GI practice questions

The nurse receives a call from the mother of a 6-month-old who describes her child as alternately sleepy and fussy. She states that her infant vomited once this morning and had two episodes of diarrhea. The last episode contained mucus and a small amount of blood. She asks the nurse what she should do. Select the nurse's best response.

"Your infant will need to have some tests in the emergency room to determine if anything serious is going on."

The nurse is caring for a 3-month-old being evaluated for possible Hirschsprung disease. His parents call the nurse and show her his diaper containing a large amount of mucus and bloody diarrhea. The nurse notes that the infant is irritable, and his abdomen appears very distended. Which should be the nurse's next action?

. Immediately obtain all vital signs with a quick head-to-toe assessment.

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?

30 minutes before the feeding

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?

Administer a bolus of normal saline.

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?

After the saline bolus, begin maintenance fluids of D5 1/4 NS with 10 mEq KCl/L.

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?

Analysis of serum electrolytes.

The nurse is caring for a 3-year-old who had an appendectomy 2 days ago. The child has a fever of 101.8°F (38.8°C) and breath sounds are slightly diminished in the right lower lobe. Which action is most appropriate?

Encourage the child to blow bubbles.

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.

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.

A 10-year-old is being evaluated for possible appendicitis and complains of nausea and sharp abdominal pain in the right lower quadrant. An abdominal ultrasound is scheduled, and a blood count has been obtained. The child vomits, finds the pain relieved, and calls the nurse. Which should be the nurse's next action?

Immediately notify the physician of the child's status

The nurse is caring for an infant newly diagnosed with Hirschsprung disease. What does the nurse understand about this infant's condition?

There is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention.

Which child may need extra fluids to prevent dehydration? Select all that appl

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.

The nurse is caring for a 14-year-old with celiac disease. The nurse knows that the patient understands the diet instructions by ordering which of the following meals?

Cheese, banana slices, rice cakes, and whole milk

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?

Continue breastfeeding per routine.

The nurse is providing discharge instructions to the parents of a child who had an appendectomy for a ruptured appendix 5 days ago. The nurse knows that further education is required when the parent states:

"We will wait 2 weeks before allowing our child to return to sports."

the nurse is caring for a 5-month-old infant with a diagnosis of intussusception. The infant has periods of irritability during which the knees are brought to chest and the infant cries, alternating with periods of lethargy. Vital signs are stable and within age-appropriate limits. The physician elects to give an enema. The parents ask the purpose of the enema. Select the nurse's most appropriate response

"The enema will help confirm the diagnosis and has a good chance of fixing the intussusception."

The nurse is to receive a 4-year-old from the recovery room after an appendectomy. The parents have not seen the child since surgery and ask what to expect. Select the nurse's best response.

"Your child will be very sleepy and have an intravenous line in the hand. If your child needs pain medication, we will give it intravenously."

The nurse is caring for an 8-week-old male who has just been diagnosed with Hirschsprung disease. The parents ask what they should expect. Select the nurse's best response.

"Although your child will require surgery, there are different ways to manage the disease, depending on how much bowel is involved."

The nurse is caring for an infant diagnosed with Hirschsprung disease. The mother states she is pregnant with a boy and wants to know if her new baby will likely have the disorder. Select the nurse's best response.

"Genetics play a small role in Hirschsprung disease, so there is a chance the baby will develop it as well."

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.

"Give your child 1/2 ounce of Pedialyte every 10 minutes. If vomiting continues, wait an hour, and then repeat what you previously gave.

More education about necrotizing enterocolitis (NEC) is needed in a nursing in-service when one of the participants states:

"NEC occurs only in preemies and low-birth-weight infants.

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.

"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."

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.

"Prilosec decreases stomach acid, so it will not be as irritating when your child spits up.

The nurse is caring for a newborn with a cleft lip and palate. The mother states, "I will not be able to breastfeed my baby." Select the nurse's best response.

"Sometimes breastfeeding is still an option for babies with a cleft lip and palate. Would you like more information?"

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."

"The baby is always hungry after vomiting so I refeed."

The parent of a child being evaluated for celiac disease asks the nurse why it is important to make dietary changes. Select the nurse's best response.

"The body's response to gluten causes damage to the mucosal cells in the intestine, leading to absorption problems."

Which manifestation suggests that an infant is developing necrotizing enterocolitis (NEC)?

Bloody diarrhea.

An expectant mother asks the nurse if her new baby will have an umbilical hernia. The nurse bases the response on the fact that it occurs:

More often in premature infants

A child is diagnosed with chronic constipation that has been unresponsive to dietary and activity changes. Which pharmacological measure is most appropriate?

Osmotic agent.

The nurse is caring for a 1-month-old term infant who experienced an anoxic episode at birth. The health-care team suspects that the infant is developing necrotizing enterocolitis (NEC). Which would the nurse expect to be included in the plan of care?

Prepare to administer antibiotics intravenously.

The nurse will soon receive a 4-month-old who has been diagnosed with intussusception. The infant is described as very lethargic with the following vital signs: T 101.8°F (38.7°C), HR 181, BP 68/38. The reporting nurse states the infant's abdomen is very rigid. Which is the most appropriate action for the receiving nurse?

Prepare to get the infant ready for immediate surgical correctio

The nurse is caring for a 4-month-old who has just had an isolated cleft lip repaired. Select the best position for the child in the immediate post-operative period

Supine.