GI/GU metabolic course point quiz

The nurse is to obtain a stool specimen from a 4-year-old child who has very liquid stool. The child is ambulatory but weak. Which collection method would be most effective for the nurse to use? Apply a urine bag to the anal area. Use a tongue blade to scrape a specimen from a diaper. Have the child defecate into a container in the toilet. Use a clean bedpan to collect the specimen.

Apply a urine bag to the anal area

A 4-year-old diagnosed with diabetes insipidus is being discharged. Which information below is most important to emphasize to the parents? Only one person in the house needs to learn how to give the injections of vasopressin. Children younger than 5 do not need to wear medical alert tags. Diabetes insipidus is different from diabetes mellitus. Children outgrow this diagnosis over time.

Diabetes Insipidus is different from diabetes mellitus

A nurse is reviewing with an 8-year-old how to self-administer insulin. Which of the following is the proper injection technique for insulin injections? Place the needle with the bevel facing down before the injection. Spread the skin before the injection. Aspirate the syringe for blood return before the injection. Elevate the subcutaneous tissue before the injection.

Elevate subcutaneous tissue before the injection

The mother of a newborn with a cleft lip reports she is having a hard time looking her baby. What is the best action by the nurse? -Explain that surgery will make this better in the future. -Encourage the mother to provide care for her infant. -Encourage the child's mother to hold her infant against her shoulder to provide closeness while not looking at the defect. -Tell the mother that while this is difficult it will get easier.

Encourage the mother to hold infant against her shoulder

The nurse is assessing a toddler and palpates a sausage-shaped mass in the upper mid abdomen. When taking the toddler's history, what question would the nurse ask the parent first? "Has your toddler been having different colored stools?" "Can you describe any pain your toddler is having?" "How is your toddler's appetite?" "Has your toddler been around anyone who has been sick?"

Has your toddler been having different colored stools

A child is hospitalized with dehydration as a result of rotavirus. When reviewing the plan of treatment, what can the nurse anticipate will be included? Select all that apply. antidiarrheal agents antibiotic therapy IV fluid administration monitor of intake and output daily weight assessment

IV fluid administraion Monitor I/O Daily Weight

The nurse is providing client education to an adolescent newly diagnosed with type 1 diabetes. Which statement indicates that the nurse's teaching is effective. "If I take my insulin, I can eat any kind of carbohydrate I want." "I will pack a snack to eat right after my gym class." "I will have to decrease my carbohydrates and increase the amount of protein that I eat." "Since I will be losing lots of weight, I probably won't have to take so much insulin."

If I take my insulin, I can eat any kind of carbohydrate I want.

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time? Preparing family for home care Promoting comfort Maintaining skin integrity Improving hydration

Improving hydration

The nurse is teaching an 11-year-old boy and his family how to manage his diabetes. Which instruction does not focus on glucose management? Teaching that 50% of daily calories should be carbohydrates. Instructing the child to rotate injection sites. Encouraging the child to maintain the proper injection schedule. Promoting higher levels of exercise than previously maintained.

Instructing the child to rotate injection sites

A 9-month-old infant presents to the emergency department with vomiting and abdominal pain. While assessing the client, the nurse notes the client screaming intermittently and drawing up legs toward chest a palpable mass in upper right quadrant (above). What does the nurse anticipate in this child's stools? narrow, ribbon-like stools loose, watery stools jellylike, bloody stools foul-smelling, fatty stools

Jellylike, bloody stools

A child has been admitted to the acute care facility for the management of dehydration. The nurse is preparing to administer intravenous fluid replacement to the child. Which fluids are suitable for use? Select all that apply. lactated Ringer's normal saline 5% dextrose in water 0.45% saline 10% dextrose in water

LR, NS

The nurse teaches a parent to differentiate between regurgitation and vomiting in the infant. The parent correctly states which characteristic of regurgitation? Select all that apply. SATA occurs with feedings no appearance of distress followed by dry retching forceful expulsion of stomach contents timing unrelated to feeding

Occurs with feedings No appearance of distress Forceful expulsion of stomach contents

A toddler is being seen in the clinic. The parents describe a 2-day history of vomiting and diarrhea. The nurse's assessment finds the toddler is listless, has pale and slightly dry mucous membranes, and has decreased skin turgor. Based on this assessment, what intervention would the nurse implement first? oral rehydration therapy bolus IV fluids administer an antiemetic administer an antidiarrheal

Oral rehydration therapy (moderate dehydration- if severe we would use bolus)

A child is getting a diagnostic work-up for nephrotic syndrome. Which lab results would the nurse expect to see? -Proteinuria, hypoalbuminemia, and hypercholesterolemia -Hematuria, proteinuria, and hyperalbuminemia -Neutropenia, hematuria, and hypocholesterolemia -Proteinuria, hyperalbuminemia, and hypocholesterolemia

Proteinuria, hypoalbuminemia, and hypercholesterolemia

A 3-month-old is admitted with severe diarrhea. Yesterday, the infant weighed 11 pounds (5 kg). Today, this infant weighs 9 pounds, 8 ounces (4.3 kg). Based on this information the nurse documents that the infant has: severe dehydration. failure to thrive. malabsorption syndrome. risk for fluid volume deficit.

