Final Exam: GI Dysfunction NCLEX Questions
c d e
The nurse is teaching parents about high-fiber foods that can prevent constipation. What foods should the nurse include in the teaching? (Select all that apply) a. Oranges b. Bananas c. Lima beans d. Baked beans e. Raisin bran cereal
a b d
A nurse is teaching a parent of an infant about GERD. which of the following should the nurse include in the teaching? Select all that apply a. offer frequent feedings b. thicken formula with rice cereal c. use a bottle with a one-way valve d. position baby upright after feedings e. use a wide-based nipple for feedings
a c d
What should the nurse assess in a newborn diagnosed with an anorectal malformation? Select all that apply a. abdominal distention b. loose stools c. vomiting d. meconium in the urine e. meconium stools
b
A nurse is caring for an infant who has just returned from the PACU following cleft lip and palate repair. Which of the following actions should the nurse take? a. remove the packing in the mouth b. place the infant in an upright position c. offer a pacifier with sucrose d. assess the mouth with a tongue blade
b
The nurse is caring for a newborn who has just been diagnosed with tracheoesophageal fistula and is scheduled for surgery. Which should the nurse expect to do in the preoperative period? a. keep the child in a monitored crib, obtain frequent vital signs, and allow the parents to visit but not hold their infant b. administer IV fluids and antibiotics. c. place the infant on 100% oxygen via a non-rebreather mask d. Have the mother feed the infant slowly in a monitored area, stopping all feedings 4-6 hours before surgery
b
A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include? a. Dilating the stoma b. Assessing bowel function c. Limitation of physical activities d. Measures to prevent prolapse of the rectum
d
A health care provider prescribes feedings of 1 to 2 oz Pedialyte every 3 hours and to advance to 1/2 strength Similac with iron as tolerated postoperatively for an infant who had a pyloromyotomy. The nurse should decide to advance the feeding if which occurs? a. The infants IV line has infiltrated. b. The infant has not voided since surgery. c. The infants mother states the infant is tolerating the feeding okay. d. The infant is taking the Pedialyte without vomiting or distention.
a b e
A nurse is assessing an infant who has hypertrophic pyloric stenosis. Which of the following manifestations should the nurse expect? Select all that apply a. projectile vomiting b. dry mucus membranes c. currant jelly stools d. sausage-shaped abdominal mass e. constant hunger
b
A nurse is caring for a child who has Hirschsprung's disease. Which of the following actions should the nurse take? a. encourage a high-fiber, low-protein, low-calorie diet b. prepare the family for surgery c. place an NG tube for decompression d. initiate bed rest
a
After teaching the parent of an infant who has had a surgical repair for a cleft lip about the use of elbow restraints at home, the nurse determines that teaching has been successful when the parent makes which statement? a. "we will keep the restraints on continuously except when checking the skin under them for redness" b. "we will keep the restraints on during the day while he is awake, but take them off when we put him to bed at night" c. "after we get home, we will not have to use the restraints because our child does not suck on his hands or fingers" d. "we will be sure to keep the restraints on all the time until we come to see the care provider for a follow-up visit"
a
Amber Mecca, age 5 months, is suspected of having intussusception. What clinical manifestations would she most likely have? a. crampy abdominal pain, inconsolable crying, a drawing up of the knees to the chest, and passage of red, currant jelly-like stools b. fever, diarrhea, vomiting, lowered WBC count, and tender, distended abdomen c. weight gain, constipation, refusal to eat, and rebound tenderness d. abdominal distention, periodic pain, hypotension, and lethargy
b
An infant diagnosed with Hirschsprung's disease undergoes surgery with the creation of a temporary colostomy. Which statement by the parent regarding the colostomy indicates the need for further teaching? a. "the colostomy is only temporary" b. "the colostomy will give time for the nerves to return to normal" c. "the colostomy may include two separate abdominal openings" d. "right after the procedure, the stoma may appear purple"
a b d
Because children with celiac disease must limit their intake of products containing gluten in wheat, rye, oats, and barley, they are at risk for which of the following nutritional deficiencies? Select all that apply a. iron deficiency anemia b. folic acid anemia c. zinc deficiency d. vitamin A, D, E, and K deficiency e. vitamin B12 deficiency
b
Brenda Snyder, age 1 month, is brought to the clinic by her mother. The nurse suspects pyloric stenosis. Which of the following symptoms would support this theory? a. diarrhea b. projectile vomiting c. fever and dehydration d. abdominal distention
b
Constipation in infancy a. may be due to normal developmental changes b. may be related to dietary practices c. is found more often in breast fed infants d. may be due to environmental stressors
