1
Wong’s Essentials of Pediatric Nursing, 10th Edition |
Complete Study Guide + Verified Q&A | Exam-Ready
Content 2025
Your Ultimate Pediatric Nursing Companion – Clear,
Concise, and Focused on What Matters Most
What are the results of excessive vomiting in an infant with pyloric stenosis?
a. Hyperchloremia
b. Hypernatremia
c. Metabolic acidosis
d. Metabolic alkalosis
Metabolic alkalosis
Infants with excessive vomiting are prone to metabolic alkalosis from the loss of hydrogen
ions. Chloride ions and sodium are lost with vomiting. Metabolic alkalosis, not acidosis, is
likely.
, 2
Which is an important nursing consideration in the care of a child with celiac disease?
a. Refer to a nutritionist for detailed dietary instructions and education.
b. Help child and family understand that diet restrictions are usually only temporary.
c. Teach proper hand washing and standard precautions to prevent disease transmission.
d. Suggest ways to cope more effectively with stress to minimize symptoms.
Refer to a nutritionist for detailed dietary instructions and education.
The main consideration is helping the child adhere to dietary management. Considerable
time is spent explaining to the child and parents about the disease process, the specific role
of gluten in aggravating the condition, and foods that must be restricted. Referral to a
nutritionist would help in this process. The most severe symptoms usually occur in early
childhood and adult life. Dietary avoidance of gluten should be lifelong. Celiac disease is
not transmissible or stress related.
An infant with short bowel syndrome will be discharged home on total parenteral nutrition
(TPN) and gastrostomy feedings. What should be included in the discharge teaching?
a. Prepare family for impending death.
b. Teach family signs of central venous catheter infection.
c. Teach family how to calculate caloric needs.
d. Secure TPN and gastrostomy tubing under diaper to lessen risk of dislodgment.
Teach family signs of central venous catheter infection.
During TPN therapy, care must be taken to minimize the risk of complications related to
the central venous access device, such as catheter infections, occlusions, or accidental
, 3
removal. This is an important part of family teaching. The prognosis for patients with short
bowel syndrome depends in part on the length of residual small intestine. It has improved
with advances in TPN. Although parents need to be taught about nutritional needs, the
caloric needs and prescribed TPN and rate are the responsibility of the health care team.
The tubes should not be placed under the diaper due to risk of infection.
A nurse is receiving report on a newborn admitted yesterday after a gastroschisis repair. In
the report, the nurse is told the newborn has a physician's prescription for an NG tube to
low intermittent suction. The reporting nurse confirms that the NG tube is to low
intermittent suction and draining light green stomach contents. Upon initial assessment,
the nurse notes that the newborn has pulled the NG tube out. Which is the priority action
the nurse should take?
a. Replace the NG tube and continue the low intermittent suction.
b. Leave the NG tube out and notify the physician at the end of the shift.
c. Leave the NG tube out and monitor for bowel sounds.
d. Replace the NG tube, but leave to gravity drainage instead of low wall suction.
Replace the NG tube and continue the low intermittent suction.
A newborn with a gastroschisis performed the day before will require bowel decompression
with an NG tube to low wall intermittent suction. The nurse's priority action is to replace
the NG tube and continue with the low wall intermittent suctioning. The NG tube cannot be
left out this soon after surgery. The physician's prescription was to have the NG tube to low
wall intermittent suction, so the tube cannot be placed to gravity drainage.
, 4
A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The
physician explained the plan of therapy and its expected good results. However, the mother
refuses to see or hold her baby. What is the initial therapeutic approach for the mother?
a. Restating what the physician has told her about plastic surgery.
b. Encouraging her to express her feelings.
c. Emphasizing the normalcy of her baby and the baby's need for mothering.
d. Recognizing that negative feelings toward the child continue throughout childhood
ANS: B
For parents, cleft lip and cleft palate deformities are particularly disturbing. The nurse
must emphasize not only the infant's physical needs but also the parents' emotional needs.
The mother needs to be able to express her feelings before she can accept her child.
Although the nurse will restate what the physician has told the mother about plastic
surgery, it is not part of the initial therapeutic approach. As the mother expresses her
feelings, the nurse's actions should convey to the parents that the infant is a precious
human being. The nurse emphasizes the child's normalcy and helps the mother recognize
the child's uniqueness.
