CPN GI
You are caring for a newborn who is being evaluated for imperforate anus. Which of the following nursing interventions would be most important? a. maintaining NPO status b. taking axillary temperatures only c. providing warm soaks to the anal area d. maintaining the child in a supine position
A
What is the most common assessment finding in a child with ulcerative colitis? a Abdominal cramps b. Bloody diarrhea c. Anal fissures d. Abdominal distention
B
The nurse is caring for 12 year old Lani, who has taken an acetaminophen overdose. Lani's parents ask the nurse when she will be considered 'out of the woods'. How long must Lani be monitored for liver damage? a. 8 hours b. 12 hours c. 36 hours d. 48 hours
C
The nurse is caring for Allie, a 9 year old being evaluated for appendicitis. She initially complained of generalized pain, but now points to her right lower quadrant when asks where it hurts. The nurse knows that this location is referred to as which of the following? a. Rovsing sign b. McBurney's point c. Psoas sign d. Obtruator sign
B
The nurse in a pediatric clinic asks a mother to bring her baby in for evaluation. The nurse suspects that the baby will be tested for pyloric stenosis when the mother states the following: a. "My baby spits up a little 45 minutes after every feeding." b. "My baby vomits right before I begin to give his next feeding." c. "When my baby vomits, it is forceful and green." d. "My baby still wants to eat right after he vomits."
D
The nurse is providing dietary teaching for the parents of a child with celiac disease. This child should avoid: a. Vegetables b. Fruits c. Prepared puddings d. Rice
C
The nurse is caring for Tammy, a premature infant. The nurse is concerned that Tammy is developing NEC. Which of the following could indicate NEC? a. Prior to administering Tammy's feeding by nasogastric (NG) tube, the nurse checks for residual feeds and discovers that none of the previous feed remains. b. Tammy has a low body temperature. c. Tammy's stool is soft and formed. d. Tammy's abdominal girth has decreased.
B
The nurse is doing a presentation on hepatitis for a group of day care workers. The nurse knows that clarification is needed when one of the day care teachers makes which of the following statements? a. "Most children have been vaccinated against hepatitis B." b. "In order to prevent the spread of hepatitis A, we should not allow the toddlers to assist with toileting." c. "It would be best to have the cook not help care for the children." d. "We need to make sure that everyone is washing their hands well."
B
The nurse is presenting a review on necrotizing enterocolitis (NEC). The nurse knows that more information is needed when one of the students states which of the following? a. "Infants who receive CPR are at risk for developing NEC." b. "When the bowel dies, more mucus invades the bowel." c. "Extra gas would be seen on x-ray." d. "Bacteria can grow in formula."
B
The nurse is providing discharge instructions to Isabella, a 14 year old with ulcerative colitis. Which is the nurse's best advice regarding her diet? a. "You'll know what to eat and what to avoid by how your body responds. Keeping a journal is always a good idea. b. It's recommended that you eat high protein, high calorie, and low fat foods." c. "It's recommended that you eat high protein, high calorie, and high fat foods." d. "That is a good question; I'll have the dietician come talk to you."
B
Mrs. Crawford calls the nurse and tells her that a classmate of her daughter has been diagnosed with hepatitis A. She asks when she would likely see symptoms if her daughter were to also come down with hepatitis A. The nurse bases her response on the knowledge that the incubation period of hepatitis A is which of the following? a. Less than 1 week b. 2 weeks c. 4 weeks d. Up to 1 year
C
The nurse, working in a large children's hospital is preparing to receive a transfer from a small community hospital. Cameron is a toddler diagnosed with intussusception who arrives lethargic, with a very rapid heart rate and a blood pressure that is only palpable. His abdomen is rigid and Cameron does not respond vigorously when examined. The nurse correctly expects: a. Cameron will immediately be brought to the operating room for surgical correction. b. Cameron will be brought to the radiology department for an attempt at reduction with a barium enema. c. Cameron will be closely observed in the emergency room to see if his condition changes. d. Cameron will be encouraged to increase his consumption of clear liquids.
A
The nurse is caring for Bobby, a four year old with Celiac disease, when reviewing Bobby's history the nurse would expect to find which of the following? a. Bobby has always been tall for his age. b. Bobby has a history of fatty stools. c. Bobby didn't start solid food until he was 8 months old. d. Bobby has an elevated hematocrit and hemoglobin.
