3, 4.
1. Children with myasthenia gravis should not
play strenuous sports. The increased stress from being in a competitive sport tends to
negatively impact children, and they should learn strategies to decrease stress.
2. It is important that children with myasthenia gravis have activities they can participate in
The nurse judges teaching as successful when the parent of a child with myasthenia gravis without causing stress. Activities such as board games, horseback riding, and hiking should
states which of the following? Select all that apply. be encouraged. Some children would benefit from meditation but may take time to appreciate
1. "My child should play on the school's basketball team." the results.
2. "My child should meditate every day." 3. Children with myasthenia gravis can do many things other children do. They should be
3. "My child should be allowed to do what other kids do." advised not to play strenuous sports, and they should learn how to control stress.
4. "My child should be watched carefully for signs of illness." 4. Children are watched for signs of illness because of the exacerbation of signs of myasthenia
5. "My child should sleep in my room so that I can watch him better." gravis.
5. It's not recommended that children sleep in the same bedroom as their parents unless it
can't be avoided.
TEST-TAKING HINT: The test taker must know the physiology of the illness and consider that this
is a chronic disease. The child is first a child, so he will have all the growth and development
issues children without a chronic disease have.
The parent of a newborn asks, "Will my baby spit out the formula if it is too hot or too cold?" 1. Swallowing is a reflex in neonates; infants younger than 6 weeks cannot voluntarily control
Which is the nurse's best response? swallowing.
1. "Babies have a tendency to reject hot fluids but not cold fluids, which could result in 2. Swallowing is a reflex in neonates; infants younger than 6 weeks cannot voluntarily control
abdominal discomfort." swallowing.
2. "Babies have a tendency to reject cold fluids but not hot fluids, which could result in 3. The infant is not capable of selectively rejecting fluid because swallowing is a reflex until 6
esophageal burns." weeks.
3. "Your baby would most likely spit out formula that was too hot, but your baby could swallow 4. Swallowing is a reflex in infants younger than 6 weeks.
some of it, which could result in a burn." TEST-TAKING HINT: Swallowing is a reflex that is present until the age of 6 weeks. The test
4. "Your baby is too young to be physically capable of spitting out fluids and will automatically taker should eliminate answers 1, 2,and 3 because they suggest that the infant is capable of
swallow anything." selectively rejecting fluids.
1. The caloric content of breast milk and formula tends to be similar.
The mother of a newborn asks the nurse why the infant has to nurse so frequently. Which is
2. Peristalsis in infants is greater than in older
the best response?
children.
1. Formula tends to be more calorically dense, and formula-fed babies require fewer feedings
3. The small-stomach capacity and rapid movement of fluid through the digestive system
than breastfed babies.
account for the need for small, frequent feedings.
2. The newborn's stomach capacity is small, and peristalsis is slow.
4. Breastfed babies and formula-fed babies do not necessarily have a ditterence in feeding
3. The newborn's stomach capacity is small, and peristalsis is more rapid than in older
time.
children.
TEST-TAKING HINT: The test taker should eliminate answers 1 and 4 because they both form
4. Breastfed babies tend to take longer to complete a feeding than formula-fed babies.
generalizations that are not supported by current literature.
1. The information obtained from a urinalysis of an infant is not as helpful as serum elec-
trolytes. The infant has limited ability to concentrate urine, so the specific gravity is not usually
attected.
A 4-month-old has had vomiting and diarrhea for 24 hours. The infant is fussy, and the
2. The information obtained from a urinalysis of an infant is not as helpful as serum elec-
anterior fontanel is sunken. The nurse notes the infant does not produce tears when crying.
trolytes. The infant has limited ability to concentrate urine, so the specific gravity is not usually
Which task will help confirm the diagnosis of dehydration?
attected. A urinalysis does not need to be obtained by catheterization.
1. Urinalysis obtained by bagged specimen.
3. The analysis of serum electrolytes otters the most information and assists with the diagnosis
2. Urinalysis obtained by sterile catheterization.
of dehydration.
3. Analysis of serum electrolytes.
4. Although critical in diagnosing meningitis, a lumber puncture and analysis of cerebrospinal
4. Analysis of cerebrospinal fluid.
fluid are not done to confirm dehydration.
