Pediatric Nursing: Gastrointestinal Disorders NCLEX Practice Quiz (15 Questions)

Gastrointestinal Disorders .This nursing exam covers the gastrointestinal disorders among infants, children, and the main role of pediatric nurses.

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Pediatric Nursing: Gastrointestinal Disorders

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Pediatric Nursing: Gastrointestinal Disorders

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1. Dustin who was diagnosed with Hirschsprung’s disease has a fever and watery explosive diarrhea. Which of the following would Nurse Joyce do first?

A. Administer an antidiarrheal.
B. Notify the physician immediately.
C. Monitor the child every 30 minutes.
D. Nothing. (These findings are common in Hirschsprung’s disease.)

2. Nurse Nancy is assessing a child with pyloric stenosis; she is likely to note which of the following?

A. “Currant jelly” stools
B. Regurgitation
C. Steatorrhea
D. Projectile vomiting

3. An 11-year-old girl with celiac disease was discharged from the hospital. An appropriate teaching was carried out by the nurse if the parents are aware of avoiding which of the following?

A. Chicken
B. Wheat
C. Milk
D. Rice

4. Which of the following applies to the defect emerging from residual peritoneal fluid confined within the lower segment of the processus vaginalis?

A. Inguinal hernia
B. Incarcerated hernia
C. Communicating hydrocele
D. Noncommunicating hydrocele

5. Baby Jonathan was born with cleft lip (CL); Nurse Barbara would be alert that which of the following will most likely be compromised?

A. GI function
B. Locomotion
C. Sucking ability
D. Respiratory status

6. Will is being assessed by Nurse Lucas for possible intussusception; which of the following would be least likely to provide valuable information?

A. Abdominal palpation
B. Family history
C. Pain pattern
D. Stool inspection

7. Mr. and Ms. Byers’ child failed to pass meconium within the first 24 hours after birth; this may indicate which of the following?

A. Celiac disease
B. Intussusception
C. Hirschsprung’s disease
D. Abdominal-wall defect

8. Which of the following parameters would Nurse Max monitor to evaluate the effectiveness of thickened feedings for an infant with gastroesophageL REFLUX (GER)?

A. Urine
B. Vomiting
C. Weight
D. Stools

9. Baby Ellie is diagnosed with gastroesophageal reflux (GER); which of the following nursing diagnoses would be inappropriate?

A. Risk for aspiration
B. Impaired oral mucous membrane
C. Deficient fluid volume
D. Imbalanced nutrition: Less than body requirements

10. Steve is diagnosed with celiac disease and experiences celiac crisis secondary to upper respiratory tract infection; which of the following would Nurse Nancy expect to assess?

A. Lethargy
B. Weight gain
C. Respiratory distress
D. Watery diarrhea

11. Nurse Karen is providing postoperative care for Dustin who has cleft palate (CP); she should position the child in which of the following?

A. In an infant seat
B. In the supine position
C. In the prone position
D. On his side

12. Nurse Joyce is assessing a child’s cultural background, she should keep in mind that:

A. Cultural background usually has little bearing on a family’s health practices
B. Physical characteristics mark the child as part of a particular culture
C. Heritage dictates a group’s shared values
D. Behavioral patterns are passed from one generation to the next

13. In pediatric gastroesophageal reflux disease (GERD), the immaturity of lower esophageal sphincter function is manifested by frequent transient lower esophageal relaxations, which result in retrograde flow of gastric contents into the esophagus. Which statement about the esophagus is TRUE? Select all that apply.

A. It is a cartilaginous tube.
B. It has upper and lower sphincters.
C. It lies anterior to the trachea.
D. It extends from the nasal cavity to the stomach.
E. All statements describe the esophagus.

14. Mrs. Byers tells the nurse that she is very worried because her 2-year old child does not finish his meals. What should the nurse advise the mother?

A. Make the child seat with the family in the dining room until he finishes his meal
B. Provide quiet environment for the child before meals
C. Do not give snacks to the child before meals
D. Put the child on a chair and feed him

15. Nurse Lonnie is aware that the most common assessment finding in a child with ulcerative colitis is:

A. Intense abdominal cramps
B. Profuse diarrhea
C. Anal fissures
D. Abdominal distention

Answers and Rationale

1. Answer: B. Notify the physician immediately.

  • B: For the child with Hirschsprung’s disease, fever and explosive diarrhea indicate enterocolitis, a life-threatening situation. Therefore, the physician should be notified directly.
  • A: Generally, because of the intestinal obstruction and inadequate propulsive intestinal movement, antidiarrheals are not used to treat Hirschsprung’s disease.
  • C: The child is acutely ill and requires intervention, with monitoring more frequently than every 30 minutes.
  • D: Hirschsprung’s disease typically presents with chronic constipation.

2. Answer: D. Projectile vomiting

  • D: Projectile vomiting is a key sign of pyloric stenosis.
  • B: Regurgitation is seen more commonly with gastroesophageal reflux.
  • C: Steatorrhea occurs in malabsorption disorders such as celiac disease.
  • A: “Currant jelly” stools are characteristic of intussusception.

