NUR 410 PEDS PrePU
A 4-month-old has had a fever, vomiting, and loose watery stools every few hours for 2 days. The mother calls the physician's office and asks the nurse what she should do. Which response by the nurse is most appropriate?
"Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment."
The nurse is taking a health history of an 11-year-old girl with recurrent abdominal pain. Which response would lead the nurse to suspect irritable bowel syndrome?
"I always feel better after I have a bowel movement."
The nurse is advising a group of new parents on how to care for their infant at home if the baby develops mild diarrhea. Which statement indicates that teaching has been effective?
"I should offer Pedialyte after 1 hour and frequently thereafter to prevent dehydration."
The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with Kwashiorkor. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of Kwashiorkor?
"It is important to increase the intake of protein for these children."
The nurse is providing instructions to the parents of a 10-year-old boy who has undergone a barium swallow/upper and lower GI for suspected inflammatory bowel disease. Which of the following instructions is most important?
"It is very important to drink lots of water and fluids after the test is finished."
The nurse is collecting data on a 2-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask?
"Tell me about the types of stools you child has been having."
The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis?
"The treatment for the disorder will be a surgical procedure."
The nurse is providing teaching for the mother of an infant who receives all of his nutrition through a tube. The nurse is reviewing interventions to promote growth and development. Which response from the mother indicates a need for further teaching?
"We need to keep feeding time very quiet."
A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful?
"We should not stop this medication abruptly."
The nurse is caring for a 13-year-old girl with suspected autoimmune hepatitis. The girl inquires about the testing required to evaluate the condition. How should the nurse respond?
"You will most likely have a blood test to check for certain antibodies."
The nurse is determining maintenance fluid requirements for a child who weighs 25 kg (55 lb). How much fluid would the child need per day?
1,600 ml
A nurse is caring for a 4-year-old child who has undergone surgery to repair a hernia. Which of the following is a priority nursing intervention for this patient?
Assisting with early ambulation to facilitate peristalsis
A child has presented to the clinic with diarrhea. The nurse should teach the mother to give which of the following to properly care for her child?
Bananas
The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would most likely document the stool's appearance as having what quality?
Currant jelly-like
A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason?
Detect Helicobacter pylori
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?
Encourage the mother to provide care for her infant.
A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. The nurse would be especially alert for which of the following in the newborn?
Esophageal atresia
The labor and delivery nurse is caring for a mother who has demonstrated polyhydramnios upon delivery. The newborn displays copious, frothy bubbles of mucus in the mouth and nose, as well as drooling. The nurse is concerned that the infant has what disorder?
Esophageal atresia
A nurse is teaching a group of parents about hepatitis A viral infection. The nurse would describe which of the following as the route of transmission?
Fecal-oral
A parent brings a 2-year-old child to the health clinic with reports of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and his child is enrolled in a local day care center. Based on this information, what gastrointestinal condition might the nurse suspect?
Gastroenteritis
The parents of a boy diagnosed with Hirschsprung disease are anxious and fearful of the upcoming surgery. The mother states, "I'm worried about having to care for our son's ostomy." Which intervention would be most helpful for the parents?
Having a wound, ostomy, and continence nurse meet with them
For what condition will the nurse prepare the child for administration of an enema and teach the child how to retain it for 2 to 3 hours?
Hyperkalemia
The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux?
In this disorder the sphincter that leads into the stomach is relaxed.
A nurse is instructing the parents of a child who is suspected of having pinworms how to check the child. Which of the following instructions would be most appropriate?
Inspect the child's anus with a flashlight 2 to 3 hours after he is asleep.
The nurse has developed a plan of care for a 12-month-old hospitalized with dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care?
Maintaining the intravenous (IV) fluid rate as ordered
A child is diagnosed with giardiasis. The physician prescribes medication to treat the infection. Which of the following would the nurse anticipate being prescribed?
Metronidazole
A mother calls the doctor's office and tells the nurse that she is concerned because her 4-month-old keeps "spitting up" with every feeding. What would indicate that the child is regurgitating as opposed to vomiting?
Only occurs with feeding
A child with chronic hepatitis develops cirrhosis. Which would the nurse indicate as a progression of the disease on shift hand-off? Select all that apply.
Pallor Abdominal distention Prominent abdominal veins Petechaie and bruising
The student nurse is preparing a presentation on celiac disease. What information should be included? Select all apply.
Prepare the child for admission to the hospital
A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child?
Pyloric stenosis
A child with gastroenteritis has been unable to keep oral medication down. What nursing intervention would be appropriate for this client?
Request an intravenous form of the medication.
The nurse is caring for an infant recovering from surgery for pyloric stenosis. Which nursing diagnosis should the nurse use to guide care during the immediate postoperative period?
Risk for infection of incision line, related to disruption of skin barrier during surgery
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
The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration?
Tenting of skin
Parents ask the nurse to explain why they should encourage their reluctant child to eat when the youngster is receiving total parenteral nutrition (TPN). What is the reason the nurse will provide?
To keep the digestive system healthy and functioning
Which type of nutrition would the nurse expect to administer to a preterm infant who was born at 34 weeks' gestation and has developed necrotizing enterocolitis (NEC)?
Total parenteral nutrition (TPN)
A 6-week-old infant is diagnosed with pyloric stenosis. When taking a health history from the parent, which symptom would the nurse expect to hear described?
Vomiting immediately after feeding
The nurse is caring for a 12-year-old child with Crohn disease. What assessment finding will the nurse report to the health care provider when caring for the child?
fever
An infant is on continuous parenteral nutrition (PN) and pulls out the nasoduodenal (ND) tube. After verifying that the ND tube is back in place with an x-ray, which of the following would be the appropriate nursing intervention?
painless rectal bleeding.
The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is:
painless rectal bleeding.
In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention?
The infusion of parenteral nutrition should be restarted at previous rate.
A mother is told that her child will receive total parenteral nutrition. She asks the nurse what this means. The nurse bases her response on knowledge that total parenteral nutrition is:
administration of fluids, electrolytes, amino acids, lipids, dextrose, and minerals through an IV.
The toddler with sudden, severe abdominal pain and currant jelly stools will be treated with a hydrostatic enema. The nurse explains the therapy in this way. The enema will:
unfold the intestine that is pushed in on itself to resolve the obstruction.
The emergency department nurse is assessing a child who has presented with a 2-day history of nausea and vomiting with pain that is isolated to the right upper quadrant of the abdomen. Which action is most appropriate?
1. "Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders." 2. "The only treatment for celiac disease is a strict gluten-free diet." 3. "Gluten is found in most wheat products, rye, barley and possibly oats."
