Chapter 19: The Child with a Gastrointestinal Alteration

Chapter 19: The Child with a Gastrointestinal Alteration

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. Which is the best nursing response to a mother asking about the cause of her infant’s bilateral cleft lip?

a.	“Did you have trouble with this pregnancy?”
b.	“Do you know of anyone in your family or the baby’s father’s family that were born with cleft lip or palate problems?”
c.	“This defect is associated with intrauterine infection during the second trimester.”
d.	“Was your husband in the military and involved in chemical warfare?”

 

 

ANS:   B

 

	Feedback
A	A troublesome pregnancy has not been associated with bilateral cleft lip.
B	Cleft lip and palate result from embryonic failure resulting from multiple genetic and environmental factors. A genetic pattern or familial risk seems to exist.
C	The defect occurred at approximately 6 to 8 weeks’ gestation. Second-trimester intrauterine infection is not a known cause of bilateral cleft lip.
D	Chemical warfare is not significantly associated with bilateral cleft lip and palate.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pgs 513-514

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity

 

2. Which of the following nursing interventions is most helpful to parents of a neonate with bilateral cleft lip?

a.	Assure the parents that the correction will be immediate and uncomplicated.
b.	Show the parents “before-and-after” pictures of an infant whose cleft lip has been successfully repaired.
c.	Teach the parents about long-term enteral feedings.
d.	Refer parents to a community agency.

 

 

ANS:   B

 

	Feedback
A	Correction is usually done around 4 weeks but may be done as early as 2 to 3 days after birth.
B	Showing the parents pictures of successful lip repair promotes bonding and enhances coping ability.
C	The infant with a bilateral cleft lip can be fed orally using a compressible, longer nipple, and making a larger hole in the nipple. Long-term enteral feedings are not usually indicated.
D	A community agency referral is not appropriate at this time and may not be indicated long term.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 516

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Psychosocial Integrity

 

3. The postoperative care plan for an infant with surgical repair of a cleft lip includes which of the following?

a.	A clear liquid diet for 72 hours
b.	Nasogastric feedings until the sutures are removed
c.	Elbow restraints to keep the infant’s fingers away from the mouth
d.	Rinsing the mouth after every feeding

 

 

ANS:   C

 

	Feedback
A	The infant’s diet is advanced from clear liquid to soft foods within 48 hours of surgery.
B	After surgery, the infant can resume preoperative feeding techniques.
C	Keeping the infant’s hands away from the incision reduces potential complications at the surgical site.
D	Rinsing the mouth after feeding is an inappropriate intervention. Feeding a small amount of water after feedings will help keep the mouth clean. A cleft lip repair site should be cleansed with a wet sterile cotton swab after feedings.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Text Reference: pg 515

OBJ:    Nursing Process Step: Planning         MSC:   NCLEX: Physiological Integrity

 

4. Which of the following is the most accurate statement about tracheoesophageal fistula (TEF)?

a.	This defect results from an embryonal failure of the foregut to differentiate into the trachea and esophagus.
b.	It is a fistula between the esophagus and stomach that results in the oral intake being refluxed and aspirated.
c.	An extra connection between the esophagus and trachea develops because of genetic abnormalities.
d.	The defect occurs in the second trimester of pregnancy.

 

 

ANS:   A

 

	Feedback
A	When the foregut does not differentiate into the trachea and esophagus during the fourth to fifth week of gestation, a TEF occurs.
B	TEF is an abnormal connection between the esophagus and trachea.
C	There is no connection between the trachea and esophagus in normal fetal development.
D	This defect occurs early in pregnancy during the fourth to fifth week of gestation.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 515

OBJ:    Nursing Process Step: Assessment    MSC:   NCLEX: Physiological Integrity