Peds Chapter 41; The Child With Gastrointestinal Dysfunction and F&E Imbalance

A preschooler with severe vomiting and diarrhea was admitted to the hospital. The vomiting has stopped and rehydration has begun intravenously. When should the nurse begin feeding the child solid food? A. When the parents give their permission to feed their child. B. After the child has been rehydrated. C. After the diarrhea has stopped for 24 hours. D. When the IV rehydration can be stopped.

B. After the child has been rehydrated.

A 4-year-old has had diarrhea for several days, and her perineum is inflamed and almost excoriated. What nursing actions are indicated? (Select all that apply.) A. Gently wash the perineum with cold water and mild soap after each stool. B. Apply an ointment to the inflamed area to provide a moisture barrier. C. Place the child without underwear for brief periods to allow air to the area. D. Turn the child at least every two hours.

B. Apply an ointment to the inflamed area to provide a moisture barrier. C. Place the child without underwear for brief periods to allow air to the area. D. Turn the child at least every two hours.

A toddler is hospitalized with severe dehydration. The nurse should assess the child for which possible complication? A. Hypertension B. Hypokalemia C. A rapid, bounding pulse D. Decreased specific gravity

B. Hypokalemia

A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child will begin with which intervention? a. Intravenous fluids b. Oral rehydration solution (ORS) c. Clear liquids, 1 to 2 ounces at a time d. Administration of antidiarrheal medication

a. Intravenous fluids

A proximal segment of the bowel telescopes into a more distal segment, pulling the mesentery with it is called: a. Intussusception. b. Pyloric stenosis. c. Tracheoesophageal fistula. d. Hirschsprung disease.

a. Intussusception.

A mother shares with the clinic nurse that she has been giving her 4 year old the antidiarrheal drug loperamide. What conclusion should the nurse arrive at based on knowledge of this classification of drugs? a. Not indicated b. Indicated because it slows intestinal motility c. Indicated because it decreases diarrhea d. Indicated because it decreases fluid and electrolyte losses

a. Not indicated

What is the most appropriate nursing action when a child with a probable intussusception has a normal, brown stool? a. Notify the practitioner b. Measure abdominal girth c. Auscultate for bowel sounds d. Take vital signs, including blood pressure

a. Notify the practitioner

After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time? a. Notify the practitioner. b. Insert the NG tube so feedings can be given. c. Replace the NG tube to maintain gastric decompression. d. Leave the NG tube out because it has probably been in long enough.

a. Notify the practitioner.

What food choice by the parent of a 2-year-old child with celiac disease indicates a need for further teaching? a. Oatmeal b. Rice cake c. Corn muffin d. Meat patty

a. Oatmeal

In what condition should the nurse be alert for altered fluid requirements in children? (Select all that apply.) a. Oliguric renal failure b. Increased intracranial pressure c. Mechanical ventilation d. Compensated hypotension e. Tetralogy of Fallot f. Type 1 diabetes mellitus

a. Oliguric renal failure b. Increased intracranial pressure c. Mechanical ventilation

A 10-month-old is being admitted to the hospital with acute gastroenteritis and severe dehydration due to vomiting and excessive fluid loss. The health care provider prescribes an antiemetic. Which of the following antiemetic drugs does the nurse anticipate being given? a. Ondansetron (Zofran) b. Promethazine (Phenergan) c. Metoclopramide (Reglan) d. Dimenhydrinate (Dramamine)

a. Ondansetron (Zofran)

A nurse is providing postoperative care to an infant who has undergone a cleft lip and palate repair. Which of the following would be appropriate interventions to implement in the postoperative period? Select all that apply. a. Pain analgesia as ordered. b. Use of an upright position or infant seat. c. Sterile water irrigations to the operative site as ordered. d. Feeding resumed when tolerated, using a blenderized or soft diet in older children. e. Use of elbow immobilizers to protect the operative site. f. Application of petroleum jelly to operative site as ordered

a. Pain analgesia as ordered. b. Use of an upright position or infant seat. d. Feeding resumed when tolerated, using a blenderized or soft diet in older children. e. Use of elbow immobilizers to protect the operative site. f. Application of petroleum jelly to operative site as ordered

Which is a high-fiber food that the nurse should recommend for a child with chronic constipation? a. Raisins b. Pancakes c. Muffins d. Ripe bananas

a. Raisins

An important nursing consideration in the care of a child with celiac disease is to facilitate which intervention? a. Refer to a nutritionist for detailed dietary instructions and education. b. Help the child and family understand that diet restrictions are usually only temporary. c. Teach proper hand washing and Standard Precautions to prevent disease transmission. d. Suggest ways to cope more effectively with stress to minimize symptoms.

a. Refer to a nutritionist for detailed dietary instructions and education.