3. Answer: B. Wheat

  • B: Children with celiac disease cannot tolerate or digest gluten. Therefore, because of its gluten content, wheat and wheat-containing products must be avoided.
  • A,C,D: Rice, milk, and chicken do not contain gluten and need not be avoided.

4. Answer: D. Noncommunicating hydrocele

  • D: With a noncommunicating hydrocele, most commonly seen at birth, residual peritoneal fluid is trapped within lower segment of the processus vaginalis (the tunica vaginalis). There is no communication with the peritoneal cavity and the fluid usually is absorbed during the first months after birth.
  • A: An inguinal hernia arises from the incomplete closure of the processus vaginalis leading to the descent of an intestinal portion.
  • B: Incarceration occurs when the hernia becomes tightly caught in the hernia sac.
  • C: A communicating hydrocele usually is associated with an inguinal hernia because the processus vaginalis remains open from the scrotum to the abdominal cavity.

5. Answer: C. Sucking ability

  • C: Because of the defect, the child will be unable to form mouth adequately around the nipple, thereby requiring special devices to allow for feeding and sucking gratification.
  • A: GI functioning is not compromised in the child with a CL.
  • B: Locomotion would be a problem for older infant because of the use of restraints.
  • D: Respiratory status may be compromised if the child is fed improperly during post-operative period.

6. Answer: B. Family history

  • B: Because intussusception is not believed to have familial tendency, obtaining a family history would provide the least amount of information.
  • A,C,D: Stool inspection, pain pattern, and abdominal palpation would reveal possible indicators of intussusception. “Currant jelly” stools, containing blood and mucus, are an indication of intussusception. Acute, episodic abdominal pain is characteristic of intussusception. A sausage-shaped mass may be palpated in the right upper quadrant.

7. Answer: C. Hirschsprung’s disease

  • C: Failure to pass meconium within the first 24 hours after birth may be a sign of Hirschsprung’s disease, a congenital anomaly resulting in mechanical obstruction due to weak motility in an intestinal segment.
  • A,B,D: Failure to pass meconium is not connected with celiac disease, intussusception, or abdominal-wall defect.

8. Answer: B. Vomiting

  • B: Thickened feedings are used with GERto stop the vomiting. Therefore, the nurse would monitor the child’s vomiting to evaluate the effectiveness of using the thickened feedings.
  • A,D: No relationship exists between feedings and characteristics of stools and urine.
  • C: If feedings are ineffective, this should be noted before there is any change in the child’s weight.

9. Answer: B. Impaired oral mucous membrane

  • B: GER is the backflow of gastric contents into the esophagus resulting from relaxation or incompetence of the lower-esophageal (cardiac) sphincter. No alteration in the oral mucous membranes occurs with this disorder.
  • A,C,D: Fluid volume deficit, risk for aspiration, and imbalanced nutrition are appropriate nursing diagnoses.

10. Answer: D. Watery diarrhea

  • D: Episodes of celiac crises are precipitated by infections, ingestion of gluten, prolonged fasting, or exposure to anticholinergics. Celiac crisis is typically characterized by severe watery diarrhea.
  • A: Irritability, rather than lethargy, is more likely.
  • B: Because of the fluid loss associated with the severe watery diarrhea, the child’s weight is more likely to be decreased.
  • C: Respiratory distress is unlikely in a routine upper respiratory tract infection.

11. Answer: C. In the prone position

  • C: Postoperatively, children with a CP should be placed on their abdomens to facilitate drainage.
  • A: Using an infant seat does not facilitate drainage.
  • B: If the child is placed int he supine position, aspiration is a concern.
  • D: Side-lying does not facilitate drainage as well as the prone position.

12. Answer: D. Behavioral patterns are passed from one generation to the next

  • D: A family’s behavioral patterns and values are passed from one generation to the next.
  • A: Cultural background commonly plays a major role in determining a family’s health practices.
  • B: Physical characteristics do not indicate a child’s culture.
  • C: Although heritage plays a role in culture, it does not dictate a group’s shared values and its effect on culture is weaker than that of behavioral patterns.

13. Answer: B. It has upper and lower sphincters.

  • B: Upper and lower esophageal sphincters, located at the upper and lower ends of the esophagus, respectively, regulate the movement of food into and out of the esophagus.
  • A: The esophagus is a muscular tube, lined with moist stratified squamous epithelium.
  • C: It lies anterior to the vertebrae and posterior to the trachea within the mediastinum.
  • D: It extends from the pharynx to the stomach. It is about 25 centimeters (cm) long.

14. Answer: Answer C. do not give snacks to the child before meals

  • C: If the child is hungry he/she more likely would finish his meals. Therefore, the mother should be advised not to give snacks to the child. The child is a “busy toddler.” He/she will not able to keep still for a long time.

15. Answer: B. Profuse diarrhea

  • B: Ulcerative colitis causes profuse diarrhea.
  • A,C,D: Intense abdominal cramps, anal fissures, and abdominal distensions are more common in Crohn’s disease.

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