NURS 535 CORRECT TEST PAPER QUESTIONS AND
ANSWERS SET A+
✔✔Treatment of bacterial diarrhea - ✔✔Campylobacter: Erythromycin 40mg/kg/day
;TID dosing( 5-7 days)
Clostridium: Metronidazole 30mg/kg/day; QID dosing (7-10 days)
Salmonella: Antibiotics children < 1 year of age or immune-compromised
Trimethoprim-sulfamethoxazole (TMP-SMZ); 8mg/kg/day; BID dosing x 7-10days
Shigella: TMP-SMZ
E-coli: TMP-SMZ if diarrhea mod-severe
✔✔Parasitic Infections - Giardiasis - ✔✔Manifestations:
Infants & children at daycare centers
Spread in water
Cysts passed in feces, mature in hours --> days
Diarrhea,vomiting,anorexia,poorgrowth
Watery, greasy, foul smelling stools
5 years: cramps, intermittent loose stools & constipation
✔✔Giardiasis - Diagnosis and treatment - ✔✔Stool cultures over several weeks
Furazolidone 5-8 mg/kg/day; QID; (7-
10days)
,Metronidazole 40mg/kg/day; TID; ( 7- 10 days)
✔✔Parasitic infections - Enterobiasis (Pinworms) - ✔✔Manifestations:
Anal itching, not diarrhea
Irritability, restlessness, bedwetting
Hand-mouth ingestion from environment
Scratching causes re- infestation
✔✔Pinworms treatment - ✔✔Tape test
Mebendazole (Vermox) 100mg tablet x1- repeat in 14 days (>2yrs)
Pyrantel (Antiminth) 11mg/kg x1 dose-repeat in
14 days •Stains stool & emesis red
Wash linens & clothes in hot water, vacuum
Clip fingernails , hand washing
✔✔Definition of constipation - ✔✔Fails to defecate over several days
Hard stools or painful defecation
Fewer than three stools a week and/or dry hard pebble fecal matter for more than 2
weeks
✔✔Encopresis - ✔✔A childhood disorder characterized by repeated defecating in
inappropriate places, such as one's clothing
✔✔Red flags of bowel problems - ✔✔Failure to thrive
Lack of lumbosacral curve
Pilonidal dimple with tuft of hair
Flat buttocks
Displaced anus
Occult blood
Absent cremasteric reflex
Low tone
✔✔Management of functional constipation - ✔✔Diet
Meds
Behavior modification
Long-term follow up
, ✔✔Constipation - Medication management options - ✔✔Osmotic agents: Sorbitol,
lactulose, mag hydroxide, Haley's MO
Lubricants: Mineral oil
Stimulants: Save for rescue therapy and those children who have poor response to
lubricants and osmotic agnts
Senna
✔✔Hirschsprung disease - ✔✔Absent ganglion cells in submucosal/myenteric plexus
rectosigmoid
✔✔Hirschsprung disease - Clinical manifestations - ✔✔Newborn
- Failure to pass meconium
- Anorexia, vomiting, abdominal distention
Older Infant/child
- Failure to gain weight - Abdominal distention - Constipation, fecal masses
- Ribbon stools, foul smelling
✔✔Appendicitis - ✔✔inflammation of the appendix
Cause: Obstruction of the appendiceal lumen caused by fecalith, parasite, stenosis,
hyperplasia of lymphoid tissue, or tumor
✔✔Appendicitis S/S - ✔✔abdominal pain, rebound tenderness, low grade fever,
increased WBCs
McBurney's point (RLQ tenderness on palpation)
✔✔Psoas sign - ✔✔RLQ pain with extension of right thigh indicative of appendicitis
✔✔Obturators sign - ✔✔RLQ on internal rotation of right thigh indicative of appendicitis
✔✔Rovsing's sign - ✔✔Pain in RLQ with palpation of LLQ indicative of appendicitis
✔✔Dunphy's sign - ✔✔increased pain with coughing
✔✔Appendicitis - Diagnosis - ✔✔CT A/P with PO contrast
Ultrasound, barium enema, CBC, CRP
✔✔Appendicitis - Treatment - ✔✔Hydration, surgery, 7 - 10 days of abx
✔✔Hernia - ✔✔Protrusion of an organ through the wall of the cavity that normally