The nurse is caring for a child with newly diagnosed Hirschsprung disease. Which of the following does the nurse understand about the infant's condition? a. There is a lack of peristalsis in the large intestine resulting in accumulation of abdominal contents causing abdominal distention. b. There is excessive peristalsis throughout the large intestine resulting in diarrhea. c. There is a small-bowel obstruction resulting in dark, tarry-like stools. d. There is inflammation throughout the large intestine, leading to accumulation of abdominal contents and subsequent abdominal distention.

a. There is a lack of peristalsis in the large intestine resulting in accumulation of abdominal contents causing abdominal distention.

Which of the following findings is the most important determinant of the percent of total body fluid loss in infants and younger children? a. Weight. b. Intake and output. c. Fontanel assessment. d. Skin turgor.

a. Weight.

The nurse is preparing to care for an infant returning from pyloromyotomy surgery. Which prescribed orders should the nurse anticipate implementing? (Select all that apply.) a. Nothing by mouth for 24 hours b. Administration of analgesics for pain c. Ice bag to the incisional area d. Intravenous (IV) fluids continued until tolerating fluids by mouth e. Clear liquids as the first feeding

b. Administration of analgesics for pain d. Intravenous (IV) fluids continued until tolerating fluids by mouth e. Clear liquids as the first feeding

What is a common cause of acute diarrhea? a. Hirschsprung's disease b. Antibiotic therapy c. Hypothyroidism d. Meconium ileus

b. Antibiotic therapy

What is the most frequent cause of hypovolemic shock in children? a. Sepsis b. Blood loss c. Anaphylaxis d. Heart failure

b. Blood loss

An infant is brought to the emergency department with poor skin turgor, sunken fontanel, lethargy, and tachycardia. This is suggestive of which condition? a. Overhydration b. Dehydration c. Sodium excess d. Calcium excess

b. Dehydration

What is an approximate method of estimating output for a child who is not toilet trained? a. Have parents estimate output. b. Document number of wet diapers. c. Place a urine collection device on the child. d. Have the child sit on a potty chair 30 minutes after eating.

b. Document number of wet diapers.

A mother who intended to breastfeed has given birth to an infant with a cleft palate. Which nursing interventions should be included in the plan of care? (Select all that apply.) a. Giving medication to suppress lactation. b. Encouraging and helping mother to breastfeed. c. Teaching mother to feed breast milk by gavage. d. Recommending use of a breast pump to maintain lactation until infant can suck.

b. Encouraging and helping mother to breastfeed. d. Recommending use of a breast pump to maintain lactation until infant can suck.

One of the major problems for infants born with cleft lip and palate is related to: a. Rejection by the mother. b. Feeding problems and weight loss. c. Apnea and bradycardia. d. Aspiration pneumonia

b. Feeding problems and weight loss.

What is the best description of pyloric stenosis? a. Dilation of the pylorus b. Hypertrophy of the pyloric muscle c. Hypotonicity of the pyloric muscle d. Reduction of tone in the pyloric muscle

b. Hypertrophy of the pyloric muscle

Which of the following choices most accurately describes dehydration or fluid loss in infants and young children? a. As a percentage b. In milliliters per kilogram of body weight c. By the amount of edema present d. By the degree of skin elasticity

b. In milliliters per kilogram of body weight

A child is admitted to the emergency department with acute abdominal pain. The nurse observes that the child is screaming and drawing the knees toward the chest. During assessment, the nurse detects a palpable, sausage-shaped mass in the upper right quadrant of the abdomen. What can the nurse deduce that the child has from these symptoms and findings? a. Hiatal hernia b. Intussusception c. Zollinger-Ellison syndrome d. Hypertrophic pyloric stenosis

b. Intussusception

Enemas are ordered to empty the bowel preoperatively for a child with Hirschsprung disease. What enema solution should be used? a. Tap water b. Normal saline c. Oil retention d. Phosphate preparation

b. Normal saline

The nurse is preparing to admit a 3-year-old child with intussusception. What clinical manifestations should the nurse expect to observe? (Select all that apply.) a. Absent bowel sounds b. Passage of red, currant jelly-like stools c. Anorexia d. Tender, distended abdomen e. Hematemesis f. Sudden acute abdominal pain

b. Passage of red, currant jelly-like stools d. Tender, distended abdomen f. Sudden acute abdominal pain

The nurse is caring for a 2-month-old infant whose cleft lip was repaired. Important aspects of this infant's postoperative care include: a. Elbow immobilizers, lip irrigations, cleansing the suture line daily. b. Petroleum jelly application, elbow immobilizers, pain management. c. Lip irrigations, prone position, cleansing suture line after feedings. d. Supine position, chest physiotherapy (CPT), elbow immobilizers.

b. Petroleum jelly application, elbow immobilizers, pain management.