d
Immediately after the first oral feeding after corrective surgery for pyloric stenosis, a 4 week old infant is fussy and restless. Which action would be most appropriate at this time? a. encourage the parents to hold the infant b. hang a mobile over the infant's crib c. give the infant more to eat d. give the infant a pacifier to suck on
b
In preschool children, GER may manifest with a. symptoms of heartburn and reswallowing b. intermittent vomiting c. respiratory conditions such as bronchospasm and penumonia d. failure to thrive, bleeding, and dysphagia
b
Melena, the passage of black, tarry stools, suggests bleeding from which source? a. The perianal or rectal area b. The upper gastrointestinal (GI) tract c. The lower GI tract d. Hemorrhoids or anal fissures
a
On the 2nd postoperative day after repair of a cleft palate, what should the nurse use to feed a toddler? a. cup b. straw c. rubber-tipped syringe d. large-holed nipple
d
Preoperative care of the neonate with either gastrochisis or omphalocele includes all of the following except a. protect the exposed bowel from injury b. adequate thermoregulation c. fluid management d. mechanical ventilation
b
Shannon Scully, age 5, has been diagnosed with chronic constipation. Management includes a. decreasing the water and increasing the milk in Shannon's diet b. an organized approach of at least 6-12 months of treatment to be effective c. daily use of rectal stimulation to promote stool passage d. having Shannon sit on the toilet each day until she has a bowel movement
a
Symptoms in celiac disease include stools that are a. fatty, frothy, bulky, and foul smelling b. currant jelly-appearing c. small, frothy, and dark green d. white with an ammonia-like smell
b
The best definition of biliary atresia is a. jaundice persisting beyond 2 weeks of age with elevated direct bilirubin levels b. progressive inflammatory process causing intrahepatic and extrahepatic bile duct fibrosis c. absence of bile pigment d. hepatomegaly and palpable liver
c
The healthcare provider is able to reduce an infant's hernia and schedules the infant for a hernorrhaphy in 2 days. The parent asks the nurse why the surgery is not being performed now. Which response about delaying the surgery is most appropriate? a. "delaying the surgery ensures that your infant will receive the proper preoperative preparation" b. "we need to make sure that your infant receives nothing by mouth for at least 24 hours before the surgery" c. "waiting these 2 days helps to allow any edema and inflammation in the area to subside" d. "your infant needs to wear a truss for at least 24 hours before any surgery can be attempted"
a
The healthcare provider prescribes IV fluid replacement therapy with potassium chloride to be added for a child with severe gastroenteritis. Before hanging the IV fluids with potassium chloride, which assessments would be most important? a. ability to void b. passage of stool today c. baseline ECG d. serum calcium level
d
The major emphasis of nursing case for the vomiting infant or child is a. determining prior treatments used for the vomiting b. preventing the spread of infection c. managing the fever associated with the vomiting d. observing and recording vomiting behavior and associated symptoms
c
The nurse observes that a newborn is having problems after birth. What should indicate a tracheoesophageal fistula? a. Jitteriness b. Meconium ileus c. Excessive frothy saliva d. Increased need for sleep
d
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 nurses best response a. "replace the next feeding with regular water, and see if that is better tolerated" b. "do not allow your baby to eat any solids; give half the normal formula feeding, and see if that is better tolerated" c. "do not let your baby eat or drink anything for 24 hours to give the stomach a chance to rest" d. "give your child 1/2 ounce of pedialyte every 10 minutes. If vomiting continues, wait an hour, and then repeat what your previously gave"
d
What clinical manifestation should be the most suggestive of acute appendicitis? a. Rebound tenderness b. Bright red or dark red rectal bleeding c. Abdominal pain that is relieved by eating d. Colicky, cramping, abdominal pain around the umbilicus
a
What intervention is contraindicated in a suspected case of appendicitis? a. Enemas b. Palpating the abdomen c. Administration of antibiotics d. Administration of antipyretics for fever
c
What is the initial therapeutic management of the child with acute diarrhea and dehydration? 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
b
What should preoperative care of a newborn with an anorectal malformation include? a. Frequent suctioning b. Gastrointestinal decompression c. Feedings with sterile water only d. Supine position with head elevated
c
What should the nurse consider when providing support to a family whose infant has just been diagnosed with biliary atresia? a. The prognosis for full recovery is excellent. b. Death usually occurs by 6 months of age. c. Liver transplantation may be needed eventually. d. Children with surgical correction live normal lives.
