NR 4828 PED EXAM: Gastrointestinal Dysfunction QUESTIONS
WITH CORRECT ANSWERS GRADED A+ SUCCESS ASSUARED
1. Nurses must be alert for increased fluid requirements when a child has:
a. Fever.
Fever leads to great insensible fluid loss in young children because of increased body surface area relative to fluid
volume. Respiratory rate influences insensible fluid loss and should be monitored in the mechanically ventilated child.
Congestive heart failure is a case of fluid overload in children. ICP does not lead to increased fluid requirements in
children.
2. Which type of dehydration results from water loss in excess of electrolyte loss?
d. Hypertonic dehydration
Hypertonic dehydration results from water loss in excess of electrolyte loss. This is the most dangerous type of
dehydration. It is caused by feeding children fluids with high amounts of solute. Isotonic dehydration occurs in
conditions in which electrolyte and water deficits are present in balanced proportion. Isosmotic dehydration is another
term for isotonic dehydration. Hypotonic dehydration occurs when the electrolyte deficit exceeds the water deficit,
leaving the serum hypotonic.
3. An infant is brought to the emergency department with poor skin turgor, weight loss, lethargy, and tachycardia.
This is suggestive of:
b. Dehydration.
These clinical manifestations indicate dehydration. Symptoms of overhydration are edema and weight gain. Regardless
of extracellular sodium levels, total body sodium is usually depleted in dehydration. Symptoms of hypocalcemia are a
result of neuromuscular irritability and manifest as jitteriness, tetany, tremors, and muscle twitching.
, NR 4828 PED EXAM: Gastrointestinal Dysfunction QUESTIONS
WITH CORRECT ANSWERS GRADED A+ SUCCESS ASSUARED
4. Acute diarrhea is often caused by:
b. Antibiotic therapy.
Acute diarrhea is a sudden increase in frequency and change in consistency of stools and may be associated with
antibiotic therapy. Hirschsprungs disease, hypothyroidism, and meconium ileus are usually manifested with constipation
rather than diarrhea.
5. The viral pathogen that frequently causes acute diarrhea in young children is:
c. Rotavirus.
Rotavirus is the most frequent viral pathogen that causes diarrhea in young children. Giardia and Salmonella are
bacterial pathogens that cause diarrhea. Shigella is a bacterial pathogen that is uncommon in the United States.
6. A parasite that causes acute diarrhea is:
c. Giardia lamblia.
Giardia is a parasite that represents 15% of nondysenteric illness in the United States. Shigella, Salmonella, and E. coli are
bacterial pathogens.
7. A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells. This is
most suggestive of which condition?
d. Bacterial gastroenteritis
Neutrophils and red blood cells in stool indicate bacterial gastroenteritis. Protein intolerance is suspected in the
presence of eosinophils. Parasitic infection is indicated by eosinophils. Fat malabsorption is indicated by foul- smelling,
greasy, bulky stools.
8. Therapeutic management of the child with acute diarrhea and dehydration usually begins with:
, NR 4828 PED EXAM: Gastrointestinal Dysfunction QUESTIONS
WITH CORRECT ANSWERS GRADED A+ SUCCESS ASSUARED
c. Oral rehydration solution (ORS).
ORS is the first treatment for acute diarrhea. Clear liquids are not recommended because they contain too much sugar,
which may contribute to diarrhea. Adsorbents are not recommended and neither are antidiarrheals because they do not
get rid of pathogens.
9. A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea
and vomiting. Therapeutic management of this child will begin with:
a. Intravenous fluids.
Intravenous fluids are initiated in children with severe dehydration. ORS is acceptable therapy if the dehydration is not
severe. Diarrhea is not managed by using clear liquids by mouth. These fluids have a high carbohydrate content, low
electrolyte content, and high osmolality. Antidiarrheal medications are not recommended for the treatment of acute
infectious diarrhea.
10. Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies,
which are now being successfully treated with antihistamines. The nurse should suspect that the constipation is
most likely caused by:
c. Antihistamines.