B
A 3-month old infant undergoes a surgical repair of cleft lip. After surgery what should the nurse teach the parents regarding how to feed the infant? a. Breast-feed or bottle-feed b. Use a cup to feed c. Use a paper straw d. Use a medicine dropper
A
A toddler is brought to the emergency department with sudden onset of abdominal pain, vomiting, and stools that look like red currant jelly. To confirm intussusception, the nurse expects the doctor to order which of the following tests? a. A barium enema b. Suprapubic catheter insertion c. Nasogastric tube insertion d. Indwelling urinary (Foley) catheter insertion
A
Adam is a 6 year old with severe cerebral palsy (CP). He is the youngest of 4 siblings and is cared for at home. His mother is discussing his usual daily ritual with the nurse. Which of the following is important for both Adam and his family? a. Adam receives his tube feedings at the table during family meal times. b. Adam receives his tube feedings before the family meal, so that he can nap while the rest of the family is together, allowing Adam's parents to have more time with his siblings. c. In order to save time, Adam receives his tube feedings in the family vehicle, while they are travelling his siblings' sports events. d. Adam receives his feedings at night when the home health nurse is present.
A
Forty-eight hours after birth, a neonate has not passed meconium. The nurse suspects which condition? a. Cystic fibrosis b. Celiac disease c. Intussusception d. An abdominal wall defect
A
Joey is a 12 year old diagnosed with inflammatory bowel disease (IBD). He has recently developed mouth ulcers and arthritis in his joints. Which of the following is likely occurring? a. Joey likely has Crohn's disease. b. Joey likely has Ulcerative colitis. c. It is impossible to distinguish the type if IBD that Joey has, but he likely has a secondary inflammatory illness unrelated to the IBD. d. The medications used to treat IBD have caused mouth ulcers and arthritis.
A
Stevie is a 1 year old diagnosed with Hirschsprung's disease. He is likely going to have surgery in a few days. In the meantime, the nurse suggests to Stevie's mother which of the lol lowing diets? a. Low fiber, high calorie, and high protein b. High fiber, high calorie, and high protein. c. Low fiber, low calorie, and high protein. d. High fiber, low calorie, and high protein.
A
The mother of newborn Hannah, an infant with cleft palate tells the nurse that she is so disappointed because she probably won't be able to nurse Hannah. Which of the following is the nurse's best response? a. "Some mothers are still able to nurse their babies, have you tried yet?" b. "I understand you're frustrated, let's talk about other ways to feel close to Hannah." c. "The risk of aspiration is too great, I know you want what's best for Hannah." d. "It will be hard enough to feed her with a bottle, I certainly wouldn't attempt breastfeeding."
A
The nurse is caring for Amber, a 6 year old who has just been diagnosed with appendicitis. When the nurse is performing Amber's assessment and gathering her history, she would expect to find which of the following? a. Amber complains of increased pain when the nurse releases her hand from her right lower quadrant. b. Amber complains of increased pain when the nurse presses down on her right lower quadrant. c. Amber has a decreased white blood cell count. d. Amber has increased bowel sounds.
A
The nurse is caring for Henry, a 2 month old male with pyloric stenosis. Henry was admitted to the pediatric unit for rehydration prior to his pyloromyotomy. When the nurse reviews Henry's bloodwork, she is not surprised to find which of the following results? a. pH - 7.49, HCO3 - 29 b. pH - 7.49, HCO3 - 18 c. pH - 7.32, HCO3 - 29 d. pH - 7.32, HCO3 -18
A
The nurse is obtaining a history on David, a toddler with Hirschsprung's Disease. She asks about his bowel patterns and is not surprised when David's mother says which of the following? a. "David tends to have long skinny stools." b. "David occasionally has bloody stools that contain mucus." c. "David always has large amounts of liquid diarrhea." d. "David has very small constipated white stools."