Severe dehydration

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac disease. The caregivers make the following statements. Which statement indicates a need for further teaching regarding the dietary restrictions for the child with celiac disease? "The soup we eat at our house is all made from scratch." "She loves hot dogs, and we always cut hers up into small pieces." "I have learned to make my own bread with no gluten." "Even though milk and pudding are good for her, we don't give her those foods."

She loves hotdogs (many processed foods such as creamed soups, cold cuts, hotdogs contain wheat)

The nurse is collecting data on a 2 year old child admitted with a diagnosis of gastroenteritis. When interviewing the caregiver, which questions is most important for the nurse to ask? "How many times a day does your child urinate?" "How long has your child been toilet trained?" "Tell me about the types of stools your child has been having." "What foods has your child eaten during the last few days?"

Tell me about the type of stools your child has been having

A voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents? The VCUG will rule out vesicoureteral reflux. The VCUG will detect if the infection is gone. The VCUG will rule out kidney stones. The VCUG will prevent further complications of the urinary tract infection (UTI).

The VCUG will rule out vesicouteteral reflux

A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a 1-week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out what possible explanation for the bedwetting? The child has a urinary tract infection due to not bathing while on the fishing trip. The child is out of the habit of waking himself up during the night to void. The child did not want to go on the fishing trip and is now retaliating against being made to go. The child has been sexually abused, maybe on the fishing trip.

The child has been sexually abused, mabe on the fishing trip

A group of students are reviewing information about fluid balance and losses in children in comparison to adults. The students demonstrate a need for additional review when they state that: children have a proportionately greater amount of body water than do adults. fever plays a greater role in insensible fluid losses in infants and children. a higher metabolic rate plays a major role in increased insensible fluid losses. the infant's immature kidneys have a tendency to overconcentrate urine.

The infants immature kidneys have a tendency to overconcentrate urine.

Testing is being performed to confirm the presence of Meckel diverticulum. Which findings are consistent with this condition? Select all that apply. hemoglobin 9.4 g/dl (94 g/L) white blood cell count 8 g/dl Stool test reveals occult blood. platelet count 200,000 hematocrit 37% (0.37)

hemoglobin 9.4 g/dL (94 g/L) Stolle test reveals occult blood

A group of nursing students are reviewing information about celiac disease. The students demonstrate understanding of this disorder when they identify which classic symptoms? Select all that apply. steatorrhea constipation diarrhea failure to thrive sunken abdomen polycythemia

steatorrhea constipation diarrhea failure to thrive

A nurse is preparing a presentation for a group of parents with children diagnosed with type 1 diabetes. The children are all adolescents. What issues would the nurse address related to their developmental level? Select all that apply. Self-monitoring of blood glucose levels Feelings of being different Deficient decision-making skills Body image conflicts Struggle for independence

-Deficient decision-making skills -Body image conflicts -Struggle for independence

An infant brought to the emergency department has been vomiting for 2 days. The nurse assesses the infant and finds sunken fontanels (fontanelles), tenting skin, dry mucus membranes and no urine output for 12 hours. Which intervention(s) will the nurse complete as first-line care for this infant? Select all that apply. -Insert a peripheral IV. -Begin maintenance IV fluids. -Start oral rehydration. -Administer a prescribed IV fluid bolus. -Administer an antiemetic.

-Insert a peripheral IV. -Administer a prescribed IV fluid bolus. -Administer an antiemetic.

An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep throat a little over a week ago. Which condition should the nurse suspect? Acute glomerulonephritis Kidney agenesis Polycystic kidney Nephrosis

Acute glomerulonephritis

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition? Barium enema Surgery Upper endoscopy Endoscopic retrograde cholangiopancreatography

Barium enema (pushes slid intestine back into place)

The nurse is caring for a 2 month patient with cleft palate and undergoing surgery at 3 months. The mother would like to continue breastfeeding after surgery and wonders if it is possible. How should the nurse respond? "There is a good chance that you will be able to breastfeed almost immediately." "Breastfeeding is likely to be possible, but check with the surgeon." "After the suture line heals, breastfeeding can resume." "We will have to wait and see what happens after the surgery."

