Ch. 25 Quiz (Complete)

A (Continue breastfeeding)

A 2-month-old breastfed infant is successfully rehydrated with oral rehydration solutions for acute diarrhea. What instructions are include to the mother specific to breastfeeding? A. Continue breastfeeding. B. Stop breastfeeding until the breast milk is cultured. C. Stop breastfeeding until diarrhea is absent for 24 hr. D. Express breast milk and dilute it with sterile water before feeding it.

Regurgitation

A backward flowing such as the return of gastric contents into the mouth or esophagus.

A (Growth failure)

A common presenting manifestation of inflammatory bowel diseases (IBD) in pediatric patients is: A. Growth failure B. Chronic constipation C. Obstruction D. Burning epigastric pain

Constipation

A decrease in bowel movement frequency, consistency, or ease of passing stool.

D (Bacterial gastroenteritis)

A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells. This is most suggestive of what conditions? A. Parasitic infection B. Fat malabsorption C. Protein intolerance D. Bacterial gastroenteritis

A (Intravenous fluids)

A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. What is the therapeutic management of this child? A. Intravenous fluids B. Oral rehydration solution C. Clear liquids, 1 to 2 oz at a time D. Administration of antidiarrheal medication

Malrotation

Abnormal rotation of the intestine is called _____________________.

Hepatitis C (HCV)

About 85% of persons infected develop chronic disease. Often becomes a chronic condition and can cause cirrhosis.

Atresia

Absence of a normal opening or normally patent lumen.

Projectile vomiting

Accompanied by vigorous peristaltic waves.

C (Can be caused by viral, bacterial, and parasitic pathogens)

Acute diarrhea: A. Can be caused by celiac disease B. Can be caused by hypothyroidism C. Can be caused by viral, bacterial, and parasitic pathogens D. Is an increase in stool frequency and increased water content with a duration of more than 14 days

B (increases fluid in the colon)

After fecal impaction is removed, maintenance therapy for constipation may include laxative use. Why is polyethylene glycol considered safe to use for pediatric patients? A. Decreases fluid in the colon B. Increases fluid in the colon C. Increases peristaltic stimulation D. Increases osmotic pressure and acidification of the colon contents

Stool for O&P (Ova and Parasites)

Aids in the diagnosis of parasitic infections.

C (Observation of stools)

Al's intussusception is reduced without surgery. The nurse should expect care for Al after the reduction to include: A. Administration of antibiotics B. Enema administration to remove remaining stool C. Observation of stools D. Rectal temperatures every 4 hours

A (Crampy abdominal pain, inconsolable crying, a drawing up of the knees to the chest, and passage of red, currant jelly-like stools)

Al, age 5 months, is suspected of having intussusception. What clinical manifestations would he most likely have? A. Crampy abdominal pain, inconsolable crying, a drawing up of the knees to the chest, and passage of red, currant jelly-like stools B. Fever; diarrhea; vomiting; lowered white blood cell count; and tender, distended abdomen C. Weight gain, constipation, refusal to eat, and rebound tenderness D. Abdominal distension, periodic pain, hypotension, and lethargy

A (Intussusception)

An invagination of one portion of the intestine into another is called: A. Intussusception B. Pyloric stenosis C. Tracheoesophageal fistula D. Hirschsprung disease

C (Secondary gastric ulcer)

Billy, age 14, has an ulcer with an acute onset involving the mucosa of the stomach that has resulted from prolonged use of nonsteroidal anti-inflammatory agents. The best term to describe the ulcer Billy has is: A. Secondary duodenal ulcer B. Primary duodenal ulcer C. Secondary gastric ulcer D. Primary gastric ulcer

C (Decreases the formation of ammonia)

Brian, 16 years old, has been diagnosed with cirrhosis. The healthcare practitioner has ordered daily administration of lactulose. What is the rationale for the use of this drug? A. Decreases ascites B. Decreases bleeding from the esophageal varices C. Decreases the formation of ammonia D. Improves absorption of fat-soluble vitamins

B (Is an increase in stool frequency and increased water content with a duration of more than 14 days)

Chronic diarrhea: A. Can be caused by viral, bacterial, and parasitic pathogens B. Is an increase in stool frequency and increased water content with a duration of more than 14 days C. Is a leading cause of illness in children younger than 5 years D. Is often associated with upper respiratory or urinary tract infections

B (Famotidine (Pepcid))

Common therapeutic management of peptic ulcer disease includes histamine receptor antagonists. Which of the following medications is an example of this drug class? A. Bismuth subsalicylate B. Famotidine (Pepcid) C. Omeprazole (Prilosec) D. Sulfasalazine

Rectal atresia

Complete obstruction; inability to pass stool.

