N138 Chp 22 GI Quiz
Which type of diarrhea is associated with antibiotic therapy? 1 Acute diarrhea 2 Chronic diarrhea 3 Chronic nonspecific diarrhea 4 Intractable diarrhea of infancy
1 Acute diarrhea is associated with antibiotic therapy. Chronic diarrhea is associated with malabsorption syndromes. Chronic nonspecific diarrhea is associated with dietary indiscretions and food sensitivities. Intractable diarrhea of infancy is a syndrome that occurs in the first few months of life.
A 2-month-old breastfed infant is receiving oral rehydration solution for acute diarrhea. What instructions should the nurse give the mother about breastfeeding? 1 To continue breastfeeding 2 To supplement breastfeeding with water 3 To stop breastfeeding until the diarrhea has ceased for 24 hours 4 To express breast milk and dilute it with sterile water before feedings
1 Breastfeeding should be continued while an infant is receiving oral rehydration solution (ORS) for acute diarrhea. The mother should not be told to supplement breastfeeding with water, to stop breastfeeding until diarrhea has been absent for 24 hours, or to express breast milk and dilute it with sterile water before feeding when her infant is receiving ORS for acute diarrhea. Test-Taking Tip: Relax during the last hour before an exam. Your brain needs some recovery time to function effectively.
The nurse is discussing home care with the mother of a 6-year-old child with hepatitis A. What should the discharge teaching plan include? 1 Teaching infection-control measures to family members 2 The importance of bedrest until 1 week after the icteric phase 3 The need for the child not to return to school until 3 weeks after the icteric phase 4 Reassurance for the mother that hepatitis A cannot be transmitted to other family members
1 Hepatitis A is a contagious disease that is transmitted by way of the fecal-oral route. The nurse should teach infection-control measures to family members. Hepatitis A does not usually have an icteric phase and often is subclinical. The period of communicability for hepatitis A is the latter half of the incubation period to 1 week after the onset of clinical illness; therefore the child may return to school after that time frame. Because hepatitis A is infectious through the fecal-oral route, family members may be susceptible to the disease if they fail to institute proper infection-control measures. Test-Taking Tip: Many times the correct answer is the longest alternative given, but do not count on it. NCLEX item writers (those who write the questions) are also aware of this and attempt to avoid offering you such "helpful hints."
What does the nurse recognize as a nursing intervention that is contraindicated for children, especially infants with acute diarrhea? 1 Bathing 2 BRAT diet 3 Breastfeeding 4 Rehydration solution
2 A nursing intervention known as the BRAT diet (bananas, rice, applesauce, and toast or tea) that used to be offered for dehydration is now contraindicated in children, especially infants with acute diarrhea, because it is of little nutritional value. Bathing is not contraindicated. Breastfeeding is not contraindicated if it is established. Rehydration solution is the treatment of choice and therefore not contraindicated.
An adolescent who has been consuming a low-sodium diet for a long period is at risk for: 1 Water excess 2 Hyponatremia 3 Hypernatremia 4 Water depletion
2 A teenager who consumes a low-sodium diet for a prolonged period is at risk for hyponatremia, a low sodium level. Water excess occurs when intake exceeds output. Hypernatremia can be caused by a high-sodium, rather than a low-sodium, diet. Water depletion occurs when the body fails to absorb or resorb water or there is a prolonged reduction in the intake of water.
The nurse is caring for a child with Crohn disease (CD). What is a distinctive characteristic of CD? 1 Inflammation is limited to the distal colon and rectum. 2 Inflammation results in stiffening of the bowel wall. 3 The most dangerous form is toxic megacolon. 4 Rectal bleeding is common in these patients.
2 CD is a form of inflammatory bowel disease. The inflammation may result in the stiffening of the bowel wall. Other manifestations include ulcerations, fibrosis, adhesions, stricture formation, and fistulas to other loops of bowel, bladder, vagina, or skin. Inflammation occurs in any part of the gastrointestinal tract from the mouth to the anus but most often affects the terminal ileum. In ulcerative colitis (UC), the inflammation is limited to the distal colon and rectum. The most dangerous form of severe colitis is toxic megacolon. Rectal bleeding due to inflammation and ulceration is common in patients with UC. STUDY TIP: Becoming a nursing student automatically increases stress levels because of the complexity of the information to be learned and applied and because of new constraints on time. One way to decrease stress associated with school is to become very organized so that assignment deadlines or tests do not come as sudden surprises. By following a consistent plan for studying and completing assignments, you can stay on top of requirements and thereby prevent added stress.