Breastfeeding is likely to be possible but check with the surgeon.

The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child? Eyes Fingers Abdomen Sacrum

Eyes

A group of nursing students are reviewing information about neonatal screenings. The students demonstrate understanding of the information by identifying which system is most consistently affected by metabolic disorder. nervous system cardiovascular system gastrointestinal system respiratory system

Nervous System

The nurse is obtaining the history of an infant with suspected intestinal obstruction. Which response regarding newborn stool patterns would indicate a need for further evaluation for Hirschsprung disease? passed a meconium stool in the first 24 to 48 hours of life has had diarrhea for 3 days constipated and passing gas for 2 days passed a meconium plug

Passed a meconium plug

A nurse is providing education to parents of a child diagnosed with vesicoureteral reflux (VUR). Which would be included in the parental education? -This occurs when there is backflow of urine into the bladder and sometimes the kidneys. -This occurs only when there is an obstruction of the ureteropelvic junction. -This is diagnosed by abdominal x-ray. -This is typically treated with a kidney transplant.

This occurs when there is backflow of urine into the bladder and sometimes the kidneys.

A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect? Syndrome of inappropriate diuretic hormone Diabetes insipidus Type 1 diabetes mellitus Hypothyroidism

Type 1 diabetes mellitus

A nurse is taking care of an infant with diabetes insipidus. Which assessment data are most important for the nurse to monitor while the infant has a prescription for fluid restriction? Vital signs Oral intake Oral mucosa Urine output

Urine Output

The nurse is providing discharge teaching regarding oral fluid rehydration to a mother who brought her child to the clinic because of vomiting over the past 2 days. The child is mildly dehydrated. Which comments by the mother indicated learning occurred? SATA "I should not give my child any fluids for 1 to 2 hours after an episode of vomiting." "My child can drink milk if he feels like it to help in rehydration." "Oral rehydration solutions (ORS) are good sources of fluids for rehydration." "I should be sure my child receives 50 to 100 ml/kg of oral rehydration solution (ORS) over 4 hours." "Solutions like Pedialyte are not necessary for mild dehydration."

"I should not give my child any fluids for 1 to 2 hours after an episode of vomiting." "Oral rehydration solutions (ORS) are good sources of fluids for rehydration." "I should be sure my child receives 50 to 100 ml/kg of oral rehydration solution (ORS) over 4 hours."

A 16-year-old adolescent is at the office for a checkup. The parent states, "My child keeps forgetting to take insulin. What can we do to make sure my child takes it?" Which is the best response by the nurse? "You can set a medication time that allows your child to have a normal routine that does not interrupt school or sleep." "You can offer your child prizes for taking the medication." "You can make sure that you are the only one who understands and is able to administer the medication." "You can remind your child that the medication is in the cabinet, and that the child should take it when needed."

"You can set a medication time that allows your child to have a normal routine that does not interrupt school or sleep."

A school-aged child is brought to the emergency room with severe abdominal pain. The nurse performs a physical assessment. Which assessment parameters indicate appendicitis? Select all that apply. SATA: -Normal to hyperactive bowel sounds early -Hypoactive bowel sounds with perforation -Irritation and pain in the right lower quadrant -Low-grade fever, nausea, anorexia, and vomiting -Rebound tenderness present with palpation in the left upper quadrant -Distended abdomen with unperforated appendicitis

-Normal to hyperactive bowel sounds early -Hypoactive bowel sounds with perforation -Irritation and pain in the right lower quadrant -Low-grade fever, nausea, anorexia, and vomiting

A child diagnosed with acute glomerulonephritis will most likely have a history of: -recent illness such as strep throat. -a sibling diagnosed with the same disease. -hemorrhage or history of bruising easily. -hearing loss with impaired speech development.

-recent illness such as strep throat.

Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration? -dusky extremities -tenting of skin -sunken fontantels (fontanelles) -hypotension

-sunken fontantels (fontanelles)

A child weighing 10 kg is admitted with severe vomiting for the past 3 days. The nurse writes a nursing diagnosis of Risk for deficient fluid volume related to vomiting. When the nurse reassesses the child, which outcomes would indicate the effectiveness of the treatment plan? Select all that apply. -urine specific gravity of 1.008 -urine output of 15 mL/hour -tolerating sips of clear fluids -poor skin turgor on abdomen -drinks 16 ounces of milk per nursing shift

-urine specific gravity of 1.008 -urine output of 15 mL/hour -tolerating sips of clear fluids