TEST-TAKING HINT: Infants have limited ability to concentrate urine, so answers 1 and 2 can
be eliminated immediately.
A 4-month-old is brought to the emergency department with severe dehydration. The heart
rate is 198, and her blood pressure is 68/38. The infant's anterior fontanel is sunken. The
nurse notes that the infant does not cry when the intravenous lineis inserted. The child's parents state that she has not "held anything down" in 18 hours. The nurse obtains a
,
,1. Dehydration is corrected with the administration of an isotonic solution, such as normal
saline or lactated Ringer solution.
2. Solutions containing dextrose should never be administered in bolus form because they
may result in cerebral edema.
3. Solutions containing dextrose should never be administered in bolus form because they
may result in cerebral edema.
4. Severe dehydration is not usually corrected with oral solutions; children with altered levels
of consciousness should be kept NPO.
TEST-TAKING HINT: The test taker should immediately eliminate answers 2 and 3 because
they both suggest administering glucose in bolus form, which is always contraindicated in
pediatric clients. Answer 4 should be eliminated because the infant is severely dehydrated and
not responding to painful stimulation, which is suggested by the lack of a cry on intravenous
insertion.
The nurse is caring for a 2-year-old child who was admitted to the pediatric unit for moderate
1. Fluid boluses of normal saline are administered according to the child's body weight. It is
dehydration due to vomiting and diarrhea. The child is restless with periods of irritability. The
not unusual to have to repeat the bolus multiple times in order to see an improvement in the
child is afebrile with a heart rate of 148 and a blood pressure of 90/42. Baseline laboratory
child's condition.
tests reveal the following: Na 152, Cl 119, and glucose 115. The parents state that the child 2. It is important to monitor serum electrolytes frequently in the dehydrated child.
has not urinated in 12 hours. After establishing a saline lock, the nurse reviews the physician's
3. Potassium is contraindicated because the child has not yet urinated. Potassium is not added
orders. Which order should the nurse question?
to the maintenance fluid until kidney function has been verified.
1. Administer a saline bolus of 10 mL/kg, which may be repeated if the child does not
4. The child with dehydration secondary to vomiting and diarrhea is placed on a clear liquid
urinate.
diet.
2. Recheck serum electrolytes in 12 hours.
TEST-TAKING HINT: Be aware of the usual ways in which dehydration is treated. Answer 3
3. After the saline bolus, begin maintenance fluids of D5 1⁄4 NS with 10 mEq KCl/L.
should be selected because the description states that the child has not urinated.
4. Give clear liquid diet as tolerated.
1. When Pedialyte is not tolerated, it is usually recommended that clear sodas and juices
be diluted. Diet beverages are not recommended because the sugar is needed to help the
The parent of a 5-year-old states that the child has been having diarrhea for 24 hours, vomited sodium be reabsorbed.
twice 2 hours ago, and now claims to be thirsty. The parent asks what to otter the child because
2. Pedialyte is the best choice. If the child is not encouraged to drink Pedialyte, the child
the child is refusing Pedialyte. Which is the nurse's most appropriate response?
1. "You can otter clear diet soda such as Sprite and ginger ale." may become severely dehydrated. Other ways to encourage oral rehydration need to be
2. considered.
"Pedialyte is really the best thing for your child, who, if thirsty enough, will eventually drink
it." 3. Pedialyte is the first choice, as recommended by the American Academy of Pediatrics.
3. Ottering the child appropriate choices may allow the child to feel empowered and less likely
"Pedialyte is really the best thing for your child. Allow your child some choice in the way to
take it by ottering small amounts in a spoon, medicine cup, or syringe." to refuse the Pedialyte. Small, frequent amounts are usually better tolerated.
4. 4. Ottering small amounts of liquids is important. The type of beverage does matter because
"It really does not matter what your child drinks as long as it is kept down. Try ottering small
many fluids may increase vomiting and diarrhea.
amounts of fluids in medicine cups."
TEST-TAKING HINT: The test taker should eliminate answer 2 because it otters an ultimatum
to a child. The child is likely to refuse the Pedialyte, worsening the state of dehydration.