Persistent cloaca

Complex anorectal malformation in which the rectum, vagina, and urethra drain into a common channel opening into the perineum.

B (May be related to dietary practices)

Constipation in infancy: A. May be due to normal developmental changes B. May be related to dietary practices C. Is found more often in breastfed infants D. May be due to environmental stressors

Failure to thrive

Deceleration from normal pattern of growth or growth below the 5th percentile.

In CD The Chronic inflammatory process may involve any part of the GI tract, from the mouth to the anus, but most commonly affects the terminal ileum. It can affect segments of the intestine with intact mucosa in between. CD involves all layers of the wall. The inflammation may result in ulcerations, fibrosis, adhesions, stiffening of the bowel wall, and obstruction. In UC the inflammation is limited to the colon and rectum, with the distal colon and rectum often the most severely affected. UC involves the mucosa and submucosa; it also involves continuous segments with varying degrees of ulceration, bleeding, and edema. Long-standing UC can cause shortening of the colon and strictures.

Describe the pathophysiologic differences between Crohn disease (CD) and ulcerative colitis (UC).

Occult blood guaiac test

Detects presence of blood in the stool.

Dysphagia

Difficulty swallowing.

Hepatitis E (HEV)

Does not cause chronic liver disease, is not a chronic condition, and has no carrier state; however, can be a devastating disease among pregnant women, with an unusually high fatality rate. Formally known as non-A, non-B, with transmission through the fecal-oral route or with contaminated water.

D (Has no adverse effects, lessons the severity and duration of the illness, and improves weight gain when compared to gradual reintroduction of foods)

Early reintroduction of nutrients (normal diet) in the patient with diarrhea: A. Is delayed until after the diarrhea has stopped except in the case of breastfed infants B. Has adverse effects and actually prolongs diarrhea C. Should be limited to formula-fed infants being given lactose-free formula D. Has no adverse effects, lessons the severity and duration of the illness, and improves weight gain when compared to gradual reintroduction of foods

Pica

Eating disorder in which there is compulsive eating of both food and non-food substances.

Hepatitis B (HBV)

HBsAg Has been detected in breast milk, but no increased risk of transmission has been found, and breastfeeding is currently recommended after infant immunization. Universal vaccination recommended for all newborns.

B (Malignancy)

IBD can be treated with immunomodulators such as 6-mercaptopurine and azathioprine. When the patient is receiving these drugs, the nurse knows that which of the following adverse effects can occur? A. Anemia B. Malignancy C. Peripheral neuropathy D. Decreased serum calcium levels, leading to osteoporosis

Clostridium difficile

ID the suspected cause of diarrhea: Administration of an antibiotic (cefaclor) for recurrent ear infections.

Fat malabsorption

ID the suspected cause of diarrhea: Foul smelling, greasy, bulky stools.

Parasitic infection or protein intolerance

ID the suspected cause of diarrhea: High numbers of eosinophils in the stools.

Bacterial gastroenteritis or Irritable bowel disease (IBD)

ID the suspected cause of diarrhea: Neutrophils or RBCs in the stool.

Glucose intolerance

ID the suspected cause of diarrhea: Watery, explosive stools.

Paralytic ileus

Impaired motility of the GI tract.

