GI PEDS Q
a
A 2-month-old breast-fed infant is successfully rehydrated with oral rehydration solutions for acute diarrhea. Instructions to the mother about breast-feeding should include which of the following? A. Continue breast-feeding. B. Stop breast-feeding until breast milk is cultured. C. Stop breast-feeding until diarrhea is absent for 24 hours. D. Express breast milk and dilute with sterile water before feeding it.
a
A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initial therapeutic approach to the mother should be which of the following? A. Encourage her to express her feelings. B. Suggest holding baby but without eye contact. C. Restate what the physician has told her about plastic surgery. D. Recognize that attachment usually does not occur until after initial surgery.
d
A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells. This is most suggestive of which of the following conditions? A. Parasitic infection B. Fat malabsorption C. Protein intolerance D. Bacterial gastroenteritis
a
A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child begins with: A. Intravenous fluids. B. oral rehydration solution. C. clear liquids, 1 to 2 oz at a time. D. administration of antidiarrheal medication.
a
An adolescent girl is cooking on a gas stove when her bathrobe catches fire. Her father smothers the flames with a rug and calls an ambulance. She has sustained major burns over much of her body. Which of the following is also important in her immediate care? A. Cool with a single application of tepid water. B. Encourage her to drink clear liquids. C. Remove her burned clothing and jewelry. D. Leave the rug in place until the ambulance arrives.
c
An appropriate intervention to encourage food and fluid intake in a hospitalized child is which of the following? A. Force child to eat to combat caloric losses. B. Administer large quantities of flavored fluids at frequent intervals. C. Give high-quality foods and snacks whenever child expresses hunger. D. Discourage participation in noneating activities until caloric intake is sufficient.
c
Enteral feedings are ordered for a young child with burns covering 40% of total body surface area. The nurse should know that: A. oral feedings are contraindicated. B. enteral feedings must be stopped during painful procedures. C. presence of a paralytic ileus does not preclude use of enteral feedings. D. the feedings will be high carbohydrate, low protein.
d
In which of the following conditions is the fluid requirement for children decreased? A. Burns B. Fever C. Vomiting D. Increased intracranial pressure
b
Rapid replacement of fluid is essential in the treatment of which of the following types of dehydration? A. Isotonic, osmotic B. Hypotonic, isotonic C. Osmotic, hypertonic D. Hypertonic, hypotonic
a
The nurse is assessing an infant brought to the clinic with diarrhea. He is lethargic and has dry mucous membranes. Which of the following should the nurse recognize as an early sign of dehydration? A. Tachycardia B. Bulging, tense fontanel C. Decreased blood pressure D. Capillary refill of less than 3 seconds
a
The nurse is caring for a 12-year-old boy who sustained major burns when he put charcoal lighter on a campfire. The nurse observes that he is "very brave" and appears to accept pain with little or no response. The most appropriate nursing action related to this is which of the following? A. Request a psychologic consultation. B. Ask child why he doesn't have pain. C. Praise child for ability to withstand pain. D. Encourage continued bravery as a coping strategy.
c
The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. Which of the following should the nurse include? A. Give nothing by mouth for 24 hours. B. Avoid carbohydrate-containing liquids. C. Brush teeth or rinse mouth after vomiting. D. Give plain water until vomiting ceases for at least 24 hours.
d
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. The nurse should do which of the following first? A. Determine what the child has eaten. B. Administer diphenhydramine (Benadryl). C. Move child to nurse's office or hallway. D. Have someone call for an ambulance or paramedic rescue squad.
c
Therapeutic management of the child with acute diarrhea and dehydration usually begins with which of the following? 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
What type of dehydration is defined as "dehydration that occurs in conditions in which electrolyte and water deficits are present in approximately balanced proportion"? A. Isotonic dehydration B. Hypotonic dehydration C. Hypertonic dehydration D. All types of dehydration in infants and small children
b
When administering a gavage feeding to a school-age child, the nurse should do which of the following? A. Administer feedings over 5 to 10 minutes. B. Position child on right side after administering feeding. C. Check the placement of the tube by inserting 20 ml of sterile water. D. Lubricate the tip of the feeding tube with Vaseline to facilitate passage.
c
When caring for a child with an intravenous infusion, the nurse should do which of the following? A. Change the insertion site every 24 hours. B. Use a macrodropper to facilitate the prescribed flow rate. C. Observe the insertion site frequently for signs of infiltration. D. Avoid restraining the child to prevent undue emotional stress.
a
Which of the following is a major long-term problem for a child with cleft lip and palate? A. Faulty dentition B. Nutritional deficits C. Aspiration pneumonia D. Abnormally small maxilla
c
Which of the following is the viral pathogen that frequently causes acute diarrhea in young children? A. Giardia organisms B. Shigella organisms C. Rotavirus D. Salmonella organisms
a
Which of the following occurs in septic shock? A. Massive vasodilation B. Increased respiratory rate C. Decreased capillary permeability D. Increased systemic vascular resistance
d
Which of the following should the nurse recognize as an early clinical sign of compensated shock in a child? A. Confusion B. Sleepiness C. Hypotension D. Apprehension
b
Which of the following statements regarding burn injuries in children is correct? A. Burns are the most frequent cause of accidental death during childhood. B. Prognosis for burned child is directly related to amount of tissue destroyed. C. Standard "rule of nines" chart is typically used for assessing the size of a burn in small children. D. Children under age 2 years have significantly lower mortality than older children with similar burns.
a
Which of the following types 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
