NR 328 2027 EXAMINERS ANSWERS AND
QUESTIONS SET A+
✔✔Celiac Disease: S/S - ✔✔- Diarrhea (watery and pale w/ offensive odor
- Anorexia
- Abdominal Pain & Distension
- Muscle wasting particularly in the buttocks and extremities
✔✔Celiac Disease: Interventions - ✔✔- gluten free diet substituting corn, rice and millet
as grain sources
- mineral and vitamin supplementation including iron, folic acid and fat soluble vitamins
A, D, E and K
✔✔Celiac Disease: Foods to Avoid - ✔✔- barley, rye, wheat
- beer
- bread
- cakes/cookies
- pasta
- imitation meat or fish
- processed lunch meat
- vegetables in sauce
- soups
- snack foods
- salad dressings
✔✔Celiac Disease: Foods that are Ok - ✔✔- eggs
- fish
- poultry
- beans
- nuts
- seeds
- fruits and veggies
- some dairy
✔✔Rotavirus: S/S - ✔✔- mild to moderate fever
,- vomiting followed by onset of watery stools
- fever and vomiting generally abates in 2 days but diarrhea persists for 5-7 days
✔✔Appendicitis: S/S - ✔✔- RLQ pain
- fever
- rigid abdomen
- decreased or absent bowel sounds
- vomiting
- constipation or diarrhea
- anorexia
- tachycardia
- pallor
- lethargy
✔✔Ruptured Appendix - ✔✔same as appendicitis - peritonitis develops as appendix
has ruptured
✔✔Gastro-Esophageal Reflux - ✔✔- Dysfunction of the lower sphincter = transfer of
gastric contents into the esophagus
- delay of gastric emptying
- susceptibility of esophageal injury
- usually improves in 12-18 months
✔✔Gastro-Esophageal Reflux: Therapeutic Management (Positioning) - ✔✔- put them
up in a car seat after feedings
- prop them up
✔✔Gastro-Esophageal Reflux: Feedings - ✔✔- smaller more frequent feedings
- burp several times during feedings
- thickened feeds/formulas (1 tsp or 1 tbsp of rice per ounce of formula
- enlarge nipple hole for thickened foods
✔✔Things to Avoid when Breastfeeding Gastro Esophageal Babies - ✔✔- azole drugs
(proton pumps)
- dine drugs (h2 agonists)
✔✔Gastro-Esophageal Reflux: Surgical Interventions - ✔✔- Nissan Fundoplication
- may need g tube until healed
✔✔Tracheo-Esophageal Fistula: S/S - ✔✔- Coughing
- Choking
- Cyanosis
- Regurgitation and Vomiting
- Respiratory Distress
, ✔✔Tracheo-Esophageal Fistula: Interventions - ✔✔- maintain patent airway
- prevent pneumonia
- gastric or blind pouch decompression
- supportive surgery
- surgical repair
✔✔Crohn's Symptoms - ✔✔- abdominal pain with cramps
- diarrhea
- weight loss
- fever
- anorexia
- rectal bleeding
✔✔Ulcerative Colitis Symptoms - ✔✔- ulceration
- bleeding
- edema
✔✔Short Bowel Syndrome: Enteral Feedings - ✔✔- will not take the place of TPN
- small amounts and increase as bowel grows
- stimulate the intestine to keep functioning (keep bowel alive)
✔✔Short Bowel Syndrome: Phases - ✔✔1st Phase: total parenteral nutrition via central
line
2nd Phase: introduction to enteral formula feeds
*TPN is only discontinued if growth can be maintained with enteral feeds*
✔✔Cleft Lip: Feeding - ✔✔- assess ability to suck, swallow, handle secretions, breathe
without distress and fluid and calorie intake
- modify feeding techniques, obturators and special nipples and feeders (lamb nipple)
✔✔Cleft Lip: Post Op Care - ✔✔- protect site
- avoid prone position (suture damage)
- pain management
- clear liquids when fully recovered from anesthesia
- layer of antibiotic ointment for suture
- avoid suction or objects in the mouth
✔✔Cleft Palate: Post Op Care - ✔✔- can lie on abdomen
- may resume feedings by special device shortly after surgery
- speech language therapist evaluates child
- humidified air may be used to alleviate edema
- usually discharged on blended or soft diet
✔✔Pyloric Stenosis: Feedings - ✔✔- usually begun 4-6 hours postoperatively
- starts with small, frequent feedings of glucose, water or electrolyte solution