1. Loperamide (Imodium) slows intestinal motility and allows overgrowth of organisms and
should therefore be avoided.
2. Bismuth subsalicylate (Kaopectate) slows intestinal motility and allows overgrowth of or-
The nurse is caring for a 9-month-old with diarrhea secondary to rotavirus. The child has not
ganisms and should therefore be avoided.
vomited and is mildly dehydrated. Which is likely to be included in the discharge teaching?
3. Breastfeeding is usually well tolerated and helps prevent death of intestinal villi and
1. Administer loperamide (Imodium) as needed.
malabsorption.
2. Administer bismuth subsalicylate (Kaopectate) as needed.
4. Antibiotics are not ettective in viruses. Children should not return to day care while they are
3. Continue breastfeeding per routine.
still having diarrhea.
4. The infant may return to day care 24 hours after antibiotics have been started.
TEST-TAKING HINT: The test taker can eliminate answer 4 because antibiotics are not ettective
with viruses such as rotavirus. Answers 1 and 2 can be eliminated because antidiarrheal agents
are not recommended in the pediatric population.
, Which child can be discharged without further evaluation? 1. Diarrhea containing blood needs further evaluation to determine the source of the blood,
and the child's blood counts and electrolyte balance need to be tested.
1. A 2-year-old who has had 24 hours of watery diarrhea that has changed to bloody diarrhea
2. It is common for children to have a relapse of diarrhea after resuming a regular diet.
in the past 12 hours.
3. Children who have had vomiting and diarrhea for more than 2 days require evaluation to
2. A 3-year-old who had a relapse of one diarrhea episode after restarting a normal diet.
determine whether IV rehydration and hospital admission are necessary.
3. A 6-year-old who has been having vomiting and diarrhea for 2 days and has decreased
4. Diarrhea following a camping trip needs further evaluation because it may be caused by
urine output.
bacteria or parasites.
4. A 10-year-old who has just returned from a Scout camping trip and has had several
TEST-TAKING HINT: The test taker should eliminate answers 1 and 3 because they describe
episodes of diarrhea.
children who may have altered electrolytes and blood counts due to prolonged diarrhea.
The nurse receives a call from the parent of a 10-month-old who has vomited three times in 1. Free water should not be given because it does not contain any electrolytes and can lead
the past 8 hours. The parent describes the baby as playful and wantingto drink. The parent to critical electrolyte imbalances.
asks the nurse what to give the child. Select the nurse's best response. 2. Formula should be avoided, and clear liquids such as Pedialyte should be ottered.
1. "Replace the next feeding with regular water, and see if that is better tolerated." 3. Twenty-four hours is too long for the infant to remain NPO. The infant needs to drink a
2. "Do not allow your baby to eat any solids; give half the normal formula feeding, and see if rehydration solution such as Pedialyte in order to avoid severe dehydration.
that is better tolerated." 4. Ottering small amounts of clear liquids is usually well tolerated. If the child vomits, make
3. "Do not let your baby eat or drink anything for 24 hours to give the stomach a chance to NPO for an hour to allow the stomach to rest and then restart fluids. The child in this scenario
rest." is described as playful and therefore does not appear to be at risk for dehydration.
4. "Give your child 1⁄2 ounce of Pedialyte every 10 minutes. If vomiting continues, wait an hour, TEST-TAKING HINT: The test taker should eliminate answers 1 and 3 because they could cause
and then repeat what you previously gave." harm to the infant.
The parents of a 4-year-old ask the nurse how to manage their child's constipation. Select the 1. Two ounces of apple juice is most likely not a suflcient quantity to alter a 4-year-old child's
nurse's best response. bowel movements.
1. "Add 2 ounces of apple or pear juice to the child's diet." 2. Although fresh fruits help decrease constipation, bananas tend to increase constipation.
2. "Be sure your child eats a lot of fresh fruit such as apples and bananas." 3. Increasing fluid consumption helps to decrease the hardness of the stool.
3. "Encourage your child to drink more fluids." 4. Whole-grain bread and brown rice are high in fiber and help decrease constipation.