d
What term describes invagination of one segment of bowel within another? a. Atresia b. Stenosis c. Herniation d. Intussusception
b
When developing the plan of care for a neonate who was diagnosed with an anorectal malformation and who subsequently underwent surgery, what intervention would be most helpful in facilitating parent-infant bonding? a. explaining to the parents that they can visit any time b. encouraging the parents to hold their infant c. asking the parents to help monitor the infant's intake and output d. helping the parents plan for their infant's discharge
c
When developing the preoperative plan of care for an infant with Hirschsprung's disease, which intervention should the nurse include? a. administering a tap water enema b. inserting a gastrostomy tube c. restricting oral intake to clear liquids d. using povidone-iodine solution to prepare the perineum
a
When obtaining the initial health history from a 10 year old child with abdominal pain and suspected appendicitis, which question would be most helpful in eliciting data to help support the diagnosis? a. "where did the pain start?" b. "what did you do for the pain?" c. "how often do you have a bowel movement?" d. "is the pain continuous, or does it let up?"
a
When obtaining the nursing history from the mother of an infant with suspected intussusception, which question would be most helpful? a. "what do the stools look like" b. "when was the last time your child urinated?" c. "is your child eating normally?" d. "has your child had any episodes of vomiting?"
b
Which assessment would be the most important for the nurse to include in the plan of care for an infant experiencing severe diarrhea? a. monitoring the total 8 hour formula intake b. weighting the infant each day c. checking the anterior fontanel every shift d. monitoring abdominal skin turgor every shift
c
Which is the best position for an 8 year old who has just returned to the pediatric unit after an appendectomy for a ruptured appendix? a. semi-fowler b. prone c. right side-lying d. left side-lying
a
Which manifestation would the nurse expect to see in a 4 week old infant with biliary atresia? a. abdominal distention, enlarged liver, enlarged spleen, clay-colored stool, and tea-colored urine b. abdominal distention, multiple bruises, bloody stools, and hematuria c. yellow sclera and skin tones, excessively oily skin, and prolonged bleeding times d. no manifestations until the disease has progressed to the advanced stage
a
Which measure would be most effective in helping the infant with a cleft lip and palate to retain oral feedings? a. burp the infant at frequent intervals b. feed the infant small amounts one at a time c. place the end of the nipple far to the back of the infant's tongue d. maintain the infant in a supine position while feeding
c
Which of the following dietary instructions given by the nurse to the parents of a pediatric patient with acute diarrhea without dehydration is correct? a. follow the BRAT diet for the first 24 hours b. give clear fluid diet for the first 24 hours c. give fluids and a normal diet during diarrhea illness d. keep the patient NPO until stool output slows
d
Which of the following is a congenital anomaly that results in mechanical obstruction from inadequate motility of part of the intestine? a. insussusception b. short-bowel syndrome c. crohn disease d. hirschsprung disease
a
Which of the following usually indicates that the intussusception has resolved itself? a. passage of a normal brown stool b. increase in appetite c. hyperactive bowel sounds d. normal complete blood count
d e
Which should the nurse include in the plan of care to decrease symptoms of GERD in a 2 month old? Select all that apply a. place the infant in an infant seat immediately after feedings b. place the infant in the prone position immediately after feeding to decrease the risk of aspiration c. encourage the parents to not worry because most infants outgrow GER within the first year of life d. 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
d
A 10 year old is being evaluated for possible appendicitis and complains of nausea and sharp abdominal pain 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? a. cancel the ultrasound and obtain an order for oral Zofran b. cancel the ultrasound and prepare to administer an intravenous bolus c. prepare for the probable discharge of the patient d. immediately notify the health-care provider of the child's status
c
A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect? a. Pyloric stenosis b. Intussusception c. Hirschsprung disease d. Celiac disease
c
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? a. urinalysis obtained by bagged specimen b. urinalysis obtained by sterile catheterization c. analysis of serum electrolytes d. analysis of cerebrospinal fluid
a c e
A 9 month old is admitted because of dehydration. How should the nurse go about accurately monitoring fluid intake and output? Select all that apply a. weighing and recording all wet diapers b. changing breast-feedings to bottle-feedings c. obtaining an accurate daily weight d. restricting fluids prior to weighing the child e. obtaining an accurate stool count
c
A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube? a. Prevent spread of infection. b. Monitor electrolyte balance. c. Prevent abdominal distention. d. Maintain accurate record of output.