The nurse, caring for an infant whose cleft lip was repaired, should include which interventions into the infant's postoperative plan of care? (Select all that apply.) a. Postural drainage b. Petroleum jelly to the suture line c. Elbow restraints d. Supine and side-lying positions e. Mouth irrigations

b. Petroleum jelly to the suture line c. Elbow restraints

A 1-month-old infant is brought to the clinic by his mother. The nurse suspects pyloric stenosis because the mother gives a history of: a. Diarrhea. b. Projectile vomiting. c. Fever and dehydration. d. Abdominal distension

b. Projectile vomiting.

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

b. Stimulate adaptation of the small intestine

The parents of a newborn with an umbilical hernia ask about treatment options. The nurse's response should be based on which knowledge. a. Taping the abdomen to flatten the protrusion is sometimes helpful but can be painful for the infant. b. The defect usually resolves spontaneously by 3-5 years of age. c. Radiation treatment is necessary to reduce the hernia. d. Surgery is recommended as soon as possible.

b. The defect usually resolves spontaneously by 3-5 years of age.

A 4-month-old infant diagnosed with gastroesophageal reflux disease (GERD) is thriving without other complications. What should the nurse suggest to minimize reflux? a. Place in Trendelenburg position after eating. b. Thicken formula with rice cereal. c. Give continuous nasogastric tube feedings. d. Give larger, less frequent feedings.

b. Thicken formula with rice cereal.

Which of the following clinical manifestations indicates a fluid volume deficit in infants? a. Brisk skin turgor. b. Urine output less than 1 ml/kg/hr. c. Capillary refill less than 2 seconds. d. Soft and flat anterior fontanel

b. Urine output less than 1 ml/kg/hr.

Which description of a stool is characteristic of intussusception? a. Ribbon-like stools b. Hard stools positive for guaiac c. "Currant jelly" stools d. Loose, foul-smelling stools

c. "Currant jelly" stools

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.

c. Allow the child to assume a position of comfort.

Constipation has recently become a problem for a school-age child who is being treated for seasonal allergies. The nurse should focus the assessment on what possibly related factor? a. Diet b. Allergies c. Antihistamines d. Emotional factors

c. Antihistamines

A 5-month-old infant's intussusception is treated with hydrostatic reduction. The nurse should expect care after the reduction to include: a. Administration of antibiotics. b. Enema administration to remove remaining stool. c. Close observation of stool patterns. d. Blood pressure every 4 hours.

c. Close observation of stool patterns.

A school-age child with acute diarrhea and mild dehydration is being given oral rehydration solutions (ORS). The child's mother calls the clinic nurse because he is also occasionally vomiting. The nurse should recommend which intervention? a. Bring the child to the hospital for intravenous fluids. b. Alternate giving ORS and carbonated drinks. c. Continue to give ORS frequently in small amounts. d. Keep child NPO (nothing by mouth) for 8 hr and resume ORS if vomiting has subsided.

c. Continue to give ORS frequently in small amounts.

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. Corn on the cob with butter

What is used to treat moderate-to-severe inflammatory bowel disease? a. Antacids b. Antibiotics c. Corticosteroids d. Antidiarrheal medications

c. Corticosteroids

An infant with moderate dehydration may demonstrate: a. Mottled skin color and decreased pulse and respirations. b. Decreased urine output, tachycardia, and fever. c. Dry mucous membranes and prolonged capillary refill greater than two seconds. d. Tachycardia, bulging fontanel, and decreased blood pressure

c. Dry mucous membranes and prolonged capillary refill greater than two seconds.

The most important therapeutic management for the child with celiac disease is: a. Eliminating corn, rice, and millet from the diet. b. Adding iron, folic acid, and fat-soluble vitamins to the diet. c. Eliminating wheat, rye, barley, and oats from the diet. d. Educating the child's parents about the short-term effects of the disease and the necessity of reading all food labels for content until the disease is in remission.

c. Eliminating wheat, rye, barley, and oats from the diet.