4. "Decrease bulky foods such as whole-grain breads and brown rice." TEST-TAKING HINT: Answer 1 decreases constipation in an infant but not in a preschooler.
1. Natural supplements and herbs are not recommended because the safety and eflcacy are
not standardized.
A child is diagnosed with chronic constipation that has been unresponsive to dietary and 2. A stimulant laxative is not the drug of choice because it may increase abdominal discomfort
activity changes. Which pharmacological measure is most appropriate? and may lead to dependency.
1. Natural supplements and herbs. 3. A stool softener (osmotic agent) is the drug of choice because it will lead to easier
2. Stimulant laxative. evacuation.
3. Osmotic agent. 4. Although diet and activity modification are tried first, medications are sometimes needed.
4. Pharmacological measures are not used in pediatric constipation. TEST-TAKING HINT: The test taker should eliminate answer 4 because it impliesthat medica-
tions are never given to the constipated child. In health care, there are very few cases of "never"
and "always."
2, 4.
1. Dairy products are limited because they can
Which instructions for a child diagnosed with encopresis should the nurse question? Select lead to constipation.
all that apply. 2. A diet high in protein will cause more constipation.
1. Limit the intake of milk. 3. A complete dietary log should be kept to correlate the foods that lead to constipation.
2. Otter a diet high in protein. 4. The child and family would not be encouraged initially to seek counseling unless a psy-
3. Obtain a complete dietary log. chological component to the encopresis had been identified.
4. Follow up with a child psychologist. 5. Children with constipation/encopresis are advised to sit on the toilet for 10 minutes after
5. After dinner, have the child sit on the toilet for 10 minutes. dinner to take advantage of the gastrocolic reflex.
TEST-TAKING HINT: Recall foods and behaviors that cause constipation in children and suc-
cessful approaches to meet their needs.
The nurse is caring for an infant diagnosed with Hirschsprung disease. The mother states she
1. There is a genetic component to Hirschsprung disease, so any future siblings are also at
is pregnant with a boy and wants to know if her new baby will likely have the disorder. Which
risk.
is the nurse's best response?
1. Children with myasthenia gravis should not
play strenuous sports. The increased stress from being in a competitive sport tends to
negatively impact children, and they should learn strategies to decrease stress.
2. It is important that children with myasthenia gravis have activities they can participate in
The nurse judges teaching as successful when the parent of a child with myasthenia gravis without causing stress. Activities such as board games, horseback riding, and hiking should
states which of the following? Select all that apply. be encouraged. Some children would benefit from meditation but may take time to appreciate
1. "My child should play on the school's basketball team." the results.
2. "My child should meditate every day." 3. Children with myasthenia gravis can do many things other children do. They should be
3. "My child should be allowed to do what other kids do." advised not to play strenuous sports, and they should learn how to control stress.
4. "My child should be watched carefully for signs of illness." 4. Children are watched for signs of illness because of the exacerbation of signs of myasthenia
5. "My child should sleep in my room so that I can watch him better." gravis.
5. It's not recommended that children sleep in the same bedroom as their parents unless it
can't be avoided.
TEST-TAKING HINT: The test taker must know the physiology of the illness and consider that this
is a chronic disease. The child is first a child, so he will have all the growth and development
issues children without a chronic disease have.
The parent of a newborn asks, "Will my baby spit out the formula if it is too hot or too cold?" 1. Swallowing is a reflex in neonates; infants younger than 6 weeks cannot voluntarily control
Which is the nurse's best response? swallowing.
1. "Babies have a tendency to reject hot fluids but not cold fluids, which could result in 2. Swallowing is a reflex in neonates; infants younger than 6 weeks cannot voluntarily control
abdominal discomfort." swallowing.
2. "Babies have a tendency to reject cold fluids but not hot fluids, which could result in 3. The infant is not capable of selectively rejecting fluid because swallowing is a reflex until 6
esophageal burns." weeks.
3. "Your baby would most likely spit out formula that was too hot, but your baby could swallow 4. Swallowing is a reflex in infants younger than 6 weeks.
some of it, which could result in a burn." TEST-TAKING HINT: Swallowing is a reflex that is present until the age of 6 weeks. The test
4. "Your baby is too young to be physically capable of spitting out fluids and will automatically taker should eliminate answers 1, 2,and 3 because they suggest that the infant is capable of
swallow anything." selectively rejecting fluids.