B (Intermittent vomiting)

In preschool children, GER may manifest with: A. Symptoms of heartburn and reswallowing B. Intermittent vomiting C. Respiratory conditions such as bronchospasm and pneumonia D. Failure to thrive, bleeding, and dysphagia

B (C urea breath test)

Jenny, an 8 year old, has been brought to the clinic with continuing pain in the epigastric region of the abdomen. The medical provider has ordered Helicobacter pylori testing. Which of the following tests does the nurse recognize as being the most accurate method to determine active infection? A. Serology test B. C urea breath test C. Esophagus manometry D. Occult blood guaiac test

A (Administration of intravenous fluids, usually normal saline or lactated Ringer solution)

Jerry, a four year old, is brought to the emergency department by his parents, who say he vomited a large amount of bright red blood. Jerry is pale, is cool to the touch, and has increased respiratory rate and heart rate. The nurse expects priority care at this time to include: A. Administration of intravenous fluids, usually normal saline or lactated Ringer solution B. Stool testing for blood by hemoccult C. Insertion of a nasogastric tube for ice water lavage D. Preparation for tracheostomy

B (Presence of associated symptoms)

Johnny, age 2 years, is diagnosed with uncomplicated diarrhea with no signs of dehydration. Diagnostic evaluation should include which of the following? A. Cultures of stool B. Presence of associated symptoms C. Complete blood count D. Urine specific gravity

B (Projective vomiting)

Justin, age 1 month, is brought to the clinic by his mother. The nurse suspects pyloric stenosis. Which of the following symptoms would support this theory? A. Diarrhea B. Projectile vomiting C. Fever and dehydration D. Abdominal distension

D (Explain the battery will need to be removed immediately to prevent damage)

Lance, a two-year-old, has been brought to the clinic because his parents are afraid he swallowed a small disc battery from his father's watch, which he was playing with. The nurse recognizes which of the following as the most appropriate nursing action at this time? A. Reassure the parents that Lance has probably not swallow the battery because he has no symptoms, he is playing in the examination room, and his lung fields are clear B. Explain to the parents that Lance will probably be allowed to normally pass the battery through the GI system because Lance has been able to eat and drink normally since the event C. Start immediate teaching of Lance's parents on how to assess Lance's environment for hazardous objects, and how to assess Lance's toys and other items he might play with for safety D. Explain the battery will need to be removed immediately to prevent damage

Femoral hernia

May manifest as a recurrent hernia following inguinal hernia repair; occurs more often in girls than boys.

Rectal stenosis

May not become apparent until late in infancy, when the infant has a history of difficulty stooling, abdominal distention, and ribbon-like stools.

Umbilical hernia

May resolve spontaneously by 3 to 5 years of age; needs surgical repair if persists beyond this age. Taping or strapping the abdomen to flatten the protrusion does not aid in resolution.

Hepatitis D (HDV)

Occurs rarely in children and must occur in those already infected with HBV.

Encopresis

Outflow of incontinent stool, causing soiling.

Inguinal hernia

Painless inguinal swelling that varies in size; disappears during rest and is reducible by gentle compression.

Hematochezia

Passage of bright red blood from the rectum.

Melena

Passage of dark colored "tarry" stools.

B (4 year old with history of celiac disease being seen with anemia and abdominal pain)

Pica should be considered in which of the following children coming to the health clinic? A. 7 year old with nausea and vomiting for the past 3 days B. 4 year old with history of celiac disease being seen with anemia and abdominal pain C. 2 year old who is still drinking from a bottle and is seen with anemia D. 4 month old who is crying, is irritable, and has reddish stools

D (Mechanical ventilation)

Preoperative care of the neonate with either gastroschisis or omphalocele includes all the following EXCEPT: A. Protect the exposed bowel from injury B. Adequate thermoregulation C. Fluid management D. Mechanical ventilation

C (Feed through the gastrostomy tube)

Preoperative care of the neonate with esophageal atresia and tracheoesophageal fistula includes all the following EXCEPT: A. Keep NPO B. Accumulated secretions are suctioned frequently from the mouth and pharynx C. Feed through the gastrostomy tube D. Position neonate in the supine position with the head elevated on an inclined plane of 30 degrees

A, C, E (observation for dehydration; parental support and reassurance; observation of quality of stool)

Preoperatively, the nursing plan for suspected pyloric obstruction should include which of the following? (Select all that apply) A. Observation for dehydration B. Keeping body temperature below 37.7 C (100 F) C. Parental support and reassurance D. Observation for coughing and gagging after feeding E. Observation of quality of stool

D (Administration of vaccines and medications to prevent traveler's diarrhea before travel)