A
The nurse is working in the emergency room when Mrs. Evans brings 4 year old Sally in to be evaluated. Sally has been vomiting and having diarrhea for 2 days. Mrs. Evans states that Sally 'just hasn't been able to keep anything down.' The nurse notes that Sally is very pale and has dark circles around her eyes. Sally is very lethargic and doesn't cry or move when the nurse obtains her vital signs. Which of the following should the nurse anticipate will be included in Sally's plan of care? a. Administering an IV bolus of normal saline. b. Administering an IV bolus with fluids containing both saline and glucose to help correct dehydration and hypoglycemia. c. Give Sally a Pedialyte popsicle to avoid traumatizing Sally with an invasive procedure. d. Encourage Sally's mother to attempt to give her clear liquids before starting an IV.
A
The nurse is caring for Jed, a newborn with suspected TEF. When his mother offered him his first feeding, Jed became cyanotic and coughed and choked. Which of the following would the nurse expect to be part of Jed's care? a. Allow Jed's mother to feed him pedialyte slowly in a monitored area, stopping all feedings 6 hours before surgery. b. Begin IV fluids and IV antibiotics. c. Admit Jed to the ICU and immediately place him on 100% oxygen. d. Allow Jed's parents to visit him in the PICU, but not hold him until immediately before his surgery.
B
The nurse is caring for Sarah, a 12 month old toddler who has just had a repair of a cleft palate. Which of the following should be included in Sarah's plan of care? a. Position Sarah so that secretions drain from the mouth and suction her with a soft tipped catheter. b. Encourage Sarah's mother to hold and rock her frequently. c. Attempt to keep Sarah from crying, encourage her to hold her favorite stuffed animal and use her pacifier when upset. d. Keep Sarah hydrated by offering her juice and liquids in a bottle.
B
13. You are caring for a 3-year-old admitted with diarrhea and dehydration. She is NPO for bowel rest. She is ordered for IV Maintenance Fluids. Her weight is 13kg. You calculate her hourly IV fluid rate to be approximately: a. 52 ml/hour b. 46 ml/hour c. 36 ml/hour d. 26 ml/hour
B
4 year old Drew has been vomiting for 24 hours. Several labs have been ordered. The nurse would expect the results to show which of the following? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis
B
Andy is a 30 kg child who is admitted to the pediatric unit with dehydration. He is currently NPO and is receiving IV fluids at maintenance. What is the hourly rate that his IV should be at? a 60 ml/hr b 70 ml/hr c. 80ml/hr d. 90 ml/hr
B
Ben is a 12 year old who has just returned from the recovery room after having had an appendectomy. He had a perforated appendix and subsequently developed peritonitis. Which of the following is the best position for Ben at this time? a. Prone b. Right side lying c. Left side lying d. Supine
B
Johnny is suspected of having Hirschsprung's disease. The nurse would expect the child's history of present illness to include which of the following? a. anemia, abdominal distention, fecal soiling b. abdominal distention, constipation, foul smelling stools c. bloody diarrhea, fever, vomiting d. irritability, severe abdominal cramps, fecal soiling
B
Natalie, a 4 year old who has just had her appendix removed, wakes up with her mother is at her bedside. Which of the following comments by the nurse would be the most developmentally appropriate? a. "When you feel better, your friends can come to visit." b. "There is a big Band-Aid where the doctors took your appendix out." c. "You'll be able to return to preschool soon!" d. "Let's close the curtains while I look at your tummy."
B
The 1-day-old neonate is suspected to have Tracheoesophageal fistula. Which nursing intervention is most appropriate for this infant? a Avoiding suctioning unless cyanosis occurs b. Elevating the head of the bed/crib and giving nothing by mouth c. Elevating the neonate's head for 1 hour after feedings d. Giving the neonate only glucose water for the first 24 hours
B
The greatest post-operative danger from a cleft palate repair is: a. pain b. rupture of the suture lines c. infection d. dehydration
B
The nurse is caring for 18 month old Matthew who is being evaluated for gastroesophageal reflux (GER). When reviewing Matthew's history, the nurse would expect to find which of the following? a. Matthew was born 3 days after his due date. b. Matthew has a history of asthma. c. Matthew is in the 50th percentile for both height and weight. d. Matthew recently had an intussusception reduced by barium enema.