1. The caloric content of breast milk and formula tends to be similar.
The mother of a newborn asks the nurse why the infant has to nurse so frequently. Which is
2. Peristalsis in infants is greater than in older
the best response?
children.
1. Formula tends to be more calorically dense, and formula-fed babies require fewer feedings
3. The small-stomach capacity and rapid movement of fluid through the digestive system
than breastfed babies.
account for the need for small, frequent feedings.
2. The newborn's stomach capacity is small, and peristalsis is slow.
4. Breastfed babies and formula-fed babies do not necessarily have a ditterence in feeding
3. The newborn's stomach capacity is small, and peristalsis is more rapid than in older
time.
children.
TEST-TAKING HINT: The test taker should eliminate answers 1 and 4 because they both form
4. Breastfed babies tend to take longer to complete a feeding than formula-fed babies.
generalizations that are not supported by current literature.
1. The information obtained from a urinalysis of an infant is not as helpful as serum elec-
trolytes. The infant has limited ability to concentrate urine, so the specific gravity is not usually
attected.
A 4-month-old has had vomiting and diarrhea for 24 hours. The infant is fussy, and the
2. The information obtained from a urinalysis of an infant is not as helpful as serum elec-
anterior fontanel is sunken. The nurse notes the infant does not produce tears when crying.
trolytes. The infant has limited ability to concentrate urine, so the specific gravity is not usually
Which task will help confirm the diagnosis of dehydration?
attected. A urinalysis does not need to be obtained by catheterization.
1. Urinalysis obtained by bagged specimen.
3. The analysis of serum electrolytes otters the most information and assists with the diagnosis
2. Urinalysis obtained by sterile catheterization.
of dehydration.
3. Analysis of serum electrolytes.
4. Although critical in diagnosing meningitis, a lumber puncture and analysis of cerebrospinal
4. Analysis of cerebrospinal fluid.
fluid are not done to confirm dehydration.
TEST-TAKING HINT: Infants have limited ability to concentrate urine, so answers 1 and 2 can
be eliminated immediately.
A 4-month-old is brought to the emergency department with severe dehydration. The heart
rate is 198, and her blood pressure is 68/38. The infant's anterior fontanel is sunken. The
nurse notes that the infant does not cry when the intravenous lineis inserted. The child's parents state that she has not "held anything down" in 18 hours. The nurse obtains a
,
,1. Dehydration is corrected with the administration of an isotonic solution, such as normal
saline or lactated Ringer solution.
2. Solutions containing dextrose should never be administered in bolus form because they
may result in cerebral edema.
3. Solutions containing dextrose should never be administered in bolus form because they
may result in cerebral edema.
4. Severe dehydration is not usually corrected with oral solutions; children with altered levels
of consciousness should be kept NPO.
TEST-TAKING HINT: The test taker should immediately eliminate answers 2 and 3 because
they both suggest administering glucose in bolus form, which is always contraindicated in
pediatric clients. Answer 4 should be eliminated because the infant is severely dehydrated and
not responding to painful stimulation, which is suggested by the lack of a cry on intravenous
insertion.
The nurse is caring for a 2-year-old child who was admitted to the pediatric unit for moderate
1. Fluid boluses of normal saline are administered according to the child's body weight. It is
dehydration due to vomiting and diarrhea. The child is restless with periods of irritability. The
not unusual to have to repeat the bolus multiple times in order to see an improvement in the
child is afebrile with a heart rate of 148 and a blood pressure of 90/42. Baseline laboratory
child's condition.
tests reveal the following: Na 152, Cl 119, and glucose 115. The parents state that the child 2. It is important to monitor serum electrolytes frequently in the dehydrated child.
has not urinated in 12 hours. After establishing a saline lock, the nurse reviews the physician's
3. Potassium is contraindicated because the child has not yet urinated. Potassium is not added
orders. Which order should the nurse question?
to the maintenance fluid until kidney function has been verified.