Prevention measures for diarrhea in children include all the following EXCEPT: A. Wash hands, utensils, and work area with hot, soapy water after contact with raw meat B. Proper disposal of soiled diapers C. During travel to areas where water may be contaminated, allow the child to drink only bottled water from the container through a straw supplied from home D. Administration of vaccines and medications to prevent traveler's diarrhea before travel

B (An organized approach of at least 6 to 12 months of treatment to be effective)

Sally, age 5, has been diagnosed with chronic constipation. management includes: A. Decreasing the water and increasing the milk and Sally's diet B. An organized approach of at least 6 to 12 months of treatment to be effective C. Daily use of rectal stimulation to promote stool passage D. Having Sally sit on the toilet each day until she has a bowel movement

C (Standard immune globulin (IG))

Sandy's testing reflects that she has not had hepatitis A. Because her exposure to hepatitis A occurred within the past two weeks, the nurse would expect the provider to order which of the following for prophylactic administration? A. Hepatitis B immune globulin (HBIG) B. HBV vaccine C. Standard immune globulin (IG) D. HAV vaccine

A (Anti-HAV IgG)

Sandy, age 2 years, is brought to the clinic by her mother because a toddler who attends Sandy's daycare center has been diagnosed with Hepatitis A. Sandy's mother is concerned that Sandy might develop the disease. Which of the following serum laboratory tests would indicate to the nurse that Sandy has immunity to hepatitis A? A. Anti-HAV IgG B. Anti-HAV IgM C. HAsAg D. HAcAg

Hepatitis A (HAV)

Spread directly or indirectly by fecal-oral route with a routine vaccination available. Virus with incubation period of 15 to 50 days; average 21 days.

A (Fatty, frothy, bulky, and foul smelling)

Symptoms in Celiac disease include stools that are: A. Fatty, frothy, bulky, and foul smelling B. Currant jelly appearing C. Small, frothy, and dark green D. White with an ammonia like smell

B (Progressive inflammatory process causing intrahepatic and extrahepatic bile duct fibrosis)

The best definition of biliary atresia is: A. Jaundice persisting beyond two weeks of age with elevated direct bilirubin levels B. Progressive inflammatory process causing intrahepatic and extrahepatic bile duct fibrosis C. Absence of bile pigment D. Hepatomegaly and palpable liver

A (History of alternating diarrhea and constipation, recurrent abdominal pain, and bloating)

The child with irritable bowel syndrome is most likely to present with: A. History of alternating diarrhea and constipation, recurrent abdominal pain, and bloating B. Alternating patterns of constipation and bloody diarrhea with little flatulence C. History of parasitic infections, poor nutrition, and low abdominal pain D. History of colic, laxative abuse, and growth retardation

C (Painless rectal bleeding, abdominal pain, or intestinal obstruction)

The clinical manifestations expected with Meckel diverticulum include which of the following? A. Fever, vomiting, and constipation B. Weight loss, hypotension, and obstruction C. Painless rectal bleeding, abdominal pain, or intestinal obstruction D. Abdominal pain, bloody diarrhea, and foul-smelling stool

Enzymes; hormones; hydrochloric acid; mucus; water and electrolytes

The five types of GI secretions involved in chemical digestion are:

Incarcerated hernia

The hernia is constricted and cannot be reduced manually.

D (Observing and reporting vomiting behavior and associated symptoms)

The major emphasis of nursing care for the vomiting infant or child is: A. Determining prior treatments used for the vomiting B. Preventing the spread of the infection C. Managing the fever associated with the vomiting D. Observing and reporting vomiting behavior and associated symptoms

C (Eliminating wheat, rye, barley, and oats from the diet)

The most important therapeutic management for the child with celiac disease is: A. Eliminating corn, rice, and millet from the diet B. Adding iron, folic acid, and fat soluble vitamins to the diet C. Eliminating wheat, rye, barley, and oats from the diet D. Educating the child's parents about the short term effects of the disease and the necessity of reading all food labels for content until the disease is in remission

B (An upper GI series)

The most reliable way to detect peptic ulcer disease in children is: A. Fiber-optic endoscopy B. An upper GI series C. C urea breath test D. Complete blood count with differential, erythrocyte sedimentation rate, and stool analysis