a c d
A child is admitted with a diagnosis of possible appendicitis. The child is in acute pain. Which nursing interventions would be appropriate prior to surgery to decrease pain? Select all that apply a. offer an ice pack b. apply a heating pad c. encourage the child to assume a position of comfort d. limit the child's activity e. request a prescription for a cathartic
d
A child who has just had definitive repair of a high rectal malformation is to be discharged. What should the nurse address in the discharge preparation of this family? a. Safe administration of daily enemas b. Necessity of firm stools to keep suture line clean c. Bowel training beginning as soon as the child returns home d. Changes in stooling patterns to report to the practitioner
c
A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent? a. Surgical therapy is indicated. b. Place in prone position for sleep after feeding. c. Thicken feedings and enlarge the nipple hole. d. Reduce the frequency of feeding by encouraging larger volumes of formula.
c
A school-age child with celiac disease asks for guidance about snacks that will not exacerbate the disease. What snack should the nurse suggest? a. Pizza b. Pretzels c. Popcorn d. Oatmeal cookies
a
A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. What is the therapeutic management of this child? a. Intravenous fluids b. Oral rehydration solution c. Clear liquids, 1 to 2 oz at a time d. Administration of antidiarrheal medication
d
An infant is born with a gastroschisis. Care preoperatively should include which priority intervention? a. Prone position b. Sterile water feedings c. Monitoring serum laboratory electrolytes d. Covering the defect with a sterile bowel bag
b
The mother of an infant with a cleft lip asks when the repair will be scheduled. What is the nurse's best response? a. at birth b. during the first 6 months of life c. after 6 months of age d. at 1 year of age
b
The nurse instructs the parents of a 4 month old with GER to include which of the following in the infant's care? a. stop breastfeeding, since breast milk is too thin and easily leads to reflux b. rescheduling of the family's routines to accommodate more frequent feeding times c. increase the infant's intake of fruit and citrus juices d. try to increase feeding volume right before bedtime, because this is the time when the stomach is more able to retain foods
c
The nurse is assisting a child with celiac disease to select foods from a menu. What foods should the nurse suggest? a. Hamburger on a bun b. Spaghetti with meat sauce c. Corn on the cob with butter d. Peanut butter and crackers
c
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 large amounts 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? a. reassure the parents that this is an expected finding and not uncommon b. call a code for a potential cardiac arrest and stay with the infant c. immediately obtain all vital signs with a quick head-to-toe assessment d. obtain a stool sample for occult blood
c
The nurse is caring for an infant who had surgical repair of a tracheoesophageal fistula 24 hours ago. Gastrostomy feedings have not been started. What do nursing actions related to the gastrostomy tube include? a. Keep the tube clamped. b. Suction the tube as needed. c. Leave the tube open to gravity drainage. d. Lower the tube to a point below the level of the stomach.