1. Administer a saline bolus of 10 mL/kg, which may be repeated if the child does not
4. The child with dehydration secondary to vomiting and diarrhea is placed on a clear liquid
urinate.
diet.
2. Recheck serum electrolytes in 12 hours.
TEST-TAKING HINT: Be aware of the usual ways in which dehydration is treated. Answer 3
3. After the saline bolus, begin maintenance fluids of D5 1⁄4 NS with 10 mEq KCl/L.
should be selected because the description states that the child has not urinated.
4. Give clear liquid diet as tolerated.
1. When Pedialyte is not tolerated, it is usually recommended that clear sodas and juices
be diluted. Diet beverages are not recommended because the sugar is needed to help the
The parent of a 5-year-old states that the child has been having diarrhea for 24 hours, vomited sodium be reabsorbed.
twice 2 hours ago, and now claims to be thirsty. The parent asks what to otter the child because
2. Pedialyte is the best choice. If the child is not encouraged to drink Pedialyte, the child
the child is refusing Pedialyte. Which is the nurse's most appropriate response?
1. "You can otter clear diet soda such as Sprite and ginger ale." may become severely dehydrated. Other ways to encourage oral rehydration need to be
2. considered.
"Pedialyte is really the best thing for your child, who, if thirsty enough, will eventually drink
it." 3. Pedialyte is the first choice, as recommended by the American Academy of Pediatrics.
3. Ottering the child appropriate choices may allow the child to feel empowered and less likely
"Pedialyte is really the best thing for your child. Allow your child some choice in the way to
take it by ottering small amounts in a spoon, medicine cup, or syringe." to refuse the Pedialyte. Small, frequent amounts are usually better tolerated.
4. 4. Ottering small amounts of liquids is important. The type of beverage does matter because
"It really does not matter what your child drinks as long as it is kept down. Try ottering small
many fluids may increase vomiting and diarrhea.
amounts of fluids in medicine cups."
TEST-TAKING HINT: The test taker should eliminate answer 2 because it otters an ultimatum
to a child. The child is likely to refuse the Pedialyte, worsening the state of dehydration.
1. Loperamide (Imodium) slows intestinal motility and allows overgrowth of organisms and
should therefore be avoided.
2. Bismuth subsalicylate (Kaopectate) slows intestinal motility and allows overgrowth of or-
The nurse is caring for a 9-month-old with diarrhea secondary to rotavirus. The child has not
ganisms and should therefore be avoided.
vomited and is mildly dehydrated. Which is likely to be included in the discharge teaching?
3. Breastfeeding is usually well tolerated and helps prevent death of intestinal villi and
1. Administer loperamide (Imodium) as needed.
malabsorption.
2. Administer bismuth subsalicylate (Kaopectate) as needed.
4. Antibiotics are not ettective in viruses. Children should not return to day care while they are
3. Continue breastfeeding per routine.
still having diarrhea.
4. The infant may return to day care 24 hours after antibiotics have been started.
TEST-TAKING HINT: The test taker can eliminate answer 4 because antibiotics are not ettective
with viruses such as rotavirus. Answers 1 and 2 can be eliminated because antidiarrheal agents
are not recommended in the pediatric population.
, Which child can be discharged without further evaluation? 1. Diarrhea containing blood needs further evaluation to determine the source of the blood,
and the child's blood counts and electrolyte balance need to be tested.
1. A 2-year-old who has had 24 hours of watery diarrhea that has changed to bloody diarrhea
2. It is common for children to have a relapse of diarrhea after resuming a regular diet.
in the past 12 hours.
3. Children who have had vomiting and diarrhea for more than 2 days require evaluation to
2. A 3-year-old who had a relapse of one diarrhea episode after restarting a normal diet.
determine whether IV rehydration and hospital admission are necessary.
3. A 6-year-old who has been having vomiting and diarrhea for 2 days and has decreased
4. Diarrhea following a camping trip needs further evaluation because it may be caused by
urine output.
bacteria or parasites.
4. A 10-year-old who has just returned from a Scout camping trip and has had several
TEST-TAKING HINT: The test taker should eliminate answers 1 and 3 because they describe
episodes of diarrhea.
children who may have altered electrolytes and blood counts due to prolonged diarrhea.