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

c. Excessive frothy saliva

Physiologically, the child compensates for fluid volume losses by which mechanism? a. Inhibition of aldosterone secretion b.Hemoconcentration to reduce cardiac workload c. Fluid shift from interstitial space to intravascular space d. Vasodilation of peripheral arterioles to increase perfusion

c. Fluid shift from interstitial space to intravascular space

The initial phase of fluid replacement is contraindicated in which type of dehydration because of the risk of water intoxication? a. Isotonic. b. Hypotonic. c. Hypertonic. d. It is appropriate in all three types of dehydration.

c. Hypertonic.

What factor predisposes an infant to fluid imbalances? a. Decreased surface area b. Lower metabolic rate c. Immature kidney functioning d. Decreased daily exchange of extracellular fluid

c. Immature kidney functioning

Which statement is most descriptive of Meckel's diverticulum? a. It is more common in females than in males. b. It is acquired during childhood. c. Intestinal bleeding may be mild or profuse. d. Medical interventions are usually sufficient to treat the problem.

c. Intestinal bleeding may be mild or profuse.

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.

c. Leave the tube open to gravity drainage.

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

c. Lima beans d. Baked beans e. Raisin bran cereal

The nurse is planning for nutritional support to a patient suffering from inflammatory bowel disease (IBD). What will be the most suitable combination food for the patient? a. Lentils b. Oat bran c. Milkshakes d. Blackberries

c. Milkshakes

Therapeutic management of the child with acute diarrhea and dehydration usually begins with what intervention? a. Clear liquids b. Adsorbents such as kaolin and pectin c. Oral rehydration solution (ORS) d. Antidiarrheal medications such as paregoric

c. Oral rehydration solution (ORS)

The most common clinical manifestations expected with Meckel diverticulum include: a. Fever, vomiting, and constipation. b. Weight loss, hypotension, and obstruction. c. Painless rectal bleeding, abdominal pain, or intestinal obstruction. d. Abdominal pain, bloody diarrhea, and foul-smelling stool.

c. Painless rectal bleeding, abdominal pain, or intestinal obstruction.

Which observation made of the exposed abdomen is most indicative of pyloric stenosis? a. Abdominal rigidity b. Substernal retraction c. Palpable olive-like mass d. Marked distention of lower abdomen

c. Palpable olive-like mass

To assess for the presence of a cleft palate, the nurse should: a. Assess the infant's ability to swallow. b. Assess the color of the infant's oral mucosa. c. Palpate the hard and soft palates with a gloved finger. d. Flick the infant's foot and make it cry.

c. Palpate the hard and soft palates with a gloved finger.

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

c. Popcorn

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.

c. Prevent abdominal distention.

The nurse suspects shock in a child 1 day after surgery. What should be the initial nursing action? a. Place the child on a cardiac monitor. b. Obtain arterial blood gases. c. Provide supplemental oxygen. d. Put the child in the Trendelenburg position.

c. Provide supplemental oxygen.

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 patient's head for feedings. c. Raise the patient's head and give nothing by mouth. d. Avoid suctioning unless the infant is cyanotic.

c. Raise the patient's head and give nothing by mouth.

To confirm the diagnosis of Hirschsprung disease, the nurse prepares the child for: a. Endoscopy. b. Sonogram. c. Rectal biopsy. d. Esophagostomy

c. Rectal biopsy.

What is the primary purpose of prescribing a histamine receptor antagonist for an infant diagnosed with gastroesophageal reflux? a. Prevent reflux b. Prevent hematemesis. c. Reduce gastric acid production. d. Increase gastric acid production.

c. Reduce gastric acid production.

A priority goal in the management of acute diarrhea is: a. Determining the cause of the diarrhea. b. Preventing the spread of the infection. c. Rehydrating of the child. d. Managing the fever associated with the diarrhea

c. Rehydrating of the child.

The viral pathogen that frequently causes acute diarrhea in young children is: a. Giardia organisms. b. Shigella organisms. c. Rotavirus. d. Salmonella organisms.

c. Rotavirus.

When caring for a child with probable appendicitis, the nurse should be alert to recognize what sign of perforation? a. Bradycardia b. Anorexia c. Sudden relief from pain d. Decreased abdominal distention

c. Sudden relief from pain

What is the major focus of the therapeutic management for a child with lactose intolerance? a. Compliance with the medication regimen b. Providing emotional support to family members c. Teaching dietary modifications d. Administration of daily normal saline enemas

c. Teaching dietary modifications

A parent of an infant with moderate gastroesophageal reflux asks how to decrease the number and the total volume of emesis. What is the most appropriate recommendation the nurse can make? a. There will probably be the need for surgical intervention of tightening the lower esophageal stricture. b. Place in supine position to sleep after feeding with HOB elevated. c. Thicken feedings with rice cereal. d. Reduce the frequency of feeding by encouraging larger volumes of formula

c. Thicken feedings with rice cereal.