B
The nurse is providing education to Kirsten's parents. Kirsten is a 6 week old with gastroesophageal reflux (GER). Which of the following should the nurse include in her teaching plan? a. Although, most children should be put on their backs to sleep, Kirsten should be placed on her side to avoid aspiration. b. Kirsten should be fed smaller amounts in each feeding. c. The time between Kirsten's feedings should be stretched out as much as possible to assure that the stomach has fully emptied. d. Kirsten's parents should decrease the caloric density of her feedings.
B
The nurse is working in the clinic when she is told that a child with inflammatory bowel disease (IBD) is coming for lab work. In order to care for this child, the nurse reviews information on IBD. Which of the following is accurate? a. Ulcerative colitis attacks all but the mucosa of the bowel. b. Crohn's disease affects all layers of the bowel wall. c. Ulcerative colitis usually involves the small intestine. d. Crohn's disease causes more blood loss than Ulcerative colitis.
B
Which of the following assessments would you expect to note when caring for the child with pyloric stenosis? a. projectile vomiting of bile-tinged emesis b. visible peristaltic waves c. metabolic acidosis d. non projectile vomiting
B
You are caring for a 12 month old who has recently had surgery to repair his cleft palate. Which of the following would be the best toy to stimulate this infant? a. a rattle b. a mobile c. teething ring d. something to bang
B
You are the nurse caring for an infant who was just delivered. You suspect the child has tracheo-esophageal fistula. Which set of symptoms would suggest this problem? a. Drooling and diarrhea b. Increased mucous production and oral secretions c. Air distension in the stomach and vomiting d. Persistent cyanosis and visible peristaltic waves
B
Amelia is a 3 month old infant who is receiving tube feeds due to a temporary malformation in the GI system. Which of the following should the nurse encourage Amelia's mother to do during her feedings. a. Sing or play music that is calming to Amelia b. Stroke Amelia's head and talk to her during the feeding. c. Give Amelia a pacifier during the feeding. d. Encourage Amelia to sleep during the feeding.
C
Eight week old Jose is admitted for surgery to repair his cleft lip. What is the most important nursing intervention following surgery? a. lay the baby on his stomach to prevent aspiration b. provide adequate oral nutrition c. decrease stress on the suture line d. use a hard nipple and pacifier in order to teach the child how to suck properly
C
Madison is a 4-week-old with a cleft lip and palate who is scheduled for a surgical repair of the lip. Her mother asks the nurse why the lip and palate aren't being repaired at the same time. The nurse's best response is: a. "They prefer to schedule the repairs separately to avoid using too much anesthesia." b. "The palate is generally not repaired until Madison has begun talking." c. "The palate needs to have an opportunity to grow and the repair requires that Madison be drinking from an open cup, usually about 6 to 12 months of age." d. "It sounds like you have some unanswered questions. I can arrange to have you speak to the surgeon."
C
Mr. Walker asks the nurse if it matters when they give their infant Tyler his ranitidine. Which of the following is the nurse's best response? a. "Since ranitidine is an antacid it doesn't really matter when you give it to him." b. "It would probably be easiest to give it with Tyler's feeding." c. "It would be best to give the medication 30 minutes before Tyler eats." d. "It would be best to give the medication 30 minutes after Tyler eats."
C
Mrs. Plank calls the nurse and tells her that she is concerned about her 1 year old Ryan. She reports that he had an episode where he drew his legs up to his abdomen and then vomited. She later checked his diaper and found that it contained a small amount of stool stained with mucus and blood. Which of the following represents the nurse's best response to Mrs. Plank? a. "It sounds like Ryan is feeling better now, feel free to call us back if it happens again." b. "It sounds like everything is alright, but just to be sure lets schedule an appointment for Ryan to be checked in the morning." c. "You should bring Ryan to the emergency room to be evaluated to make sure that nothing serious is going on." d. "It sounds like Ryan's stomach is upset, did he eat anything different?"
C
The nurse is caring for 18 month old Kobe who has moderate diarrhea. Which of the following should be included in Kobe's plan of care? a. Encourage Kobe to drink apple juice and sports drinks. b. Have Kobe eat only bananas, rice, applesauce, and toast (BRAT diet). c. Ensure that all of Kobe's diapers are weighed. d. Keep Kobe NPO for 4-6 hours to see if the diarrhea subsides.
