UNIT 6 — GI, FLUIDS, FTT & POISONING
Questions 1–75
1.
A 10-month-old with acute diarrhea is being assessed for dehydration.
Which finding is most concerning?
A. Dry mucous membranes
B. Absence of tears
C. Hypotension
D. Sunken eyes
Answer: C
Rationale: Hypotension is a late sign of significant pediatric volume
depletion and may indicate impending cardiovascular collapse. Dry mucous
membranes, absent tears, and sunken eyes can occur earlier.
2.
A nurse is assessing an infant with hypertrophic pyloric stenosis. Which
finding is most characteristic?
A. Bilious vomiting with abdominal distention
B. Projectile nonbilious vomiting after feeding
C. Bloody diarrhea followed by vomiting
D. Regurgitation without hunger afterward
Answer: B
Rationale: Pyloric stenosis causes progressive gastric outlet obstruction,
producing projectile, nonbilious vomiting. The infant often remains hungry
after vomiting.
3.
Which assessment finding would most strongly suggest intussusception?
A. Continuous right lower quadrant pain
B. Projectile vomiting with an olive-shaped mass
C. Episodic abdominal pain with knees drawn to the chest
D. Chronic diarrhea after ingestion of gluten
,Answer: C
Rationale: Intussusception classically produces sudden episodes of severe
crampy abdominal pain during which the child draws the knees toward the
chest.
4. Select all that apply.
Which manifestations are associated with intussusception?
A. Currant-jelly stool
B. Sausage-shaped abdominal mass
C. Episodic severe abdominal pain
D. Olive-shaped epigastric mass
E. Lethargy
Answers: A, B, C, E
Rationale: Intussusception may produce episodic abdominal pain, currant-
jelly stool, lethargy, and a sausage-shaped abdominal mass. An olive-shaped
mass is associated with pyloric stenosis.
5.
A parent of an infant with GER says, “I put my baby on her stomach after
feeding and leave her that way to sleep.” Which response by the nurse is
best?
A. “That is recommended because it prevents aspiration.”
B. “Place her prone only if she has vomited.”
C. “Keep her upright after feeding, but place her supine for sleep.”
D. “Side-lying is the safest sleeping position.”
Answer: C
Rationale: Upright positioning after feeding can reduce reflux, but infants
should be placed supine for sleep because of SIDS risk.
6.
Which finding best distinguishes GERD from uncomplicated physiologic
GER in an infant?
,A. Regurgitation after feeding
B. Spitting up at 4 months
C. Failure to thrive
D. Hiccups after feeding
Answer: C
Rationale: Physiologic reflux is common in infancy. GER becomes GERD
when complications such as failure to thrive, respiratory problems, or
dysphagia occur.
7.
A child with suspected appendicitis suddenly reports that severe abdominal
pain has decreased. Which action is most appropriate?
A. Prepare the child for discharge
B. Encourage ambulation
C. Assess immediately for signs of perforation
D. Offer a regular diet
Answer: C
Rationale: Sudden reduction of appendicitis pain can indicate rupture of
the appendix rather than improvement.
8.
Which stool description is most characteristic of intussusception?
A. Clay colored
B. Currant jelly
C. Ribbonlike
D. Black tarry
Answer: B
Rationale: Blood and mucus produced by intestinal ischemia can create the
classic currant-jelly stool.
9.
, A newborn has excessive oral secretions and develops coughing and
cyanosis when feeding is attempted. Which disorder should the nurse
suspect?
A. Pyloric stenosis
B. Celiac disease
C. Esophageal atresia with tracheoesophageal fistula
D. Hirschsprung disease
Answer: C
Rationale: EA/TEF can prevent normal passage of feedings and create a
direct aspiration risk, producing coughing, choking, cyanosis, and excessive
secretions.
10.
What is the priority nursing action for a newborn with suspected
esophageal atresia?
A. Offer thickened formula
B. Keep the newborn NPO
C. Place the newborn prone for sleep
D. Stimulate the gag reflex
Answer: B
Rationale: Oral feedings are withheld because of the severe aspiration risk.
11.
A nurse is teaching the parents of an infant with a cleft palate. Which
statement demonstrates correct understanding?
A. “I will feed my baby flat on the back.”
B. “I should feed slowly and burp the baby frequently.”
C. “My baby should never receive breast milk.”
D. “I will enlarge the nipple opening as much as possible.”
Answer: B
Questions 1–75
1.