The nurse receives a call from the parent of a 10-month-old who has vomited three times in 1. Free water should not be given because it does not contain any electrolytes and can lead
the past 8 hours. The parent describes the baby as playful and wantingto drink. The parent to critical electrolyte imbalances.
asks the nurse what to give the child. Select the nurse's best response. 2. Formula should be avoided, and clear liquids such as Pedialyte should be ottered.
1. "Replace the next feeding with regular water, and see if that is better tolerated." 3. Twenty-four hours is too long for the infant to remain NPO. The infant needs to drink a
2. "Do not allow your baby to eat any solids; give half the normal formula feeding, and see if rehydration solution such as Pedialyte in order to avoid severe dehydration.
that is better tolerated." 4. Ottering small amounts of clear liquids is usually well tolerated. If the child vomits, make
3. "Do not let your baby eat or drink anything for 24 hours to give the stomach a chance to NPO for an hour to allow the stomach to rest and then restart fluids. The child in this scenario
rest." is described as playful and therefore does not appear to be at risk for dehydration.
4. "Give your child 1⁄2 ounce of Pedialyte every 10 minutes. If vomiting continues, wait an hour, TEST-TAKING HINT: The test taker should eliminate answers 1 and 3 because they could cause
and then repeat what you previously gave." harm to the infant.
The parents of a 4-year-old ask the nurse how to manage their child's constipation. Select the 1. Two ounces of apple juice is most likely not a suflcient quantity to alter a 4-year-old child's
nurse's best response. bowel movements.
1. "Add 2 ounces of apple or pear juice to the child's diet." 2. Although fresh fruits help decrease constipation, bananas tend to increase constipation.
2. "Be sure your child eats a lot of fresh fruit such as apples and bananas." 3. Increasing fluid consumption helps to decrease the hardness of the stool.
3. "Encourage your child to drink more fluids." 4. Whole-grain bread and brown rice are high in fiber and help decrease constipation.
4. "Decrease bulky foods such as whole-grain breads and brown rice." TEST-TAKING HINT: Answer 1 decreases constipation in an infant but not in a preschooler.
1. Natural supplements and herbs are not recommended because the safety and eflcacy are
not standardized.
A child is diagnosed with chronic constipation that has been unresponsive to dietary and 2. A stimulant laxative is not the drug of choice because it may increase abdominal discomfort
activity changes. Which pharmacological measure is most appropriate? and may lead to dependency.
1. Natural supplements and herbs. 3. A stool softener (osmotic agent) is the drug of choice because it will lead to easier
2. Stimulant laxative. evacuation.
3. Osmotic agent. 4. Although diet and activity modification are tried first, medications are sometimes needed.
4. Pharmacological measures are not used in pediatric constipation. TEST-TAKING HINT: The test taker should eliminate answer 4 because it impliesthat medica-
tions are never given to the constipated child. In health care, there are very few cases of "never"
and "always."
2, 4.
1. Dairy products are limited because they can
Which instructions for a child diagnosed with encopresis should the nurse question? Select lead to constipation.
all that apply. 2. A diet high in protein will cause more constipation.
1. Limit the intake of milk. 3. A complete dietary log should be kept to correlate the foods that lead to constipation.
2. Otter a diet high in protein. 4. The child and family would not be encouraged initially to seek counseling unless a psy-
3. Obtain a complete dietary log. chological component to the encopresis had been identified.
4. Follow up with a child psychologist. 5. Children with constipation/encopresis are advised to sit on the toilet for 10 minutes after
5. After dinner, have the child sit on the toilet for 10 minutes. dinner to take advantage of the gastrocolic reflex.
TEST-TAKING HINT: Recall foods and behaviors that cause constipation in children and suc-
cessful approaches to meet their needs.
The nurse is caring for an infant diagnosed with Hirschsprung disease. The mother states she
1. There is a genetic component to Hirschsprung disease, so any future siblings are also at
is pregnant with a boy and wants to know if her new baby will likely have the disorder. Which
risk.
is the nurse's best response?
