Chapter 26: The Child with Gastrointestinal Dysfunction

Chapter 26: The Child with Gastrointestinal Dysfunction

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. What test is used to screen for carbohydrate malabsorption?

a.	Stool pH
b.	Urine ketones
c.	C urea breath test
d.	ELISA stool assay

 

 

ANS:  A

The anticipated pH of a stool specimen is 7.0. A stool pH of less than 5.0 is indicative of carbohydrate malabsorption. The bacterial fermentation of carbohydrates in the colon produces short-chain fatty acids, which lower the stool pH. Urine ketones detect the presence of ketones in the urine, which indicates the use of alternative sources of energy to glucose. The C urea breath test measures the amount of carbon dioxide exhaled. It is used to determine the presence of Helicobacter pylori. ELISA (enzyme-linked immunosorbent assay) detects the presence of antigens and antibodies. It is not useful for disorders of metabolism.

 

DIF:    Cognitive Level: Understanding       REF:   p. 1055

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

 

2. A toddler’s mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse’s response should be based on which premise?

a.	An emergency laparotomy is very likely.
b.	The location needs to be confirmed by radiographic examination.
c.	Surgery will be necessary if the battery has not passed in the stool in 48 hours.
d.	Careful observation is essential because an ingested battery cannot be accurately detected.

 

 

ANS:  B

Button batteries can cause severe damage if lodged in the esophagus. If both poles of the battery come in contact with the wall of the esophagus, acid burns, necrosis, and perforation can occur. If the battery is in the stomach, it will most likely be passed without incident. Surgery is not indicated. The battery is metallic and is readily seen on radiologic examination.

 

DIF:    Cognitive Level: Applying               REF:   p. 1068           TOP:   Nursing Process: Planning

MSC:  Client Needs: Physiological Integrity

 

3. The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?

a.	Gastrointestinal perforation may have occurred.
b.	The object may have been aspirated.
c.	The object may be lodged in the esophagus.
d.	The object may be embedded in stomach wall.

 

 

ANS:  C

Gagging and drooling may be signs of esophageal obstruction. The child is unable to swallow saliva, which contributes to the drooling. Signs of gastrointestinal (GI) perforation include chest or abdominal pain and evidence of bleeding in the GI tract. If the object was aspirated, the child would most likely have coughing, choking, inability to speak, or difficulty breathing. If the object was embedded in the stomach wall, it would not result in symptoms of gagging and drooling.

 

DIF:    Cognitive Level: Applying               REF:   p. 1071

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

 

4. What is a high-fiber food that the nurse should recommend for a child with chronic constipation?

a.	White rice
b.	Popcorn
c.	Fruit juice
d.	Ripe bananas

 

 

ANS:  B

Popcorn is a high-fiber food. Refined rice is not a significant source of fiber. Unrefined brown rice is a fiber source. Fruit juices are not a significant source of fiber. Raw fruits, especially those with skins and seeds, other than ripe bananas, have high fiber.

 

DIF:    Cognitive Level: Applying               REF:   p. 1074           TOP:   Nursing Process: Planning

MSC:  Client Needs: Health Promotion and Maintenance

 

5. A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?

a.	Bowel cleansing
b.	Dietary modification
c.	Structured toilet training
d.	Behavior modification

 

 

ANS:  A

The first step in the treatment of chronic constipation is to empty the bowel and allow the distended rectum to return to normal size. Dietary modification is an important part of the treatment. Increased fiber and fluids should be gradually added to the child’s diet. A 2-year-old child is too young for structured toilet training. For an older child, a regular schedule for toileting should be established. Behavior modification is part of the overall treatment plan. The child practices releasing the anal sphincter and recognizing cues for defecation.

 

DIF:    Cognitive Level: Understanding       REF:   p. 1072

TOP:   Nursing Process: Implementation     MSC:  Client Needs: Physiological Integrity