ATI RN
Gastrointestinal Assessment in Pediatrics Questions
Question 1 of 5
Hirschsprung disease has been seen in association with the following EXCEPT
Correct Answer: A
Rationale: Rationale: Hirschsprung disease is a congenital condition characterized by the absence of nerve cells in the wall of the colon, leading to difficulty passing stool. The correct answer is A) microcephaly, as it is not typically associated with Hirschsprung disease. B) Mental retardation is not a recognized feature of Hirschsprung disease. While children with this condition may face developmental delays due to complications like chronic constipation, it is not synonymous with mental retardation. C) Autism is a neurodevelopmental disorder that is not directly linked to Hirschsprung disease, as they are distinct conditions with different etiologies and manifestations. D) Cleft lip is also not commonly associated with Hirschsprung disease. Cleft lip is a facial malformation that occurs during fetal development and is not related to the colon's nerve cell absence in Hirschsprung disease. Educationally, understanding the associations of Hirschsprung disease is crucial for healthcare providers working with pediatric patients. Recognizing the symptoms and related conditions aids in early diagnosis and appropriate management. This question highlights the need for healthcare professionals to have a comprehensive understanding of pediatric gastrointestinal disorders to provide optimal care and support for affected children and their families.
Question 2 of 5
A child is diagnosed with chronic constipation that has been unresponsive to dietary and activity changes. Which pharmacological measure is most appropriate?
Correct Answer: C
Rationale: In pediatric patients with chronic constipation unresponsive to dietary and activity changes, the most appropriate pharmacological measure is option C) Osmotic agent (stool softener). The rationale behind choosing an osmotic agent is that it helps to soften the stool by drawing water into the intestines, making it easier for the child to pass stools. This is particularly beneficial in cases of chronic constipation where stool hardening is a common issue. Osmotic agents are considered safe and effective for pediatric use, especially when other measures have not yielded the desired results. Option A) Natural supplements and herbs may not provide the necessary efficacy and consistency required for managing chronic constipation in pediatric patients. Stimulant laxatives (Option B) can be harsh on the intestines and are generally not recommended for long-term use in children. Option D) stating that pharmacological measures are not used in pediatric constipation is incorrect as there are safe and effective pharmacological options available for managing chronic constipation in children under medical supervision. Educationally, it is important to understand the pharmacological options available for managing pediatric gastrointestinal issues like chronic constipation. Knowing the appropriate use of osmotic agents in such cases can help healthcare providers make informed decisions to optimize patient care and outcomes. It is essential to consider factors like safety, efficacy, and age-appropriate dosing when selecting pharmacological interventions for pediatric patients with gastrointestinal disorders.
Question 3 of 5
The nurse is caring for a 1-month-old term infant who experienced an anoxic episode at birth. The health-care team suspects that the infant is developing necrotizing enterocolitis (NEC). Which would the nurse expect to be included in the plan of care?
Correct Answer: C
Rationale: In this scenario, the correct answer is C) Prepare to administer antibiotics intravenously. Necrotizing enterocolitis (NEC) is a serious condition that involves inflammation and damage to the intestinal tissue, often seen in premature infants or those with perinatal stress like an anoxic episode. Antibiotics are a crucial part of the treatment for NEC to address the bacterial overgrowth and prevent further complications. Option A is incorrect because removing the feeding nasogastric tube (NGT) without addressing the underlying issue of NEC would not be beneficial. Option B, obtaining vital signs every 4 hours, is important but not the priority in a suspected case of NEC where prompt treatment is crucial. Option D, changing feedings to half-strength and administering slowly, is not the immediate intervention needed for NEC. From an educational standpoint, understanding the importance of early recognition and intervention in NEC is vital for pediatric nurses. Recognizing the signs and symptoms of NEC, such as abdominal distention, bloody stools, and feeding intolerance, and knowing the appropriate actions to take, including initiating antibiotic therapy, can significantly impact patient outcomes in infants at risk for this condition.
Question 4 of 5
The nurse is caring for a 3-year-old who had an appendectomy 2 days ago. The child has a fever of 101.8°F (38.8°C) and slightly diminished breath sounds in the right lower lobe. Which action is most appropriate?
Correct Answer: B
Rationale: In this scenario, the most appropriate action is option B: Encourage the child to blow bubbles. This is the correct choice because the child is showing signs of atelectasis, which is a common complication post-appendectomy due to shallow breathing. Blowing bubbles can help improve lung expansion and prevent atelectasis by encouraging deep breathing and coughing. Option A is incorrect because teaching the child how to use an incentive spirometer may be too advanced for a 3-year-old and may not be as effective in promoting deep breathing as blowing bubbles. Option C is incorrect because obtaining an order for intravenous antibiotics is not indicated based solely on the child's symptoms of fever and diminished breath sounds. Antibiotics should be prescribed based on a confirmed diagnosis of infection. Option D is incorrect as administering Tylenol may help with fever management, but it does not address the underlying issue of atelectasis. In an educational context, it is crucial for nurses caring for pediatric patients to understand the importance of respiratory assessment and interventions to prevent complications like atelectasis. Teaching appropriate techniques like blowing bubbles can be a fun and effective way to promote respiratory function in young children post-surgery.
Question 5 of 5
The nurse is caring for a 7-week-old scheduled for a pyloromyotomy in 24 hours. Which would the nurse expect to find in the plan of care?
Correct Answer: B
Rationale: The correct answer is B) Keep infant NPO; begin intravenous fluids at maintenance; place a nasogastric tube (NGT) to low wall suction. Rationale: - Keeping the infant NPO (nothing by mouth) is crucial to prevent aspiration and reduce the risk of complications during the surgery. - Beginning intravenous fluids at maintenance helps maintain hydration and electrolyte balance in preparation for the procedure. - Placing a nasogastric tube (NGT) to low wall suction helps decompress the stomach, reducing the risk of vomiting and aspiration during and after the surgery. Why the other options are wrong: - Option A is incorrect because it does not address the need for gastric decompression, which is essential in this situation. - Option C is incorrect as obtaining serum electrolytes alone does not address the immediate preoperative management required for a pyloromyotomy. - Option D is incorrect as offering small frequent feedings to an infant scheduled for pyloromyotomy increases the risk of aspiration and complications during surgery. Educational context: Understanding the preoperative care required for infants undergoing pyloromyotomy is essential for pediatric nurses. This scenario highlights the importance of maintaining NPO status, providing intravenous fluids, and using NGT for gastric decompression to ensure a safe surgical outcome for the infant.