B (Reschedule the family's routine to accommodate more frequent feeding times)

The nurse instructs the parents of a 4 month old with GER to include which of the following in the infant's care? A. Stop breastfeeding, since breast milk is too thin and easily leads to reflux B. Reschedule the family's routine to accommodate more frequent feeding times C. Increase the infant's intake of fruit and citrus juices D. Try to increase feeding volume right before bedtime, because this is the time on the stomach is more able to retain foods

D (Add popcorn to Brian's diet)

The nurse is counseling the mother of 12 month old Brian on methods to prevent constipation. Which of the following methods would be contraindicated for Brian? A. Add bran to Brian's cereal B. Increase Brian's intake of water C. Add prunes to Brian's diet D. Add popcorn to Brian's diet

C (Brush teeth or rinse mouth after vomiting)

The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. What would the nurse include? A. Give nothing by mouth for 24 hr. B. Avoid carbohydrate-containing liquids. C. Brush teeth or rinse mouth after vomiting. D. Give plain water until vomiting ceases for at least 24 hr.

A (bowel cleansing with magnesium citrate or GoLYTELY)

The nurse is preparing Dottie, age 7, for an upper GI endoscopy. Which of the following does the nurse recognize as NOT being an appropriate preparation for this test? A. Bowel cleansing with magnesium citrate or GoLYTELY B. Keeping Dottie NPO (nothing by mouth) for 8 hours before the procedure C. Giving Dottie sedation before the procedure is begun D. Explaining to Dottie in advance about the procedure by use of pictures or play with dolls and demonstration

A (Esophageal atresia)

The nurse observes frothy saliva in the mouth and nose of the neonate, as well as frequent drooling. When fed, the infant swallows normally but suddenly the fluid returns through the infant's nose and mouth. The nurse should suspect what medical condition? A. Esophageal atresia B. Cleft palate C. Anorectal malformation D. Biliary atresia

D (History of constipation; abdominal distension; and passage of ribbonlike, foul-smelling stools)

The nurse would expect to see what clinical manifestations in the child diagnosed with Hirschsprung disease? A. History of bloody diarrhea, fever, and vomiting B. Irritability, severe abdominal cramps, fecal soiling C. Decreased hemoglobin, increased serum lipids, and positive stool for O&P D. History of constipation; abdominal distension; and passage of ribbonlike, foul-smelling stools

B (Supplementation with multivitamins, iron, and folic acid)

The pediatric nurse knows that the child diagnosed with IBD needs nutritional support that includes: A. Avoiding all foods high in fat B. Supplementation with multivitamins, iron, and folic acid C. Meal planning for 3 large meals daily D. Using bran as a source for high fiber

Small intestine

The principal absorption site in the GI system is the:

D (Total parenteral nutrition and intraluminal nutrition)

The prognosis for children with short bowel syndrome has improved as a result of: A. Dietary supplement of vitamin B12 B. Improvement in surgical procedures to correct the defect C. improved Home Care availability D. Total parenteral nutrition and intraluminal nutrition

D (Have someone call for an ambulance or paramedic rescue squad)

The school nurse is called to the cafeteria because a child "has eaten something he is allergic to." The child is in severe respiratory distress. What is the priority nursing intervention? A. Determine what the child has eaten. B. Administer diphenhydramine (Benadryl). C. Move the child to the nurse's office or hallway. D. Have someone call for an ambulance or paramedic rescue squad.

Digestion; absorption; metabolism

The three processes necessary for the body to convert nutrients into forms it can use are:

D (Gastroesophageal reflux (GER))

The transfer of gastric contents into the esophagus is termed: A. Esophageal atresia B. Meckel diverticulum C. Gastritis D. Gastroesophageal reflux (GER)

C (Rectal biopsy)

To confirm the diagnosis of Hirschsprung disease, the nurse prepares the child for which of the following tests? A. Barium enema B. Upper GI series C. Rectal biopsy D. Esophagoscopy

1. Bismuth, clarithromycin, and metronidazole 2. Lansoprazole, amoxicillin, and clarithromycin 3. Metronidazole, clarithromycin, and omeprazole

Triple drug therapy is the recommended treatment regimen for H. Pylori. Identify three examples of drug combinations used in triple therapy.

