Chapter 28: The Child with a Gastrointestinal Condition

Chapter 28: The Child with a Gastrointestinal Condition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which finding in a newborn is suggestive of tracheoesophageal fistula?

a.	Failure to pass meconium in 24 hours
b.	Choking on the first feeding
c.	Palpable mass in the sternal area
d.	Visible peristalsis across abdomen

 

 

ANS:  B

After birth, a newborn with tracheoesophageal fistula will vomit and choke when the first feeding is introduced.

 

DIF:    Cognitive Level: Comprehension     REF:   Page 644        OBJ:   2

TOP:   Esophageal Atresia                          KEY:  Nursing Process Step: Data Collection

MSC:  NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

 

2. A child is brought to the pediatric clinic because he has been vomiting for the past 2 days. What acid-base imbalance would the nurse expect to occur from this persistent vomiting?

a.	Hyperkalemia
b.	Hypernatremia
c.	Acidosis
d.	Alkalosis

 

 

ANS:  D

Hydrochloric acid and sodium chloride from the stomach are lost from persistent vomiting. This results in alkalosis.

 

DIF:    Cognitive Level: Comprehension     REF:   Page 650-651 | Page 658, Table 28-5

OBJ:   9                    TOP:   Acid-Base Balance

KEY:  Nursing Process Step: Data Collection

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

3. On the second day of hospitalization for a 3-month-old brought in for treatment for gastroenteritis, the nurse makes all of the assessments listed below. Which assessment finding indicates ineffectiveness of treatment?

a.	Weight loss of 4 ounces
b.	Dry mucous membranes
c.	Decreased skin turgor
d.	Depressed fontanelle

 

 

ANS:  A

Weight loss is the most significant indicator of dehydration because an infant’s weight comprises 77% water.

 

DIF:    Cognitive Level: Application           REF:   Page 656, Table 28-2

OBJ:   9                    TOP:   Dehydration   KEY:  Nursing Process Step: Data Collection

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

4. Why are rapid respirations a possible cause of dehydration?

a.	They prevent the child from drinking.
b.	They increase circulation, thus increasing urine production.
c.	They cause evaporation of fluid on the mucous membranes.
d.	They often lead to vomiting.

 

 

ANS:  C

Rapid respirations cause increased insensible fluid loss.

 

DIF:    Cognitive Level: Comprehension     REF:   Page 656        OBJ:   9

TOP:   Dehydration   KEY:  Nursing Process Step: Data Collection

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

5. Which is the most appropriate intervention for a 3-month-old infant who has gastroesophageal reflux?

a.	Position the infant in the crib on his or her abdomen, with the head elevated.
b.	Administer medication as ordered to stimulate the pyloric sphincter.
c.	Give thin rice cereal with formula before feeding solid foods.
d.	Place the infant in an infant seat after feedings.

 

 

ANS:  A

After feedings, the infant is placed in a prone position to avoid increased intraabdominal pressure.

 

DIF:    Cognitive Level: Application           REF:   Page 651        OBJ:   7

TOP:   Gastroesophageal Reflux                 KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Basic Care and Comfort