A 10-month-old with acute diarrhea is being assessed for dehydration.
Which finding is most concerning?
A. Dry mucous membranes
B. Absence of tears
C. Hypotension
D. Sunken eyes
Answer: C
Rationale: Hypotension is a late sign of significant pediatric volume
depletion and may indicate impending cardiovascular collapse. Dry mucous
membranes, absent tears, and sunken eyes can occur earlier.
2.
A nurse is assessing an infant with hypertrophic pyloric stenosis. Which
finding is most characteristic?
A. Bilious vomiting with abdominal distention
B. Projectile nonbilious vomiting after feeding
C. Bloody diarrhea followed by vomiting
D. Regurgitation without hunger afterward
Answer: B
Rationale: Pyloric stenosis causes progressive gastric outlet obstruction,
producing projectile, nonbilious vomiting. The infant often remains hungry
after vomiting.
3.
Which assessment finding would most strongly suggest intussusception?
A. Continuous right lower quadrant pain
B. Projectile vomiting with an olive-shaped mass
C. Episodic abdominal pain with knees drawn to the chest
D. Chronic diarrhea after ingestion of gluten
,Answer: C
Rationale: Intussusception classically produces sudden episodes of severe
crampy abdominal pain during which the child draws the knees toward the
chest.
4. Select all that apply.
Which manifestations are associated with intussusception?
A. Currant-jelly stool
B. Sausage-shaped abdominal mass
C. Episodic severe abdominal pain
D. Olive-shaped epigastric mass
E. Lethargy
Answers: A, B, C, E
Rationale: Intussusception may produce episodic abdominal pain, currant-
jelly stool, lethargy, and a sausage-shaped abdominal mass. An olive-shaped
mass is associated with pyloric stenosis.
5.
A parent of an infant with GER says, “I put my baby on her stomach after
feeding and leave her that way to sleep.” Which response by the nurse is
best?
A. “That is recommended because it prevents aspiration.”
B. “Place her prone only if she has vomited.”
C. “Keep her upright after feeding, but place her supine for sleep.”
D. “Side-lying is the safest sleeping position.”
Answer: C
Rationale: Upright positioning after feeding can reduce reflux, but infants
should be placed supine for sleep because of SIDS risk.
6.
Which finding best distinguishes GERD from uncomplicated physiologic
GER in an infant?
,A. Regurgitation after feeding
B. Spitting up at 4 months
C. Failure to thrive
D. Hiccups after feeding
Answer: C
Rationale: Physiologic reflux is common in infancy. GER becomes GERD
when complications such as failure to thrive, respiratory problems, or
dysphagia occur.
7.
A child with suspected appendicitis suddenly reports that severe abdominal
pain has decreased. Which action is most appropriate?
A. Prepare the child for discharge
B. Encourage ambulation
C. Assess immediately for signs of perforation
D. Offer a regular diet
Answer: C
Rationale: Sudden reduction of appendicitis pain can indicate rupture of
the appendix rather than improvement.
8.
Which stool description is most characteristic of intussusception?
A. Clay colored
B. Currant jelly
C. Ribbonlike
D. Black tarry
Answer: B
Rationale: Blood and mucus produced by intestinal ischemia can create the
classic currant-jelly stool.
9.
, A newborn has excessive oral secretions and develops coughing and
cyanosis when feeding is attempted. Which disorder should the nurse
suspect?
A. Pyloric stenosis
B. Celiac disease
C. Esophageal atresia with tracheoesophageal fistula
D. Hirschsprung disease
Answer: C
Rationale: EA/TEF can prevent normal passage of feedings and create a
direct aspiration risk, producing coughing, choking, cyanosis, and excessive
secretions.
10.
What is the priority nursing action for a newborn with suspected
esophageal atresia?
A. Offer thickened formula
B. Keep the newborn NPO
C. Place the newborn prone for sleep
D. Stimulate the gag reflex
Answer: B
Rationale: Oral feedings are withheld because of the severe aspiration risk.
11.
A nurse is teaching the parents of an infant with a cleft palate. Which
statement demonstrates correct understanding?
A. “I will feed my baby flat on the back.”
B. “I should feed slowly and burp the baby frequently.”
C. “My baby should never receive breast milk.”
D. “I will enlarge the nipple opening as much as possible.”
Answer: B