A nurse is admitting an infant with biliary atresia. Which is the earliest clinical
manifestation of biliary atresia the nurse should expect to assess?
a. Jaundice
b. Vomiting
c. Hepatomegaly
d. Absence of stooling
Wong’s Essentials of Pediatric Nursing, 10th Edition |
Complete Study Guide + Verified Q&A | Exam-Ready
Content 2025
Your Ultimate Pediatric Nursing Companion – Clear,
Concise, and Focused on What Matters Most
What are the results of excessive vomiting in an infant with pyloric stenosis?
a. Hyperchloremia
b. Hypernatremia
c. Metabolic acidosis
d. Metabolic alkalosis
Metabolic alkalosis
Infants with excessive vomiting are prone to metabolic alkalosis from the loss of hydrogen
ions. Chloride ions and sodium are lost with vomiting. Metabolic alkalosis, not acidosis, is
likely.
, 2
Which is an important nursing consideration in the care of a child with celiac disease?
a. Refer to a nutritionist for detailed dietary instructions and education.
b. Help child and family understand that diet restrictions are usually only temporary.
c. Teach proper hand washing and standard precautions to prevent disease transmission.
d. Suggest ways to cope more effectively with stress to minimize symptoms.
Refer to a nutritionist for detailed dietary instructions and education.
The main consideration is helping the child adhere to dietary management. Considerable
time is spent explaining to the child and parents about the disease process, the specific role
of gluten in aggravating the condition, and foods that must be restricted. Referral to a
nutritionist would help in this process. The most severe symptoms usually occur in early
childhood and adult life. Dietary avoidance of gluten should be lifelong. Celiac disease is
not transmissible or stress related.
An infant with short bowel syndrome will be discharged home on total parenteral nutrition
(TPN) and gastrostomy feedings. What should be included in the discharge teaching?
a. Prepare family for impending death.
b. Teach family signs of central venous catheter infection.
c. Teach family how to calculate caloric needs.
d. Secure TPN and gastrostomy tubing under diaper to lessen risk of dislodgment.
Teach family signs of central venous catheter infection.
During TPN therapy, care must be taken to minimize the risk of complications related to
the central venous access device, such as catheter infections, occlusions, or accidental
, 3
removal. This is an important part of family teaching. The prognosis for patients with short
bowel syndrome depends in part on the length of residual small intestine. It has improved
with advances in TPN. Although parents need to be taught about nutritional needs, the
caloric needs and prescribed TPN and rate are the responsibility of the health care team.
The tubes should not be placed under the diaper due to risk of infection.
A nurse is receiving report on a newborn admitted yesterday after a gastroschisis repair. In
the report, the nurse is told the newborn has a physician's prescription for an NG tube to
low intermittent suction. The reporting nurse confirms that the NG tube is to low
intermittent suction and draining light green stomach contents. Upon initial assessment,
the nurse notes that the newborn has pulled the NG tube out. Which is the priority action
the nurse should take?
a. Replace the NG tube and continue the low intermittent suction.
b. Leave the NG tube out and notify the physician at the end of the shift.
c. Leave the NG tube out and monitor for bowel sounds.
d. Replace the NG tube, but leave to gravity drainage instead of low wall suction.
Replace the NG tube and continue the low intermittent suction.
A newborn with a gastroschisis performed the day before will require bowel decompression
with an NG tube to low wall intermittent suction. The nurse's priority action is to replace
the NG tube and continue with the low wall intermittent suctioning. The NG tube cannot be
left out this soon after surgery. The physician's prescription was to have the NG tube to low
wall intermittent suction, so the tube cannot be placed to gravity drainage.
, 4
A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The
physician explained the plan of therapy and its expected good results. However, the mother
refuses to see or hold her baby. What is the initial therapeutic approach for the mother?
a. Restating what the physician has told her about plastic surgery.
b. Encouraging her to express her feelings.
c. Emphasizing the normalcy of her baby and the baby's need for mothering.
d. Recognizing that negative feelings toward the child continue throughout childhood
ANS: B
For parents, cleft lip and cleft palate deformities are particularly disturbing. The nurse
must emphasize not only the infant's physical needs but also the parents' emotional needs.
The mother needs to be able to express her feelings before she can accept her child.
Although the nurse will restate what the physician has told the mother about plastic
surgery, it is not part of the initial therapeutic approach. As the mother expresses her
feelings, the nurse's actions should convey to the parents that the infant is a precious
human being. The nurse emphasizes the child's normalcy and helps the mother recognize
the child's uniqueness.
A nurse is admitting an infant with biliary atresia. Which is the earliest clinical
manifestation of biliary atresia the nurse should expect to assess?
a. Jaundice
b. Vomiting
c. Hepatomegaly
d. Absence of stooling