An infant had a gastrostomy tube placed for feedings after a Nissen fundoplication and bolus feedings are initiated. Between feedings while the tube is clamped, the infant becomes irritable, and there is evidence of cramping. What action should the nurse implement? a. Burp the infant. b. Withhold the next feeding. c. Vent the gastrostomy tube. d. Notify the health care provider.

c. Vent the gastrostomy tube.

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis? a. Abdominal rigidity and pain on palpation b. Rounded abdomen and hypoactive bowel sounds c. Visible peristalsis and weight loss d. Distention of lower abdomen and constipation

c. Visible peristalsis and weight loss

An infant is brought to the emergency department with the following clinical manifestations: poor skin turgor, weight loss, lethargy, tachycardia, and tachypnea. This is suggestive of which situation? a. Water excess b. Sodium excess c. Water depletion d. Potassium excess

c. Water depletion

A nurse is conducting dietary teaching on high-fiber foods for parents of a child with constipation. Which foods should the nurse include as being high in fiber? (Select all that apply.) a. White rice b. Avocados c. Whole grain breads d. Bran pancakes e. Raw carrots

c. Whole grain breads d. Bran pancakes e. Raw carrots

Which clinical manifestation would most suggest acute appendicitis? a. Rebound tenderness b. Bright red or dark red rectal bleeding c. Abdominal pain that is relieved by eating d. Abdominal pain that is most intense at McBurney point

d. Abdominal pain that is most intense at McBurney point

Which of the following clinical manifestations are the most useful in predicting dehydration of 5% or more in children? a. Sunken fontanel, abnormal skin turgor, abnormal temperature. b. Rapid pulse, dry mucous membranes, absent tears. c. Rapid respirations, irritable behavior, prolonged capillary refill. d. Abnormal capillary refill, abnormal skin turgor, and abnormal respiratory pattern.

d. Abnormal capillary refill, abnormal skin turgor, and abnormal respiratory pattern.

A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells. This is most suggestive of which condition? a. Protein intolerance b. Parasitic infection c. Fat malabsorption d. Bacterial gastroenteritis

d. Bacterial gastroenteritis

The nurse would expect to see which of the following clinical manifestations in the child diagnosed with Hirschsprung disease? a. History of bloody diarrhea, fever, and vomiting. b. Irritability, severe abdominal cramps, and fecal soiling c. Increased serum lipids and positive stool for O&P (ova and parasites). d. Bilious vomiting, abdominal distention, and delay in passage of meconium.

d. Bilious vomiting, abdominal distention, and delay in passage of meconium.

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

d. Colicky, cramping, abdominal pain around the umbilicus

What should the nurse stress in a teaching plan for the mother of an 11-year-old diagnosed with ulcerative colitis? a. Preventing the spread of illness to others b. Nutritional guidance and preventing constipation c. Teaching daily use of enemas d. Coping with stress and avoiding triggers

d. Coping with stress and avoiding triggers

The assessment finding that most indicative of an anorectal malformation is: a. Abdominal distention and vomiting. b. A normal-appearing perineum. c. Passage of meconium stool after 24 hours. d. Failure to pass meconium through the anal opening.

d. Failure to pass meconium through the anal opening.

Which of the following indicates an insensible fluid loss? a. Urine output b. Fecal output c. Emesis output d. Fever

d. Fever

Which type of dehydration results from water loss in excess of electrolyte loss? a. Isotonic dehydration b. Isosmotic dehydration c. Hypotonic dehydration d. Hypertonic dehydration

d. Hypertonic dehydration

Infants and young children are at high risk for fluid and electrolyte imbalance. Which of the following factors contributes to this vulnerability? a. Decreased body surface area b. Lower metabolic rate c. Mature kidney function d. Increased extracellular fluid volume

d. Increased extracellular fluid volume

An infant diagnosed with pyloric stenosis experiences excessive vomiting that can result in which condition? a. Hyperchloremia b. Hypernatremia c. Metabolic acidosis d. Metabolic alkalosis

d. Metabolic alkalosis

The prognosis for children with short bowel syndrome has improved as a result of: a. Dietary supplemental vitamin B12 additions. b. Improvement in surgical procedures to correct the deficiency. c. Improved home care availability. d. Total parenteral nutrition and enteral feeding

d. Total parenteral nutrition and enteral feeding

Therapeutic management of most children with Hirschsprung's disease is primarily: a. daily enemas. b. low-fiber diet. c. permanent colostomy. d. surgical removal of affected section of bowel.

d. surgical removal of affected section of bowel.

