ATI RN
Gastrointestinal Assessment in Pediatrics Questions
Question 1 of 5
Regarding bezoars, all the following are true EXCEPT
Correct Answer: B
Rationale: In this case, option B is the correct answer. Phytobezoars are not composed of a combination of plant and animal material, but rather only plant material. Trichobezoars are indeed composed of the patient's own hair, making option A true. Lactobezoars can resolve when feedings are withheld for 24-48 hours, as mentioned in option C. Sunflower seed bezoars have been reported to cause small bowel obstruction, making option D accurate. Educationally, understanding different types of bezoars is crucial for healthcare providers when assessing pediatric gastrointestinal issues. Trichobezoars are commonly seen in individuals with trichotillomania or trichophagia, highlighting the importance of mental health considerations in pediatric care. Lactobezoars are typically found in premature infants and can impact feeding and digestion. Sunflower seed bezoars serve as a reminder of the potential risks associated with certain dietary habits. By knowing these distinctions, healthcare professionals can provide more targeted care and interventions for pediatric patients with gastrointestinal concerns.
Question 2 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 3 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 4 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.
Question 5 of 5
The nurse is caring for a newborn with an anorectal malformation and a colostomy. The nurse knows that more education is needed when the infant's parent states which of the following?
Correct Answer: D
Rationale: The correct answer is D) As my baby grows, a pattern will develop over time, and there should be predictable bowel movements. This statement is inaccurate because infants with anorectal malformations and colostomies typically do not have predictable bowel movements due to the nature of their condition. It is important for parents to understand that bowel patterns may vary, and they should not expect a consistent schedule. Option A is incorrect because the stoma should be pink or red, indicating good blood flow. Option B is incorrect as some discharge and irritation around the stoma can be normal and should be managed appropriately. Option C is incorrect as it is important to allow some air exposure to the stoma to promote healing and prevent skin breakdown. In an educational context, it is crucial for nurses to provide accurate information to parents of infants with anorectal malformations and colostomies to ensure proper care and management of the stoma. Understanding the nuances of stoma care and bowel patterns can help parents effectively care for their child and prevent complications.