b
The nurse is caring for an infant who has been diagnosed with short bowel syndrome. The parent asks how the disease will affect the child. Which is the nurse's best response? a. "because your child has a shorter intestine than most, your child will likely experience constipation and will need to be placed on a bowel regimen" b. 'because your child has a shorter intestine than most, he will not be able to absorb all the nutrients and vitamins in food and will need to get nutrients in other ways" c. "unfortunately, most children with this diagnosis do not do very well" d. "the prognosis and course of the disease have changed because hyperalimentation is available
b
The nurse is caring for an infant with biliary atresia. The parents ask why the child is receiving cholestyramine. Which is the nurse's best response? a. to lower the infant's cholesterol b. to relieve the infant's itching c. to help the infant gain weight d. to help feedings be absorbed in a more efficient manner
d
The nurse is counseling the mother of a 12 month old on methods to prevent constipation. Which of the following methods would be contraindicated? a. add bran to cereal b. increase intake of water c. add prunes to the diet d. add popcorn to the diet
d
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. Which is the nurse's best response? a. "your child will be very sleepy, have an IV line in the hand, and have a nasal tube to help drain the stomach. If your child needs pain medication, it will be given IV" b. "your child will be very sleepy, have an IV line in the hand, and have white stockings to help prevent blood clots. If your child needs pain medication, it will be given IV or provided via a liquid to swallow" c. "your child will be wide awake and will have an IV line in the hand. If your child needs pain medication, we will give it IV or provide a liquid to swallow" d. "your child will be very sleepy and have an IV line in the hand. If your child needs pain medication, we will give it IV"
d
The nurse should instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux at which time? a. Bedtime b. With a meal c. Midmorning d. 30 minutes before breakfast
d
The nurse would expect to see what clinical manifestation in the child diagnosed with Hirschsprung disease? a. history of bloody diarrhea, fever, and vomiting b. irritability, severe abdominal cramps, fecal soiling c. decreased hemoglobin, increased serum lipids, and positive stool for O&P d. history of constipation; abdominal distention; and passage of ribbon-like, foul-smelling stools
a
The parents of a child with a tracheoesophageal fistula express feelings of guilt about their baby's anomaly. Which approach by the nurse would best support the parents? a. helping the parents accept their feelings as a normal reaction b. explaining that the parents did nothing to cause the newborn's defect c. encouraging the parents to concentrate on planning their baby's care d. urging the parents to visit their newborn as often as possible
c
When developing the plan of care for an infant with a cleft lip before corrective surgery is performed, what should be a priority? a. maintaining skin integrity in the oral cavity b. using techniques to minimize crying c. altering the usual method of feeding d. preventing the infant from putting fingers in mouth
d
When performing discharge teaching with the parents of a neonate who has successfully undergone surgery to repair a low anorectal anomaly, which parent statement about the child's prognosis indicates teaching has been successful? a. "my child will need to wear protective pads until puberty" b. "my child will need extra fluids to prevent constipation" c. "my child will probably always need a high-fiber diet" d. "my child has a good chance of being potty trained"
b
Which finding would indicate that an infant with a tracheoesophageal fistula needs suctioning? a. barking cough b. substernal retractions c. decreased activity level d. increased respiratory rate
a
Which instruction should the nurse expect to include in the discharge teaching plan for the parent of an infant who has had an inguinal herniorrhaphy? a. change diapers as soon as they become soiled b. apply an abdominal binder c. keep the incision covered with a sterile dressing d. restrain the infant's head
d
Which should be the nurse's immediate action when a newborn begins to cough and choke and becomes cyanotic while feeding? a. inform the health-care provider of the situation b. have the mother stop feeding the infant, and observe to see if the choking episode resolves on its own c. immediately determine the infant's oxygen saturation and have the mother stop feeding the infant d. take the infant from the mother and administer blow-by oxygen while obtaining the infant's oxygen saturation
a
A child with acute gastrointestinal bleeding is admitted to the hospital. The nurse observes which sign or symptom as an early manifestation of shock? a. Restlessness b. Rapid capillary refill c. Increased temperature d. Increased blood pressure
b
