Question 1

The nurse is teaching the mother of a 5-year-old boy with a history of impaction how to administer enemas at home. Which of the following responses from the mother indicates a need for further teaching?

Accepted Answer

For a child, the correct position for administering an enema is on the left side with knees bent, not on the abdomen. This position helps facilitate the flow of the enema solution into the colon by following the natural alignment of the colon.

Question 2

The nurse is taking a health history of an 11-year-old girl with recurrent abdominal pain. Which of the following responses would lead the nurse to suspect irritable bowel syndrome?

Accepted Answer

Feeling better after a bowel movement is a common symptom of irritable bowel syndrome (IBS).

Question 3

The nurse is caring for a 3-year-old girl with short bowel syndrome as a result of trauma to the small intestine. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. How should the nurse respond?

Accepted Answer

The nurse's response of offering help and support to the mother is the most appropriate and therapeutic. It acknowledges the mother's concerns while providing reassurance and a commitment to assist her in becoming proficient in her daughter's care.

Question 4

The nurse is conducting a physical examination of a child with suspected Crohn disease. Which of the following findings would be the most highly suspicious of Crohn disease?

Accepted Answer

Perianal skin tags or fissures are highly suspicious of Crohn disease, as they are common extraintestinal manifestations of the condition.

Question 5

The nurse is caring for an infant with a temporary ileostomy. As part of the plan of care, the nurse monitors for skin breakdown around the stoma. If redness occurs, which of the following would be most appropriate to promote healing and prevent further skin breakdown?

Accepted Answer

Applying a barrier/healing cream or paste on the skin helps protect the skin from irritation and promotes healing, preventing further breakdown.

Question 6

The nurse is caring for a 4-year-old boy who has undergone an appendectomy. The child is unwilling to use the incentive spirometer. Which approach would be most appropriate to elicit the child's cooperation?

Accepted Answer

Using a game or playful activity, such as blowing a cotton ball across a tray, is an effective way to engage a child in a therapeutic activity without causing fear or resistance. This approach makes the activity fun and more appealing to a child, thereby increasing the likelihood of cooperation.

Question 7

A nurse is caring for a 14-year-old girl scheduled for a barium swallow/upper gastrointestinal (GI) series. Before providing instructions, which of the following would be the priority?

Accepted Answer

Screening for pregnancy is a priority before a barium swallow/upper GI series to avoid unnecessary radiation exposure to a fetus.

Question 8

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?

Accepted Answer

Maintaining the intravenous fluid rate as ordered is crucial for a child hospitalized with dehydration due to rotavirus. This ensures the child receives the necessary fluids and electrolytes to recover. Fruit juice, Kool-Aid, popsicles, and milk products can worsen diarrhea or are not suitable for rehydration in this context.

Question 9

The nurse is caring for a 2-month-old with a cleft palate. The child will undergo corrective surgery at age 3 months. The mother would like to continue breastfeeding the baby after surgery and wonders if it is possible. How should the nurse respond?

Accepted Answer

CBreastfeeding after cleft palate surgery is often possible, but it depends on the surgeon's advice and the healing of the suture line. The surgeon can provide specific guidance based on the details of the surgery, and once the suture line has healed, breastfeeding can typically resume, assuming there are no complications.

Question 10

The school nurse is working with a 10-year-old girl with recurrent abdominal pain. The girl's teacher has been less than understanding about the frequent absences and trips to the nurse's office. How should the nurse respond?

Accepted Answer

The nurse should validate the child's experience by affirming that the pain is real, which helps in advocating for the child's needs and ensuring they are taken seriously.

Question 11

Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration?

Accepted Answer

Sunken fontanels are a common sign of moderate dehydration in infants and young children, indicating a decrease in fluid volume.

Question 12

The nurse is determining maintenance fluid requirements for a child who weighs 25 kg. How much fluid would the child need per day?

Accepted Answer

The answer of The nurse is determining maintenance fluid requirements...

Question 13

The parents of a child diagnosed with celiac disease ask the nurse what types of food they can offer their child. Which of the following would the nurse include in the teaching plan?

Accepted Answer

Fruit juice is generally safe for someone with celiac disease, as it does not contain gluten, which is found in wheat, barley, and rye. Rye bread is not suitable due to its gluten content. Frozen yogurt and creamed spinach might contain gluten depending on additives or preparation methods.

Question 14

The mother of a 3-week-old infant old brings her daughter in for an evaluation. During the visit, the mother tells the nurse that her baby is spitting up after feedings. Which response by the nurse would be most appropriate?

Accepted Answer

Spitting up after feedings is a common occurrence in infants due to their developing digestive systems. It is usually not a cause for concern unless accompanied by other symptoms such as weight loss or discomfort.

Question 15

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 identify which of the following?

Accepted Answer

The infant's immature kidneys actually have a reduced ability to concentrate urine, not an increased tendency to overconcentrate it. This is because their renal function is not fully developed, leading to a decreased ability to handle solutes and conserve water, making them more susceptible to fluid imbalances.

Question 16

An 8-month-old infant is brought to the clinic for evaluation. The mother tells the nurse that she has noticed some white patches on the infant's tongue that look like curdled milk after breastfeeding. The nurse suspects oral candidiasis (thrush). Which question would the nurse use to help confirm this suspicion?

Accepted Answer

Oral candidiasis (thrush) in infants can cause symptoms in breastfeeding mothers, including breast pain due to the infection spreading from the infant's mouth to the breasts during nursing. This connection makes the question about breast pain relevant for confirming the suspicion of thrush.

Question 17

The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, which of the following would the nurse most likely find?

Accepted Answer

Hypertrophic pyloric stenosis is characterized by a palpable olive-shaped mass in the right upper quadrant of the abdomen, which is due to the hypertrophy of the pylorus muscle leading to obstruction.

Question 18

A nursing instructor is developing a class presentation about the medications used to treat peptic ulcer disease. Which drug class would the instructor be least likely to include in the presentation?

Accepted Answer

Prokinetics are primarily used to enhance gastrointestinal motility and are not directly involved in the treatment of peptic ulcer disease, unlike antibiotics, proton pump inhibitors, and histamine antagonists which directly target the causes and symptoms of ulcers.

Question 19

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?

Accepted Answer

Having a wound, ostomy, and continence nurse meet with the parents would be most helpful. These specialized nurses are experts in the care of patients with ostomies, and they can provide the parents with detailed, practical advice and emotional support, helping to alleviate their concerns and prepare them for post-operative care.

Question 20

A child is scheduled for a lower endoscopy. Which of the following would the nurse include in the child's plan of care in preparation for this test?

Accepted Answer

Administering a bowel cleansing regimen is essential before a lower endoscopy to ensure the bowel is clear of feces, which allows for a thorough examination. Choices A and B are not typically associated with preparation for a lower endoscopy, and withholding proton pump inhibitors is not a standard preparation step for this procedure.

Quiz 42: Nursing Care of the Child With an Alteration in Bowel Elimination/Gastrointestinal Disorder