began vomiting large amounts of blood." The child's vital signs are as follows: T 99.5°F (37.5°C), HR 124, BP 84/48, and RR 26. The nurse knows that this child is at risk for which type of renal failure? 1. CRF due to advanced disease process. 2. Prerenal failure due to dehydration. 3. Primary kidney damage due to a lack of urine flowing through the system. 4. Postrenal failure due to a hypotensive state.

2

46. The nurse should instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux at which time? 1. Bedtime 2. With a meal 3. Midmorning 4. 30 minutes before breakfast

4

A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication? 1. Hyperkalemia 2. Hyperchloremia 3. Metabolic acidosis 4. Metabolic alkalosis

4

A health care provider prescribes feedings of 1 to 2 oz Pedialyte every 3 hours and to advance to 1/2 strength Similac with iron as tolerated postoperatively for an infant who had a pyloromyotomy. The nurse should decide to advance the feeding if which occurs? 1. The infants IV line has infiltrated. 2. The infant has not voided since surgery. 3. The infants mother states the infant is tolerating the feeding okay. 4. The infant is taking the Pedialyte without vomiting or distention.

4

A 4-month-old male infant has been seen in the pediatrician's office several times for a distended abdomen, irritability, and constipation. A diagnosis of Hirschsprung disease (HD) is suspected, and further testing is being scheduled. To prepare the infant for surgery, the nurse has a number of activities to perform, including repeated saline enemas and intravenous antibiotics. What can the nurse instruct the mother to encourage while her infant is receiving nothing by mouth (NPO) preoperatively? A Have the infant use a pacifier to maintain his sucking ability. B Lubricate his lips with water to maintain their hydration. C Continually hold the infant so he feels loved and secure. D Maintain the infant in a 45-degree position for easier breathing.

A

A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect? 1. Pyloric stenosis 2. Intussusception 3. Hirschsprung disease 4. Celiac disease

3

What information should the nurse include when teaching an adolescent with Crohn disease (CD)? 1. How to cope with stress and adjust to chronic illness 2. Preparation for surgical treatment and cure of CD 3. Nutritional guidance and prevention of constipationd. 4. Prevention of spread of illness to others and principles of high-fiber diet

1

What is the purpose in using cimetidine (Tagamet) for gastroesophageal reflux? 1. The medication reduces gastric acid secretion. 2. The medication neutralizes the acid in the stomach. 3. The medication increases the rate of gastric emptying time. 4. The medication coats the lining of the stomach and esophagus.

1

What statement best describes Hirschsprung disease? 1. The colon has an aganglionic segment. 2. It results in frequent evacuation of solids, liquid, and gas. 3. The neonate passes excessive amounts of meconium. 4. It results in excessive peristaltic movements within the gastrointestinal tract.

1

a 7 year old girl presents with a UTI. what clinical manifestations of a UTI are common to this age group? 1. painful urination, swelling of face, pallor, blood in urine and abdominal or back pain 2. painful urination, excessive thirst, pallor, blood in urine and abdominal or back pain 3. failure to gain weight, swelling of face, pallor, blood in urine and abdominal or back pain 4. poor feeding, swelling of face, pallor, blood in urine and abdominal or back pain

1

Melena, the passage of black, tarry stools, suggests bleeding from which source? 1. The perianal or rectal area 2. The upper gastrointestinal (GI) tract 3. The lower GI tract 4. Hemorrhoids or anal fissures

2

Nutritional management of the child with Crohn disease includes a diet that has which component? 1. High fiber 2. Increased protein 3. Reduced calories 4. Herbal supplements

2

A school-age child with celiac disease asks for guidance about snacks that will not exacerbate the disease. What snack should the nurse suggest? 1. Pizza 2. Pretzels 3. Popcorn 4. Oatmeal cookies

3