A 4-year-old child is admitted with major facial burns. What therapeutic measures should the nurse take? Select all that apply 1. Prioritize airway maintenance. 2. Administer systemic antibiotics. 3. Ignore any otitis media infection. 4. Provide fluid replacement therapy. 5. Feed the patient a diet rich in protein.

1. Prioritize airway maintenance. 4. Provide fluid replacement therapy. 5. Feed the patient a diet rich in protein.

A nurse is assessing a preschooler with symptoms of a burning throat, choking, and coughing along with nausea and vomiting after ingesting turpentine. What should the nurse assess for as an immediate danger? 1. Allergic reaction 2. Aspiration and pneumonia 3. Burned tissue and localized damage 4. Time taken to peak serum salicylate levels

2. Aspiration and pneumonia

Parents have a 23-month-old daughter who started having vomiting and diarrhea yesterday. When should the pediatrician's office be called to find out what to do? (Select all that apply.) A. If their daughter doesn't urinate for longer than 4 hours B. If their daughter's fontanel appears sunken C. If crying produces no tears D. When the diarrhea has been present for 24 hours E. The toddler has a fever (>39° C [102° F]) F. If severe abdominal cramps occur

C. If crying produces no tears D. When the diarrhea has been present for 24 hours E. The toddler has a fever (>39° C [102° F]) F. If severe abdominal cramps occur

A common occurrence of Crohn disease is: a. Growth failure. b. Chronic constipation. c. Obstruction. d. Burning epigastric pain.

a. Growth failure.

The nurse should instruct parents to administer the prescribed daily proton pump inhibitor to their infant with gastroesophageal reflux at which time to be most effective? a. Administers 30 minutes before breakfast. b. Administers 30 minutes before any meals. c. Administers mid-afternoon. d. Administers 30 minutes before dinner

a. Administers 30 minutes before breakfast.

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

a. Citrus c. Spicy foods d. Peppermint

What condition is characterized by a chronic inflammatory process that may involve any part of the gastrointestinal (GI) tract from mouth to anus? a. Crohn's disease b. Ulcerative colitis c. Meckel's diverticulum d. Irritable bowel syndrome

a. Crohn's disease

What laboratory finding should the nurse expect in a child with an excess of water? a. Decreased hematocrit b. High serum osmolality c. High urine specific gravity d. Increased blood urea nitrogen

a. Decreased hematocrit

A child is admitted to the hospital and diagnosed with ulcerative colitis. For which associated symptoms should the nurse evaluate the patient? Select all that apply. a. Diarrhea b. Anorexia c. Joint pain d. Anal lesions e. Rectal bleeding

a. Diarrhea b. Anorexia c. Joint pain e. Rectal bleeding

The nurse, caring for a neonate with a suspected tracheoesophageal fistula, should include what intervention into the plan of care? a. Elevating the head to facilitate secrete drainage. b. Elevating the head for feedings only. c. Feeding glucose water only. d. Avoiding suctioning unless the infant is cyanotic.

a. Elevating the head to facilitate secrete drainage.

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

a. Enemas

Bismuth subsalicylate may be prescribed for a child with a peptic ulcer to effect what result? a. Eradicate Helicobacter pylori b. Coat gastric mucosa c. Treat epigastric pain d. Reduce gastric acid production

a. Eradicate Helicobacter pylori

The nurse observes frothy saliva in the mouth and nose of the neonate who is a few hours old. the infant swallows normally when fed, but suddenly the fluid returns through the nose and mouth of the infant. The nurse suspects: a. Esophageal atresia. b. Pyloric stenosis. c. Anorectal malformation. d. Biliary atresia.

a. Esophageal atresia.

A common long-term complication after surgical repair of esophageal atresia is: a. Feeding difficulties. b. Tracheomalacia. c. Pneumothorax. d. Short bowel syndrome.

a. Feeding difficulties.

Nurses must be alert for increased fluid requirements when a child presents with which possible concern? a. Fever b. Mechanical ventilation c. Congestive heart failure d. Increased intracranial pressure (ICP)

a. Fever