Constipation may be associated with drugs such as antihistamines, antacids, diuretics, opioids, antiepileptics, and iron.
Because this is the only known recent change in her habits, the addition of antihistamines is most likely the etiology of
the diarrhea, rather than diet, allergies, or emotional factors. With a change in bowel habits, the presence and role of
any recently prescribed medications should be assessed.
11. A high-fiber food that the nurse could recommend for a child with chronic constipation is:
, NR 4828 PED EXAM: Gastrointestinal Dysfunction QUESTIONS
WITH CORRECT ANSWERS GRADED A+ SUCCESS ASSUARED
a. Popcorn.
Popcorn is a high-fiber food. Pancakes and muffins do not have significant fiber unless made with fruit or bran. Raw
fruits, especially those with skins and seeds, other than ripe bananas and avocados are high in fiber.
12. Therapeutic management of most children with Hirschsprungs disease is primarily:
d. Surgical removal of affected section of bowel.
Most children with Hirschsprungs disease require surgical rather than medical management. Surgery is done to remove
the aganglionic portion of the bowel, relieve obstruction, and restore normal bowel motility and function of the
internal anal sphincter. Preoperative management may include enemas and low-fiber, high- calorie, high-protein diet
until the child is physically ready for surgery. The colostomy that is created in Hirschsprungs disease is usually
temporary.
13. A 3-year-old child with Hirschsprungs disease is hospitalized for surgery. A temporary colostomy will be
necessary. The nurse should recognize that preparing this child psychologically is:
c. Necessary because it will be an adjustment.
The childs age dictates the type and extent of psychologic preparation. When a colostomy is performed, the child who is
at least preschool age is told about the procedure and what to expect in concrete terms with the use of visual aids. It is
necessary to prepare this age child for procedures. The preschooler is not yet concerned with body image.
14. The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. The
nurse should include:
c. Brushing teeth or rinsing mouth after vomiting.
It is important to emphasize the need for the child to brush the teeth or rinse the mouth after vomiting to dilute the
hydrochloric acid that comes in contact with the teeth. Administration of a glucose-electrolyte solution to an alert child
WITH CORRECT ANSWERS GRADED A+ SUCCESS ASSUARED
1. Nurses must be alert for increased fluid requirements when a child has:
a. Fever.
Fever leads to great insensible fluid loss in young children because of increased body surface area relative to fluid
volume. Respiratory rate influences insensible fluid loss and should be monitored in the mechanically ventilated child.
Congestive heart failure is a case of fluid overload in children. ICP does not lead to increased fluid requirements in
children.
2. Which type of dehydration results from water loss in excess of electrolyte loss?
d. Hypertonic dehydration
Hypertonic dehydration results from water loss in excess of electrolyte loss. This is the most dangerous type of
dehydration. It is caused by feeding children fluids with high amounts of solute. Isotonic dehydration occurs in
conditions in which electrolyte and water deficits are present in balanced proportion. Isosmotic dehydration is another
term for isotonic dehydration. Hypotonic dehydration occurs when the electrolyte deficit exceeds the water deficit,
leaving the serum hypotonic.
3. An infant is brought to the emergency department with poor skin turgor, weight loss, lethargy, and tachycardia.
This is suggestive of:
b. Dehydration.
These clinical manifestations indicate dehydration. Symptoms of overhydration are edema and weight gain. Regardless
of extracellular sodium levels, total body sodium is usually depleted in dehydration. Symptoms of hypocalcemia are a
result of neuromuscular irritability and manifest as jitteriness, tetany, tremors, and muscle twitching.
, NR 4828 PED EXAM: Gastrointestinal Dysfunction QUESTIONS
WITH CORRECT ANSWERS GRADED A+ SUCCESS ASSUARED
4. Acute diarrhea is often caused by:
b. Antibiotic therapy.
Acute diarrhea is a sudden increase in frequency and change in consistency of stools and may be associated with
antibiotic therapy. Hirschsprungs disease, hypothyroidism, and meconium ileus are usually manifested with constipation
rather than diarrhea.