After teaching the parents of a neonate diagnosed with a tracheoesophageal fistula about this anomaly, the nurse determines that the teaching was successful when the parent describes the condition in which way? a. "the muscle below the stomach is too tight, causing the baby to vomit forcefully" b. "there is a blind upper pouch and an opening from the esophagus into the airway" c. "the lower bowel is lacking certain nerves to allow normal function" d. "a part of the bowel is on the outside without anything covering it"
a
After teaching the parent of an infant with pyloric stenosis about the condition, which cause, if stated by the parent, indicates effective teaching? a. "an enlarged muscle below the stomach sphincter" b. "a telescoping of the large bowel into the smaller bowel" c. "a result of giving the baby more formula than is necessary" d. "a result of by baby taking the formula too quickly"
c
A 16 month old has a history of diarrhea for 3 days with poor oral intake. He received IV fluids, has tolerated some oral fluids in the ED, and is being discharged home. Instructions for diet for this child should include a. BRAT diet (bananas, rice, applesauce, and toast) for 24 hours, then a soft diet as tolerated b. chicken or beef broth for 24 hours, then resume a soft diet c. offer a regular diet as child's appetite warrants d. keep on clear liquids and toast for 24 hours
a
An infant with short bowel syndrome will be on total parenteral nutrition (TPN) for an extended period of time. What should the nurse monitor the infant for ? a. Central venous catheter infection, electrolyte losses, and hyperglycemia b. Hypoglycemia, catheter migration, and weight gain c. Venous thrombosis, hyperlipidemia, and constipation d. Catheter damage, red currant jelly stools, and hypoglycemia
b d e
The nurse is caring for a child with celiac disease. The nurse understands that what may precipitate a celiac crisis? (Select all that apply) a. Exercise b. Infections c. Fluid overload d. Electrolyte depletion e. Emotional disturbance
b
An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason? a. Wean the infant from TPN the next day b. Stimulate adaptation of the small intestine c. Give additional nutrients that cannot be included in the TPN d. Provide parents with hope that the child is close to discharge
a
A 2-month-old breastfed infant is successfully rehydrated with oral rehydration solutions for acute diarrhea. What instructions are include to the mother specific to breastfeeding? a. Continue breastfeeding. b. Stop breastfeeding until the breast milk is cultured. c. Stop breastfeeding until diarrhea is absent for 24 hr. d. Express breast milk and dilute it with sterile water before feeding it.
b
A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child? a. It is unnecessary because of childs age. b. It is essential because it will be an adjustment. c. Preparation is not needed because the colostomy is temporary. d. Preparation is important because the child needs to deal with negative body image.
b
A 5 month old is seen for a complaint of vomiting and failure to grow. His birth weight was 7 pounds, and he now weighs 8 lbs 10 oz. The mother reports that he is taking 4-7 ounces of formula every 4-5 hours, but he "spits up a lot after eating and then is hungry again." The child is noted to be alert but appears malnourished. The mother reports his stools are very brown in color, and he has 1-2 bowel movements every day. Based on these findings, the nurse anticipates the infant has a. meckel diverticulum b. hypertrophic pyloric stenosis c. insussusception d. hirschprung disease
b
A nurse is caring for a child who has had watery diarrhea for the past 3 days. Which of the following is an action for the nurse to take? a. offer chicken broth b. initiate oral rehydration therapy c. start hypertonic IV solution d. keep NPO until the diarrhea subsides
d
Early reintroduction of nutrients (normal diet) in the patient with diarrhea a. is delayed until after the diarrhea has stopped except in the case of breast-fed infants b. has adverse effects and actually prolongs diarrhea c. should be limited to formula-fed infants being given lactose-free formula d. has no adverse effects, lessens the severity and duration of the illness, and improves weight gain when compared to gradual reintroduction of foods
a d e
The nurse is preparing to admit a 2-month-old child with hypertrophic pyloric stenosis. What clinical manifestations should the nurse expect to observe? (Select all that apply) a. Weight loss b. Bilious vomiting c. Abdominal pain d. Projectile vomiting e. The infant is hungry after vomiting
c
The nurse is caring for a child admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation? a. Place in the Trendelenburg position. b. Apply moist heat to the abdomen. c. Allow the child to assume a position of comfort. d. Administer a saline enema to cleanse the bowel.
d
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? a. eggs, bacon, rye toast, and lactose-free milk b. pancakes, orange juice, and sausage links c. oat cereal, breakfast pastry, and nonfat skim milk d. cheese, banana slices, rice cakes, and whole milk
c
The nurse is caring for a neonate with a suspected tracheoesophageal fistula. What should nursing care include? a. Feed glucose water only. b. Elevate the patients head for feedings. c. Raise the patients head and give nothing by mouth. d. Avoid suctioning unless the infant is cyanotic.