False

True or False: Antibiotics are seldom associated with diarrhea in children because of their lower specific gravity.

False

True or False: At birth, the term infant has the ability to move food particles from the front of the mouth to the back of the mouth.

True

True or False: Chronic and intermittent episodes of vomiting in children may indicate malrotation, whereas vomiting on a specific day at a specific time is not likely to be a result of organic disease.

False

True or False: Clostridium difficile produces a protective mechanism against diarrhea because it alters the intestinal flora, increasing absorption surfaces.

True

True or False: Continuing to feed breast milk to an infant during diarrhea illness results in reduced severity and duration of the illness.

True

True or False: Forceful vomiting in infants is associated with pyloric stenosis.

True

True or False: Infants are more susceptible to frequent and severe bouts of diarrhea because their immune system has not been exposed to many pathogens and has not acquired protective antibodies.

True

True or False: Rotavirus is the most important cause of serious gastroenteritis among children and the most common cause of diarrhea-associated hospitalizations.

True

True or False: The chewing function is facilitated by eruption of the primary teeth.

True

True or False: The infant has no voluntary control of swallowing for the first 3 months.

False

True or False: The infant's stomach at birth has an elongated shape.

True

True or False: The infant's stomach is smaller in capacity but faster to empty than the child's stomach.

True

True or False: The primary purpose of saliva in the newborn is to moisten the mouth and throat.

Hematemesis

Vomiting of bright red blood as a result of bleeding in the upper GI tract or from swallowed blood from the upper respiratory tract.

Periumbilical pain, followed by nausea, RLQ pain, and then later vomiting with fever.

What are the classic first symptoms of appendicitis?

Measurement of intake and output; height measurements; weight measurements; abdominal examination; simple stool and urine tests

What are the five most important basic nursing assessments included in a thorough GI assessment?

Assessment of fluid and electrolyte imbalance; Rehydration; maintenance fluid therapy; reintroduction of adequate diet

What are the four major goals in the management of acute diarrhea?

C (Oral rehydration solution)

What is the initial therapeutic management of the child with acute diarrhea and dehydration? A. Clear liquids such as fruit juice and soft drinks B. Adsorbents, such as kaolin and pectin C. Oral rehydration solution D. Antidiarrheal medications such as paregoric

A (Beginning oral rehydration therapy of 50 ml/kg)

What is the most appropriate therapeutic management for rehydration of Jenny, age 8 months, who has been diagnosed with acute diarrhea and has evidence of mild dehydration? A. Beginning oral rehydration therapy of 50 ml/kg B. Restarting lactose-free formula C. Encouraging oral intake of clear fluids, such as fruit juices and gelatin D. Feeding the BRAT diet, which consists of bananas, rice, apples, and toast or tea

McBurney point; Midway between the right anterosuperior iliac crest and the umbilicus

What is the name given to the most intense site of pain in appendicitis? Where is this site located?

Rebound tenderness

What is the term used to describe pain elicited by deep percussion and sudden release, indicating the presence of peritoneal irritation?

C (Rotavirus)

What is the viral pathogen that frequently causes acute diarrhea in young children? A. Giardia organisms B. Shigella organisms C. Rotavirus D. Salmonella organisms

A (Chronic)

What type of diarrhea is commonly seen in malabsorption syndromes because the intestine cannot absorb nutrients or electrolytes? A. Chronic B. Secretory C. Acute D. Intractable diarrhea of infancy

Intractable diarrhea of infancy

What type of diarrhea occurs in the first few months of life, persists for longer than 2 weeks with no recognized pathogens, and is refractory to treatment?

Volvulus

When the intestine completely twists around itself, it is termed _____________________.

