ATI RN
Pediatric GI Disorders Test Bank Questions Questions
Question 1 of 5
In the reductive adaptation process of evolution to a state of full malnutrition, all the following events will be ensued EXCEPT
Correct Answer: D
Rationale: The correct answer is D) reduced responses to infection. In the reductive adaptation process of evolution to a state of full malnutrition, the body prioritizes essential functions to survive. This includes conserving energy and resources by reducing non-essential processes. The liver making glucose less readily (option A) is a mechanism to conserve energy as glucose is an energy-intensive molecule to produce. Less heat production (option B) is another way the body conserves energy in response to malnutrition. The gut producing less gastric acid and gut enzymes (option C) is a way to reduce energy expenditure on digestion. Educational Context: In pediatric GI disorders, understanding the body's adaptations to malnutrition is crucial for managing and treating patients. This question highlights the physiological responses to full malnutrition and how the body prioritizes essential functions. By grasping these concepts, healthcare providers can better care for pediatric patients with GI disorders and tailor treatment plans to support the body's adaptive mechanisms during malnutrition.
Question 2 of 5
Encephalopathy in refeeding syndrome is mainly a result of
Correct Answer: A
Rationale: In the context of pediatric GI disorders, understanding the pathophysiology of refeeding syndrome is crucial for providing effective care to patients. In this case, encephalopathy in refeeding syndrome is mainly a result of hypophosphatemia. Hypophosphatemia occurs due to a rapid shift of phosphate into cells during refeeding, leading to decreased serum levels. This drop in phosphate levels can result in neurological complications such as encephalopathy due to its essential role in cellular energy production and neurotransmitter function. Hypokalemia (Option B) and hypomagnesemia (Option C) are common electrolyte imbalances in refeeding syndrome; however, they are not primarily responsible for the development of encephalopathy. Thiamine deficiency (Option D) can cause Wernicke's encephalopathy but is not the main mechanism in refeeding syndrome-related encephalopathy. Educationally, understanding the specific contributions of electrolyte imbalances to complications like encephalopathy in refeeding syndrome is vital for healthcare providers managing pediatric patients with GI disorders. This knowledge informs appropriate monitoring, prevention strategies, and timely interventions to optimize patient outcomes.
Question 3 of 5
A 16-year-old female with a past history of hypothyroidism now manifests fever, anorexia, amenorrhea, and jaundice of 4 months' duration. Her direct bilirubin level is 6 mg/dL, and her total bilirubin value is 11 mg/dL. Results of the tests for hepatitis A, B, and C are negative, and her serum IgG level is 16.5 g/L. The most likely diagnosis is
Correct Answer: B
Rationale: The correct answer is B) Chronic active hepatitis. This diagnosis is supported by the patient's symptoms of fever, anorexia, amenorrhea, jaundice, elevated direct and total bilirubin levels, and a negative hepatitis panel. Chronic active hepatitis is a liver condition characterized by ongoing inflammation and damage to the liver, leading to symptoms such as jaundice and liver dysfunction. Option A) Mononucleosis is unlikely in this case as the symptoms and lab results are more indicative of a liver disorder rather than a viral infection like mononucleosis. Option C) α-antitrypsin deficiency typically presents with respiratory symptoms and liver disease in childhood, which do not align with the patient's current presentation. Option D) Wilson disease is characterized by copper accumulation in the liver and other organs, leading to symptoms such as liver dysfunction and neurological issues. However, the absence of Kayser-Fleischer rings and a low ceruloplasmin level make Wilson disease less likely in this scenario. Educationally, understanding the differentiation between various liver disorders is crucial for healthcare providers to accurately diagnose and manage patients presenting with liver-related symptoms. In this case, recognizing the clinical presentation and interpreting the lab results are essential for selecting the most appropriate diagnosis and treatment plan for the patient.
Question 4 of 5
A 2-year-old female was well until 12 hours ago, when lethargy, vomiting, and intermittent crying episodes began during which she appears to be in pain. During these painful episodes, she draws her legs up to her abdomen. In the office, she passes a maroon-colored stool and has a slightly tender but full abdomen. The most likely diagnosis is
Correct Answer: D
Rationale: The correct answer is D) Intussusception. Intussusception is a common cause of intestinal obstruction in young children, characterized by the telescoping of one segment of the intestine into another. The symptoms described in the scenario, such as intermittent crying, drawing legs to abdomen, maroon-colored stool (indicative of blood in stool), and a tender abdomen, are classic signs of intussusception. Option A) Pyloric stenosis typically presents with projectile vomiting in the first few weeks of life, not with the symptoms described in the case of a 2-year-old. Option B) Appendicitis usually presents with right lower quadrant abdominal pain and is uncommon in children under 5 years of age. Option C) Urinary tract infection does not typically present with the symptoms described and is less likely in a child with a tender, full abdomen and bloody stool. Educationally, understanding the distinguishing features of pediatric GI disorders is crucial for healthcare providers to make accurate diagnoses and provide timely treatment. Recognizing the unique clinical presentations of conditions like intussusception is essential to prevent complications and improve patient outcomes.
Question 5 of 5
An asymptomatic 2-year-old swallowed a hearing aid battery 4 hours previously. A radiograph at 11:00 p.m. located it in the upper third of the esophagus. The most appropriate next step is to
Correct Answer: D
Rationale: The correct answer is D) Schedule immediate esophagoscopy to retrieve the battery. In the case of a foreign body, especially a battery, lodged in the esophagus, immediate removal is crucial to prevent serious complications like tissue damage, perforation, or obstruction. This is a pediatric emergency that requires prompt intervention to prevent harm and ensure the child's safety. Option A is incorrect because waiting for 24 hours may lead to complications in this scenario. Option B is not the best choice as delaying removal until the next morning could increase the risk of complications. Option C is also incorrect as there is a risk of tissue damage if the battery remains in the esophagus for an extended period. This question highlights the importance of prompt action in pediatric emergencies involving foreign body ingestion. It underscores the significance of quick decision-making and intervention in preventing potential harm to young patients. Understanding the urgency of situations like these is crucial for healthcare providers working with pediatric populations.