Final Exam: GI Dysfunction NCLEX Questions and Correct Solutions Graded to Pass

c A 16 month old has a history of diarrhea for 3 days with poor oral intake. He received IV fluids, has tolerated some oral fluids in the ED, and is being discharged home. Instructions for diet for this child should include a. BRAT diet (bananas, rice, applesauce, and toast) for 24 hours, then a soft diet as tolerated b. chicken or beef broth for 24 hours, then resume a soft diet c. offer a regular diet as child's appetite warrants d. keep on clear liquids and toast for 24 hours b A 5 month old is seen for a complaint of vomiting and failure to grow. His birth weight was 7 pounds, and he now weighs 8 lbs 10 oz. The mother reports that he is taking 4-7 ounces of formula every 4-5 hours, but he "spits up a lot after eating and then is hungry again." The child is noted to be alert but appears malnourished. The mother reports his stools are very brown in color, and he has 1-2 bowel movements every day. Based on these findings, the nurse anticipates the infant has a. meckel diverticulum b. hypertrophic pyloric stenosis c. insussusception d. hirschprung disease a b d Because children with celiac disease must limit their intake of products containing gluten in wheat, rye, oats, and barley, they are at risk for which of the following nutritional deficiencies? Select all that apply a. iron deficiency anemia b. folic acid anemia c. zinc deficiency d. vitamin A, D, E, and K deficiency e. vitamin B12 deficiency a What type of diarrhea is commonly seen in malabsorption syndromes because the intestine cannot absorb nutrients or electrolytes? a. Chronic b. Secretory c. Acute d. Intractable diarrhea of infancy c What is the initial therapeutic management of the child with acute diarrhea and dehydration? a. Clear liquids such as fruit juice and soft drinks b. Adsorbents, such as kaolin and pectin c. Oral rehydration solution d. Antidiarrheal medications such as paregoric a A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. What is the therapeutic management of this child? a. Intravenous fluids b. Oral rehydration solution c. Clear liquids, 1 to 2 oz at a time d. Administration of antidiarrheal medication a A 2-month-old breastfed infant is successfully rehydrated with oral rehydration solutions for acute diarrhea. What instructions are include to the mother specific to breastfeeding? a. Continue breastfeeding. b. Stop breastfeeding until the breast milk is cultured. c. Stop breastfeeding until diarrhea is absent for 24 hr. d. Express breast milk and dilute it with sterile water before feeding it. c The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. What would the nurse include? a. Give nothing by mouth for 24 hr. b. Avoid carbohydrate-containing liquids. c. Brush teeth or rinse mouth after vomiting. d. Give plain water until vomiting ceases for at least 24 hr. b A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child? a. It is unnecessary because of childs age. b. It is essential because it will be an adjustment. c. Preparation is not needed because the colostomy is temporary. d. Preparation is important because the child needs to deal with negative body image. c 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 A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent? a. Surgical therapy is indicated. b. Place in prone position for sleep after feeding. c. Thicken feedings and enlarge the nipple hole. d. Reduce the frequency of feeding by encouraging larger volumes of formula. d 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 c When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation? a. Anorexia b. Bradycardia c. Sudden relief from pain d. Decreased abdominal distention c 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. d What term describes invagination of one segment of bowel within another? a. Atresia b. Stenosis c. Herniation d. Intussusception c 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 b 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 Melena, the passage of black, tarry stools, suggests bleeding from which source? a. The perianal or rectal area b. The upper gastrointestinal (GI) tract c. The lower GI tract d. Hemorrhoids or anal fissures