C
The nurse is caring for 2 month old Sophia who has been diagnosed with biliary atresia. When reviewing Sophia's history the nurse would expect: a. Sophia's urine has been very pale. b. Sophia has been having black tarry stools. c. Sophia has had very poor weight gain. d. Sophia has had a bluish tint to her sclera.
C
The nurse is reviewing information on pyloric stenosis. Which of the following reflects accurate information? a. It only occurs in males b. Vomiting will gradually become more projectile and contain more bile as the pylorus muscle thickens. c. Surgical correction involves spreading open the muscle around the pyloric valve. d. A sausage shaped mass can be palpated in the lower abdomen.
C
The nurse is teaching a class to a group of new parents when one parent tells the nurse that her neighbor's infant was treated for esophageal burns from formula that was too hot. Which of the following is the nurse's best response? a. "That is very unusual since most infants will spit out anything that is too hot or not palatable." b. "Although it is essential to warm a baby's bottle it should never be done in the microwave." c. "It is always important to test the temperature of the formula since a young baby will automatically swallow what is in his mouth." d. "That's too bad that happened to your neighbor's baby but it sounds like the parents were irresponsible."
C
The nurse is working in the emergency room when 16 year old Jeremy is admitted with a diagnosis of acetaminophen poisoning. Jeremy admits that he took the medication 50 minutes ago. Which of the following should be included in Jeremy's plan of care? a. Administer activated charcoal as soon as Jeremy's lab results come back. b. Prepare to administer whole bowel lavage. c. Administer N -acetylcysteine within 8 hours of ingestion. d. Administer syrup of ipecac.
C
The pediatric clinic nurse is evaluating 6 year old Elizabeth who has chronic constipation. Which of the following should be included in the nurse's dietary recommendations to Elizabeth and her family? a. Increase liquids and fat while decreasing protein and fiber. b. Increase liquids and protein while decreasing fiber and fat. c. Increase liquids and fiber while decreasing protein and fat. d. increase liquids, fiber, and protein, while decreasing fat.
C
When developing a postoperative plan of care for an infant scheduled for cleft lip repair, the nurse should assign highest priority to which intervention? a. Comforting the child as quickly as possible b. Maintaining the child in a prone position c. Restraining the child's arms at all times, using elbow restraints d. Avoiding disturbing any crusts that form on the suture line
C
3-year-old Kelly's mother reports that Kelly opened a bottle of medication that was in her purse. In the emergency room, Kelly has white powder around her mouth and there are no pills left in the bottle. A diagnosis of accidental overdose is made. In order to verify the placement of the nasogastric (NG) tube for charcoal administration, the nurse should: a. Instill air and auscultate over the upper left epigastrium for a popping sound. b. Assume correct placement as long as there is no choking or decreased oxygen saturations. c. Instill air and auscultate the upper chest to ensure the tube is not in the lungs. d. After the tube is placed, aspirate the contents and verify that the pH is less than 6.
D
A 10-month-old is admitted to the hospital with dehydration and metabolic acidosis. What is the most common cause of dehydration and acidosis in infants? a. Early introduction of solid foods b. Inadequate perianal hygiene c. Tachypnea d. Diarrhea
D
As the nurse caring for a 12-month-old who has just had a cleft palate repair, you would use which of the following to provide fluids for the child? a. rubber-tipped syringe b. bottle c. medicine dropper d. cup
D
Brad is a 5 year old who is being evaluated for encopresis. Which of the following would the nurse expect to hear while obtaining Brad's history? a. Brad has adjusted well to Kindergarten. b. Brad his been having fatty stools that float in the toilet water. c. Brad typically has soft formed stools 2-3 times a day. d. Brad has been having liquid stool stain his underwear.
D
Julie is a newborn infant diagnosed with tracheoesophageal fistula (TEF). When reviewing Julie's history, the nurse would expect to find which of the following? a. Julie tolerated feedings for a few days, then experienced projectile vomiting. b. Julie's mother stated that she barely looked pregnant and never needed to wear maternity clothes. c. Julie continuously appeared hungry despite being fed every 2 hours. d. Julie appeared to have a lot of secretions and became cyanotic when fed.