contains it
ANSWERS SET A+
✔✔Treatment of bacterial diarrhea - ✔✔Campylobacter: Erythromycin 40mg/kg/day
;TID dosing( 5-7 days)
Clostridium: Metronidazole 30mg/kg/day; QID dosing (7-10 days)
Salmonella: Antibiotics children < 1 year of age or immune-compromised
Trimethoprim-sulfamethoxazole (TMP-SMZ); 8mg/kg/day; BID dosing x 7-10days
Shigella: TMP-SMZ
E-coli: TMP-SMZ if diarrhea mod-severe
✔✔Parasitic Infections - Giardiasis - ✔✔Manifestations:
Infants & children at daycare centers
Spread in water
Cysts passed in feces, mature in hours --> days
Diarrhea,vomiting,anorexia,poorgrowth
Watery, greasy, foul smelling stools
5 years: cramps, intermittent loose stools & constipation
✔✔Giardiasis - Diagnosis and treatment - ✔✔Stool cultures over several weeks
Furazolidone 5-8 mg/kg/day; QID; (7-
10days)
,Metronidazole 40mg/kg/day; TID; ( 7- 10 days)
✔✔Parasitic infections - Enterobiasis (Pinworms) - ✔✔Manifestations:
Anal itching, not diarrhea
Irritability, restlessness, bedwetting
Hand-mouth ingestion from environment
Scratching causes re- infestation
✔✔Pinworms treatment - ✔✔Tape test
Mebendazole (Vermox) 100mg tablet x1- repeat in 14 days (>2yrs)
Pyrantel (Antiminth) 11mg/kg x1 dose-repeat in
14 days •Stains stool & emesis red
Wash linens & clothes in hot water, vacuum
Clip fingernails , hand washing
✔✔Definition of constipation - ✔✔Fails to defecate over several days
Hard stools or painful defecation
Fewer than three stools a week and/or dry hard pebble fecal matter for more than 2
weeks
✔✔Encopresis - ✔✔A childhood disorder characterized by repeated defecating in
inappropriate places, such as one's clothing
✔✔Red flags of bowel problems - ✔✔Failure to thrive
Lack of lumbosacral curve
Pilonidal dimple with tuft of hair
Flat buttocks
Displaced anus
Occult blood
Absent cremasteric reflex
Low tone
✔✔Management of functional constipation - ✔✔Diet
Meds
Behavior modification
Long-term follow up
, ✔✔Constipation - Medication management options - ✔✔Osmotic agents: Sorbitol,
lactulose, mag hydroxide, Haley's MO
Lubricants: Mineral oil
Stimulants: Save for rescue therapy and those children who have poor response to
lubricants and osmotic agnts
Senna
✔✔Hirschsprung disease - ✔✔Absent ganglion cells in submucosal/myenteric plexus
rectosigmoid
✔✔Hirschsprung disease - Clinical manifestations - ✔✔Newborn
- Failure to pass meconium
- Anorexia, vomiting, abdominal distention
Older Infant/child
- Failure to gain weight - Abdominal distention - Constipation, fecal masses
- Ribbon stools, foul smelling
✔✔Appendicitis - ✔✔inflammation of the appendix
Cause: Obstruction of the appendiceal lumen caused by fecalith, parasite, stenosis,
hyperplasia of lymphoid tissue, or tumor
✔✔Appendicitis S/S - ✔✔abdominal pain, rebound tenderness, low grade fever,
increased WBCs
McBurney's point (RLQ tenderness on palpation)
✔✔Psoas sign - ✔✔RLQ pain with extension of right thigh indicative of appendicitis
✔✔Obturators sign - ✔✔RLQ on internal rotation of right thigh indicative of appendicitis
✔✔Rovsing's sign - ✔✔Pain in RLQ with palpation of LLQ indicative of appendicitis
✔✔Dunphy's sign - ✔✔increased pain with coughing
✔✔Appendicitis - Diagnosis - ✔✔CT A/P with PO contrast
Ultrasound, barium enema, CBC, CRP
✔✔Appendicitis - Treatment - ✔✔Hydration, surgery, 7 - 10 days of abx
✔✔Hernia - ✔✔Protrusion of an organ through the wall of the cavity that normally
contains it