c
The nurse is caring for a newborn with an anorectal malformation and a colostomy. The nurse knows that more education is needed when the infant's parent states which of the following? a. "I will make sure the stoma is red" b. "there should not be any discharge or irritation around the outside of the stoma" c. "I will keep a bag attached to avoid the contents of the small intestine coming in contact with the baby's skin" d. "as my baby grows, a pattern will develop over time, and there should be predictable bowel movements"
c
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" b. "the baby tends to have a very forceful vomiting episode about 30 minutes after most feedings" c. "the baby is always hungry after vomiting, so I feed her again" d. "the baby is happy in spite of getting really upset after spitting up"
a e
The nurse is caring for an infant newly diagnosed with Hirschsprung disease. What does the nurse understand about the infant's condition? Select all that apply a. there is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention b. there is excessive peristalsis throughout the intestine, resulting in abdominal distention c. there is a small-bowel obstruction, leading to ribbon-like stools d. there is inflammation throughout the large intestine, leading to accumulation of intestinal contents and abdominal distention e. there is an accumulation of bowel contents, leading to non-passage of stools
c
The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. What would the nurse include? a. Give nothing by mouth for 24 hr. b. Avoid carbohydrate-containing liquids. c. Brush teeth or rinse mouth after vomiting. d. Give plain water until vomiting ceases for at least 24 hr.
a b c
The nurse is preparing to admit a 10-year-old child with appendicitis. What clinical manifestations should the nurse expect to observe? (Select all that apply) a. Fever b. Vomiting c. Tachycardia d. Flushed face e. Hyperactive bowel sounds
a c d e
The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe? (Select all that apply) a. Spitting up b. Bilious vomiting c. Failure to thrive d. Excessive crying e. Respiratory problems
a c e
The nurse is preparing to admit a 6-year-old child with celiac disease. What clinical manifestations should the nurse expect to observe? (Select all that apply) a. Steatorrhea b. Polycythemia c. Malnutrition d. Melena stools e. Foul-smelling stools
c
The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention? a. Initiating breast- or bottle-feedings to stabilize the blood glucose level b. Maintaining pain management with an intravenous opioid c. Covering the intact bowel with a nonadherent dressing to prevent injury d. Performing immediate surgery
b
The nurse is providing discharge teaching to the parents of an infant with an umbilical hernia. Which should be included in the plan of care? a. if the hernia has not resolved on its own by the age of 12 months, surgery is generally recommended b. if the hernia appears to be more swollen or tender, seek medical care immediately c. to help the hernia resolve, place a pressure dressing over the area gently d. if the hernia is repaired surgically, there is a likelihood that it will return
a c d
The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease foods that can exacerbate acid reflux. What foods should be included in the teaching session? (Select all that apply) a. Citrus b. Bananas c. Spicy foods d. Peppermint e. Whole wheat bread
c
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. Which is the nurse's most appropriate response? a. "you can offer clear diet soda such as Sprite and ginger ale" b. "pedialyte is really the best thing for your child, who, if thirsty enough, will eventually drink it" c. 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" d. "it really does not matter what your child drinks as long as it is kept down. Try offering small amounts of fluids in medicine cups"
b
The parents of a newborn with an umbilical hernia ask about treatment options. The nurses response should be based on which knowledge? a. Surgery is recommended as soon as possible. b. The defect usually resolves spontaneously by 3 to 5 years of age. c. Aggressive treatment is necessary to reduce its high mortality. d. Taping the abdomen to flatten the protrusion is sometimes helpful.
a
What type 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
a
When an infant with pyloric stenosis is admitted to the hospital, which aspect of the plan of care should the nurse implement first? a. weigh the infant b. begin an IV infusion c. switch the infant to an oral electrolyte solution d. orient the mother to the hospital unit
b
When assessing a 4 month old infant diagnosed with possible intussusception, the nurse should expect the parents to relate which information about the infant's crying and episodes of pain? a. constant accompanied by leg extension b. intermittent with knees drawn to the chest c. shrill during ingestion of solids d. intermittent while being held in the mother's arms
a
When assessing an infant with suspected inguinal hernia, which finding would me most significant? a. the inguinal swelling is reddened, and the abdomen is distended b. the infant is irritable, and a thickened spermatic cord is palpable c. the inguinal swelling can be reduced, and the infant has a stool in the diaper d. the infant's diaper is wet with urine, and the abdomen is nontender
c
When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation? a. Anorexia b. Bradycardia c. Sudden relief from pain d. Decreased abdominal distention