D
Kennedy is an infant in the ICU who has been diagnosed with NEC. The nurse anticipates that which of the following will be included in Kennedy's care? a. Decrease the amount of feeding and change it from formula to pedialyte. b. Connect the NG tube to intermittent low wall suction in between feedings. c. Decrease visitors and only allow the parents to hold the infant. d. Administer antibiotics.
D
Lucy is a 3 month old with biliary atresia. Lucy's mom asks why her infant is so irritable and restless. Which of the following is the nurse's best response? a. "Lucy's enlarged liver is probably placing pressure on other areas of her body, I'll give her some pain medication." b. "Lucy is probably restless because she must remain in the crib and can't be held and cuddled." c. "Lucy probably needs more stimulation, let's put a music box near her crib." d. "Lucy is probably feeling very itchy, I'll give her some medication for that."
D
Marcia is a 3 week old who was diagnosed with TEF. Her defect was extensive and Marcia's surgery needed to be done in stages. She also had a gastrostomy tube (G-tube) placed until complete correction can be obtained. When providing her discharge instructions, the nurse would include which of the following: a. Clean around the G-tube site with hydrogen peroxide or betadine twice daily. b. If the G-tube comes out during the night, it is acceptable to skip one feeding and call the pediatric clinic in the morning. c. Flush the G-tube with approximately 2 ounces of water after each feeding to avoid obstruction within the tube. d Always check for residual formula before beginning the next feeding by attaching a syringe and gently withdrawing.
D
Mrs. Peters calls the nurse and states that she is worried that her children will get pinworms like their neighbors. Which of the following should the nurse tell Mrs. Peters? a. "Be sure to avoid the children and their pets." b. "If you notice your children scratching their perianal area, we'll need to obtain blood and stool samples." c. "It is impossible for children to catch pinworms, it is only spread within a family." d. "Your children should be treated with medication if they have been around your neighbors."
D
The nurse is caring for Trisha, a 6 year old with pneumonia. Trisha also has celiac disease. The dietary aide brings the lunch trays and asks what Trisha can eat. Which of the following lunches would be acceptable? a. Beef and barley soup, vanilla pudding, and orange juice b. Pizza, applesauce, and sprite c. Cheeseburger, corn chips, and milk d. Grilled chicken and corn
D
The nurse is providing education on cleft lip and palate to a group of nursing students. It is apparent that more education is needed when a student states that the infants are at risk for: a. Pneumonia b. Otitis media c. Altered bonding with parents d. Gastroesophageal reflux
D
The nurse is teaching a group of nursing students about pathophysiology of Hirschsprung's disease. She knows that a student understands the teaching when the student says which of the following? a. "In Hirschsprung's disease, there is an overabundance of ganglion cells which lead to the clinical manifestations." b. "In Hirschsprung's disease, the over active ganglion cells can cause inflammation of the bowel leading to an obstruction." c. "In Hirschsprung's disease, the entire bowel is without ganglion cells." d. "In Hirschsprung's disease, there is a section without peristalsis."
D
Tonya is a 6 month old female who vomited twice this morning and had one episode of diarrhea. Which of the following would indicate that the infant is no longer in the early stages of dehydration, but has progressed to severe dehydration? a Increased heart rate b. Sunken fontanel c. Dry mucus membranes d. Decreased capillary refill
D
When caring for a 12-month-old infant with dehydration and metabolic acidosis, the nurse expects to see which of the following? a. A reduced white blood cell count b. A decreased platelet count c. Shallow respirations d. Tachypnea
D
Which of the following is the most appropriate discharge teaching for the nurse caring for the child with Celiac disease? a. eliminating corn, rice and millet from the diet b. adding iron, folic acid and fat-soluble vitamins to the diet c. reinforcing the short-terms effects of the disease and the need to adhere to dietary restrictions until the disease is in remission d. eliminating wheat, rye, barley and oats from the diet
D
You are caring for a 7-month-old who is suspected of having intussusception. What clinical manifestations would most likely be present? a. abdominal pain, vomiting, olive shaped mass to the right of the umbilicus b. anorexia, abdominal distention, constipation c. malnourished looking child, fever, diarrhea d. inconsolable crying, abdominal pain, sausage shaped mass in the right lower quadrant
D