QUESTIONS SET A+
✔✔Celiac Disease: S/S - ✔✔- Diarrhea (watery and pale w/ offensive odor
- Anorexia
- Abdominal Pain & Distension
- Muscle wasting particularly in the buttocks and extremities
✔✔Celiac Disease: Interventions - ✔✔- gluten free diet substituting corn, rice and millet
as grain sources
- mineral and vitamin supplementation including iron, folic acid and fat soluble vitamins
A, D, E and K
✔✔Celiac Disease: Foods to Avoid - ✔✔- barley, rye, wheat
- beer
- bread
- cakes/cookies
- pasta
- imitation meat or fish
- processed lunch meat
- vegetables in sauce
- soups
- snack foods
- salad dressings
✔✔Celiac Disease: Foods that are Ok - ✔✔- eggs
- fish
- poultry
- beans
- nuts
- seeds
- fruits and veggies
- some dairy
✔✔Rotavirus: S/S - ✔✔- mild to moderate fever
,- vomiting followed by onset of watery stools
- fever and vomiting generally abates in 2 days but diarrhea persists for 5-7 days
✔✔Appendicitis: S/S - ✔✔- RLQ pain
- fever
- rigid abdomen
- decreased or absent bowel sounds
- vomiting
- constipation or diarrhea
- anorexia
- tachycardia
- pallor
- lethargy
✔✔Ruptured Appendix - ✔✔same as appendicitis - peritonitis develops as appendix
has ruptured
✔✔Gastro-Esophageal Reflux - ✔✔- Dysfunction of the lower sphincter = transfer of
gastric contents into the esophagus
- delay of gastric emptying
- susceptibility of esophageal injury
- usually improves in 12-18 months
✔✔Gastro-Esophageal Reflux: Therapeutic Management (Positioning) - ✔✔- put them
up in a car seat after feedings
- prop them up
✔✔Gastro-Esophageal Reflux: Feedings - ✔✔- smaller more frequent feedings
- burp several times during feedings
- thickened feeds/formulas (1 tsp or 1 tbsp of rice per ounce of formula
- enlarge nipple hole for thickened foods
✔✔Things to Avoid when Breastfeeding Gastro Esophageal Babies - ✔✔- azole drugs
(proton pumps)
- dine drugs (h2 agonists)
✔✔Gastro-Esophageal Reflux: Surgical Interventions - ✔✔- Nissan Fundoplication
- may need g tube until healed
✔✔Tracheo-Esophageal Fistula: S/S - ✔✔- Coughing
- Choking
- Cyanosis
- Regurgitation and Vomiting
- Respiratory Distress
, ✔✔Tracheo-Esophageal Fistula: Interventions - ✔✔- maintain patent airway
- prevent pneumonia
- gastric or blind pouch decompression
- supportive surgery
- surgical repair
✔✔Crohn's Symptoms - ✔✔- abdominal pain with cramps
- diarrhea
- weight loss
- fever
- anorexia
- rectal bleeding
✔✔Ulcerative Colitis Symptoms - ✔✔- ulceration
- bleeding
- edema
✔✔Short Bowel Syndrome: Enteral Feedings - ✔✔- will not take the place of TPN
- small amounts and increase as bowel grows
- stimulate the intestine to keep functioning (keep bowel alive)
✔✔Short Bowel Syndrome: Phases - ✔✔1st Phase: total parenteral nutrition via central
line
2nd Phase: introduction to enteral formula feeds
*TPN is only discontinued if growth can be maintained with enteral feeds*
✔✔Cleft Lip: Feeding - ✔✔- assess ability to suck, swallow, handle secretions, breathe
without distress and fluid and calorie intake
- modify feeding techniques, obturators and special nipples and feeders (lamb nipple)
✔✔Cleft Lip: Post Op Care - ✔✔- protect site
- avoid prone position (suture damage)
- pain management
- clear liquids when fully recovered from anesthesia
- layer of antibiotic ointment for suture
- avoid suction or objects in the mouth
✔✔Cleft Palate: Post Op Care - ✔✔- can lie on abdomen
- may resume feedings by special device shortly after surgery
- speech language therapist evaluates child
- humidified air may be used to alleviate edema
- usually discharged on blended or soft diet
✔✔Pyloric Stenosis: Feedings - ✔✔- usually begun 4-6 hours postoperatively
- starts with small, frequent feedings of glucose, water or electrolyte solution
