Chapter 24: The Child with Gastrointestinal Dysfunction

Chapter 24: The Child with Gastrointestinal Dysfunction

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which condition in a child should alert a nurse for increased fluid requirements?

a.	Fever
b.	Mechanical ventilation
c.	Congestive heart failure
d.	Increased intracranial pressure (ICP)

 

 

ANS:  A

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. Increased ICP does not lead to increased fluid requirements in children.

 

PTS:   1                    DIF:    Cognitive Level: Understand            REF:   763

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

 

2. A nurse is conducting an in-service on gastrointestinal disorders. The nurse includes that melena, the passage of black, tarry stools, suggests bleeding from which area?

a.	Perianal or rectal area
b.	Hemorrhoids or anal fissures
c.	Upper gastrointestinal (GI) tract
d.	Lower GI tract

 

 

ANS:  C

Melena is denatured blood from the upper GI tract or bleeding from the right colon. Blood from the perianal or rectal area, hemorrhoids, or lower GI tract would be bright red.

 

PTS:   1                    DIF:    Cognitive Level: Apply                   REF:   792

TOP:   Integrated Process: Teaching/Learning

MSC:  Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

 

3. Which type of dehydration is defined as “dehydration that occurs in conditions in which electrolyte and water deficits are present in approximately balanced proportion”?

a.	Isotonic dehydration
b.	Hypotonic dehydration
c.	Hypertonic dehydration
d.	All types of dehydration in infants and small children

 

 

ANS:  A

Isotonic dehydration is the correct term for this definition and is the most frequent form of dehydration in children. Hypotonic dehydration occurs when the electrolyte deficit exceeds the water deficit, leaving the serum hypotonic. Hypertonic dehydration results from water loss in excess of electrolyte loss and is usually caused by a proportionately larger loss of water or a larger intake of electrolytes. This definition is specific to isotonic dehydration.

 

PTS:   1                    DIF:    Cognitive Level: Understand            REF:   767

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

 

4. A nurse is admitting an infant with dehydration caused from water loss in excess of electrolyte loss. Which type of dehydration is this infant experiencing?

a.	Isotonic
b.	Isosmotic
c.	Hypotonic
d.	Hypertonic

 

 

ANS:  D

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 and is another term for isotonic dehydration. Hypotonic dehydration occurs when the electrolyte deficit exceeds the water deficit, leaving the serum hypotonic.

 

PTS:   1                    DIF:    Cognitive Level: Understand            REF:   767

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

 

5. An infant is brought to the emergency department with dehydration. Which physical assessment finding does the nurse expect?

a.	Weight gain
b.	Bradycardia
c.	Poor skin turgor
d.	Brisk capillary refill

 

 

ANS:  C

Clinical manifestations of dehydration include poor skin turgor, weight loss, lethargy, and tachycardia. The infant would have prolonged capillary refill, not brisk.

 

PTS:   1                    DIF:    Cognitive Level: Understand            REF:   767

TOP:   Integrated Process: Nursing Process: Assessment

MSC:  Area of Client Needs: Physiologic Integrity: Physiologic Adaptation