5. The viral pathogen that frequently causes acute diarrhea in young children is:
c. Rotavirus.
Rotavirus is the most frequent viral pathogen that causes diarrhea in young children. Giardia and Salmonella are
bacterial pathogens that cause diarrhea. Shigella is a bacterial pathogen that is uncommon in the United States.
6. A parasite that causes acute diarrhea is:
c. Giardia lamblia.
Giardia is a parasite that represents 15% of nondysenteric illness in the United States. Shigella, Salmonella, and E. coli are
bacterial pathogens.
7. A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells. This is
most suggestive of which condition?
d. Bacterial gastroenteritis
Neutrophils and red blood cells in stool indicate bacterial gastroenteritis. Protein intolerance is suspected in the
presence of eosinophils. Parasitic infection is indicated by eosinophils. Fat malabsorption is indicated by foul- smelling,
greasy, bulky stools.
8. Therapeutic management of the child with acute diarrhea and dehydration usually begins with:
, NR 4828 PED EXAM: Gastrointestinal Dysfunction QUESTIONS
WITH CORRECT ANSWERS GRADED A+ SUCCESS ASSUARED
c. Oral rehydration solution (ORS).
ORS is the first treatment for acute diarrhea. Clear liquids are not recommended because they contain too much sugar,
which may contribute to diarrhea. Adsorbents are not recommended and neither are antidiarrheals because they do not
get rid of pathogens.
9. A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea
and vomiting. Therapeutic management of this child will begin with:
a. Intravenous fluids.
Intravenous fluids are initiated in children with severe dehydration. ORS is acceptable therapy if the dehydration is not
severe. Diarrhea is not managed by using clear liquids by mouth. These fluids have a high carbohydrate content, low
electrolyte content, and high osmolality. Antidiarrheal medications are not recommended for the treatment of acute
infectious diarrhea.
10. Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies,
which are now being successfully treated with antihistamines. The nurse should suspect that the constipation is
most likely caused by:
c. Antihistamines.
Constipation may be associated with drugs such as antihistamines, antacids, diuretics, opioids, antiepileptics, and iron.
Because this is the only known recent change in her habits, the addition of antihistamines is most likely the etiology of
the diarrhea, rather than diet, allergies, or emotional factors. With a change in bowel habits, the presence and role of
any recently prescribed medications should be assessed.
11. A high-fiber food that the nurse could recommend for a child with chronic constipation is:
, NR 4828 PED EXAM: Gastrointestinal Dysfunction QUESTIONS
WITH CORRECT ANSWERS GRADED A+ SUCCESS ASSUARED
a. Popcorn.
Popcorn is a high-fiber food. Pancakes and muffins do not have significant fiber unless made with fruit or bran. Raw
fruits, especially those with skins and seeds, other than ripe bananas and avocados are high in fiber.
12. Therapeutic management of most children with Hirschsprungs disease is primarily:
d. Surgical removal of affected section of bowel.
Most children with Hirschsprungs disease require surgical rather than medical management. Surgery is done to remove
the aganglionic portion of the bowel, relieve obstruction, and restore normal bowel motility and function of the
internal anal sphincter. Preoperative management may include enemas and low-fiber, high- calorie, high-protein diet
until the child is physically ready for surgery. The colostomy that is created in Hirschsprungs disease is usually
temporary.
13. A 3-year-old child with Hirschsprungs disease is hospitalized for surgery. A temporary colostomy will be
necessary. The nurse should recognize that preparing this child psychologically is:
c. Necessary because it will be an adjustment.
The childs age dictates the type and extent of psychologic preparation. When a colostomy is performed, the child who is
at least preschool age is told about the procedure and what to expect in concrete terms with the use of visual aids. It is
necessary to prepare this age child for procedures. The preschooler is not yet concerned with body image.
14. The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. The
nurse should include:
c. Brushing teeth or rinsing mouth after vomiting.
It is important to emphasize the need for the child to brush the teeth or rinse the mouth after vomiting to dilute the
hydrochloric acid that comes in contact with the teeth. Administration of a glucose-electrolyte solution to an alert child