What manifestation in the infant does the nurse associate with hypertrophic pyloric stenosis? 1 Abdominal pain 2 Projectile vomiting 3 Edema at the extremities 4 Distended lower abdomen
2 The infant with hypertrophic pyloric stenosis has projectile vomiting, a sign of obstruction. Vomit may be ejected 3 to 4 feet from the infant when in a side-lying position or 1 foot or more when in a supine position. The infant does not have abdominal pain, except for discomfort due to hunger. The infant is hungry and shows signs of dehydration. There is no edema at the extremities. The infant has a distended upper abdomen as a result of gas and fluid above the level of the obstruction.
A child has a nasogastric (NG) tube after surgery for acute appendicitis. What is the purpose of the NG tube? 1 Maintain electrolyte balance 2 Prevent abdominal distention 3 Prevent the spread of infection 4 Maintain an accurate record of output
2 The nasogastric (NG) tube is used to maintain gastric decompression until intestinal activity returns. The NG tube may adversely affect electrolyte balance by removing stomach secretions. NG drainage is one part of the child's output. The nurse needs to include the NG drainage with other output. There is no relationship between the NG tube and prevention of the spread of infection. Test-Taking Tip: Many times the correct answer is the longest alternative given, but do not count on it. NCLEX item writers (those who write the questions) are also aware of this and attempt to avoid offering you such "helpful hints."
A 3-month-old child presents with sudden acute abdominal pain. The child is having episodes of screaming and drawing knees to her chest followed by periods of comfort. The parent tells the nurse the child's stool looked like red jelly. What do these clinical manifestations suggest? 1 Omphalocele 2 Gastroschisis 3 Intussusception 4 Anorectal malformations
3 Acute abdominal pain followed by episodes of comfort accompanied with the passage of red jelly-like stools is the clinical manifestation of intussusception. An omphalocele is a birth defect in which the infant's intestine or other abdominal organs protrude through the abdominal wall. Gastroschisis is a birth defect in which an infant's intestines protrude from the body through a defect on one side of the umbilical cord. Anorectal malformations are birth defects in which the anus and rectum do not develop properly.
The parents of a 1-month-old infant bring the child to the clinic because the infant has been projectile vomiting 30 minutes after feeding. The parent describes the vomit as stale milk. On assessment the nurse palpates an olivelike mass. What condition do these clinical manifestations characterize? 1 Gastroschisis 2 Hiatal hernia 3 Umbilical hernia 4 Hypertrophic pyloric stenosis
4 Clinical manifestations of hypertrophic pyloric stenosis (HPS) include projectile vomiting 30 to 60 minutes after feeding with vomitus that resembles stale milk. An olivelike mass can be palpated when the stomach is empty. Gastroschisis is protrusion of intraabdominal contents. Hiatal hernia presents with dysphagia, growth failure, vomiting, neck contortions, frequent respiratory problems, and bleeding. Umbilical hernia is noted on inspection and palpation of the abdomen.
Constipation has recently become a problem for a school-age boy who just started attending a new school. What is the most likely cause of his constipation? 1 Puberty 2 Allergies 3 High-fiber diet 4 Fear of using bathrooms at school
4 Fear of using the bathrooms at school is a common cause of new-onset constipation. Puberty is not associated with constipation. Allergies do not usually cause constipation; however, antihistamines given for seasonal allergies can have the side effect of constipation. The diet may cause constipation if it is low in fiber.
When evaluating the extent of an infant's dehydration, the nurse should recognize which symptoms of severe dehydration? 1 Tachycardia, decreased tears, 5% weight loss 2 Normal pulse and blood pressure, intense thirst 3 Irritability, moderate thirst, normal eyes and fontanels 4 Tachycardia, parched mucous membranes, sunken eyes and fontanels
4 Symptoms of severe dehydration include tachycardia, parched mucous membranes, and sunken eyes and fontanels. In severe dehydration there is a 15% weight loss in infants, not 5%, although the infant will exhibit tachycardia and decreased tears. Tachycardia, orthostatic hypotension and shock, and intense thirst would be expected in an infant with severe dehydration. The infant would be extremely irritable, with sunken eyes and fontanels, if severely dehydrated. Test-Taking Tip: Look for options that are similar in nature. If all are correct, either the question is poor or all options are incorrect, the latter of which is more likely. Example: If the answer you are seeking is directed to a specific treatment and all but one option deal with signs and symptoms, you would be correct in choosing the treatment-specific option.