C (Give fluids and a normal diet during diarrheal illness)

Which of the following dietary instructions given by the nurse to the parents of a pediatric patient with acute diarrhea without dehydration is correct? A. Follow the BRAT diet for the first 24 hours B. Give clear fluid diet for the first 24 hours C. Give fluids and a normal diet during diarrhea illness D. Keep the patient NPO (nothing by mouth) until stool output slows

B (The medication is administered 30 minutes before breakfast)

Which of the following information given to the parents about administration of a proton pump inhibitor for the treatment of GER is correct? A. The medication is administered on a full stomach B. The medication is administered 30 minutes before breakfast C. The medication will be immediately effective in suppressing acid formation D. Side effects of the drug include increased fatigue, dry mouth, and bloating

B (Maintain thermoregulatory functions)

Which of the following is NOT a function of the gastrointestinal (GI) system? A. Process and absorb nutrients necessary to support growth and development B. Maintain thermoregulatory functions C. Perform excretory functions D. Maintain fluid and electrolyte balance

D (Decreased growth rate)

Which of the following is NOT a serious and immediate physiologic disturbance associated with severe diarrheal disease? A. Dehydration B. Acid-base imbalance C. Circulatory status impairment D. Decreased growth rate

C (Caffeine-containing beverages and spicy foods)

Which of the following is NOT thought to contribute to peptic ulcer disease? A. H. Pylori B. Alcohol and smoking C. Caffeine-containing beverages and spicy foods D. Psychologic factors such a stressful life events

D (Hirschsprung disease)

Which of the following is a congenital anomaly that results in mechanical obstruction from inadequate motility of part of the intestine? A. Intussusception B. short-bowel syndrome C. Crohn disease D. Hirschsprung disease

C (Parasitic infections)

Which of the following is most likely to cause acute diarrhea? A. Food allergy B. Malabsorption syndromes C. Parasitic infections D. Immunodeficiency

A (The 2-month-old infant who attends daycare each day)

Which of the following is most likely to develop acute diarrhea? A. The 2-month-old infant who attends daycare each day B. The 18-month-old infant who stays at home each day with his mother C. The 6-year-old child who attends public school D. The 24-month-old infant with two older brothers, ages 5 years and 8 years

C (Endoscopy)

Which of the following is used to visualize the surface of the GI tract to diagnose the extent of inflammation and narrowing in IBD? A. Upper GI series B. Magnetic resonance imaging C. Endoscopy D. Ultrasound

A (Elevated hemoglobin, hematocrit, blood urea nitrogen (BUN), and creatinine)

Which of the following laboratory values, often found in acute diarrhea with dehydration, will return to normal after hydration of the patient? A. Elevated hemoglobin, hematocrit, blood urea nitrogen (BUN), and creatinine B. Decreased hemoglobin, hematocrit, BUN, and creatinine C. Red blood cells in stool D. Decreased white blood cell count, decreased hemoglobin, elevated BUN, and creatinine

C (rectal temperatures at least every 4 hours to monitor fever elevations)

Which of the following nursing interventions is not appropriate for 6 month old Terry, admitted to the pediatric unit with acute diarrhea and vomiting? A. Ongoing assessment of Terry's intake and output and physical appearance B. Education of the parents about administering oral rehydration solution C. Rectal temperatures at least every 4 hours to monitor fever elevations D. Gentle cleansing of perianal areas and application of protective topical ointments

D (Temperature of 38.8 C (102 F), rigid guarding of the abdomen, and sudden relief from abdominal pain)

Which of the following should alert the nurse to possible peritonitis from a ruptured appendix in a child suspected of having appendicitis? A. Colicky abdominal pain with guarding of the abdomen B. Periumbilical pain that progresses to the lower right quadrant of the abdomen with an elevated white blood cell count C. Low grade fever of 38 C (100.6 F) with the child demonstrating difficulty walking and assuming a side-lying position with the knees flexed toward the chest D. Temperature of 38.8 C (102 F), rigid guarding of the abdomen, and sudden relief from abdominal pain

A (Passage of a normal brown stool)

Which of the following usually indicates that the intussusception has reduced itself? A. Passage of a normal brown stool B. Increase in appetite C. Hyperactive bowel sounds D. Normal complete blood count

C (Decreased ammonia levels)

Which of the following would NOT be expected in the child diagnosed with cirrhosis? A. Hepatosplenomegaly B. Jaundice C. Decreased ammonia levels D. Ascites

A (Anti-HBs)

Which of the following would indicate the patient has been immunized with HBV vaccine? A. Anti-HBs B. Anti-HBs and anti-HBc C. HBsAg D. Anti-HBc