ATI RN
Pediatric Gastrointestinal Nursing Interventions Questions
Question 1 of 5
The hallmark of refeeding syndrome is the development of severe
Correct Answer: A
Rationale: Refeeding syndrome is a potentially life-threatening condition that can occur in malnourished individuals, especially pediatric patients, when they are fed after a period of fasting or severe malnutrition. The hallmark of refeeding syndrome is the development of severe hypophosphatemia (Option A). When nutrition is reintroduced, insulin secretion is increased, leading to a shift of phosphate, potassium, and magnesium into the cells for energy metabolism and storage, resulting in decreased serum levels of these electrolytes. Option B (hypokalemia) is incorrect because although it can occur in refeeding syndrome due to intracellular shifts, it is not the hallmark or primary characteristic. Similarly, Option C (hypomagnesemia) can also occur in refeeding syndrome due to intracellular shifts, but it is not the defining feature. Option D (hypernatremia) is not typically associated with refeeding syndrome and is more commonly seen in conditions such as dehydration. In pediatric gastrointestinal nursing, understanding refeeding syndrome is crucial when managing malnourished children. Nurses need to monitor electrolyte levels closely, especially phosphate, during the refeeding process to prevent and promptly treat refeeding syndrome. Proper education and monitoring can help prevent serious complications and improve patient outcomes in pediatric gastrointestinal care.
Question 2 of 5
An 11-year-old Tanner stage 2 female experiences intermittent periumbilical abdominal pain 2 days before emergently visiting her pediatrician. Six hours later, she is nauseated and has one or two episodes of emesis. She also has had two soft bowel movements without blood or relief of symptoms. She walks cautiously into your office and lies still on your examining table. When you begin your examination, she is apprehensive and watches every move of your examining hand. You notice guarding and tenderness throughout her abdomen; the most tender area is the right lower quadrant. The most likely diagnosis is
Correct Answer: D
Rationale: The correct answer is D) Appendicitis. In this case, the patient's symptoms align with classic signs of appendicitis, such as periumbilical pain migrating to the right lower quadrant, nausea, vomiting, and tenderness upon examination. Appendicitis is a common pediatric surgical emergency that requires prompt recognition and intervention to prevent complications like perforation. A) Pelvic inflammatory disease and B) Ruptured ectopic pregnancy are less likely given the patient's age, Tanner stage, lack of sexual activity, and absence of gynecological symptoms like vaginal discharge or abnormal bleeding. C) Crohn's disease typically presents with chronic abdominal pain, diarrhea, weight loss, and other systemic symptoms, which are not evident in this acute presentation. Educationally, understanding the differential diagnosis of abdominal pain in pediatric patients is crucial for nurses to provide timely and appropriate care. Recognizing specific symptoms and signs, like those seen in appendicitis, can help nurses advocate for prompt evaluation and treatment, ultimately improving patient outcomes.
Question 3 of 5
All of the following conditions are associated with a higher incidence of inguinal hernia EXCEPT
Correct Answer: D
Rationale: The correct answer is D) Testicular feminization syndrome. Inguinal hernias are more commonly associated with conditions that involve increased intra-abdominal pressure or weakened abdominal wall musculature. Testicular feminization syndrome, also known as complete androgen insensitivity syndrome, is a genetic condition where individuals with XY chromosomes have external female genitalia and are resistant to the effects of male hormones. This syndrome does not inherently lead to increased intra-abdominal pressure or weakened abdominal walls, therefore it is not commonly associated with inguinal hernias. A) Cystic fibrosis can lead to chronic coughing and increased intra-abdominal pressure, which can predispose individuals to inguinal hernias. B) A family history of inguinal hernia may indicate a genetic predisposition or shared environmental factors that contribute to the development of inguinal hernias. C) Adrenogenital syndrome is a group of inherited disorders that can lead to hormonal imbalances and can indirectly contribute to the development of inguinal hernias. In a pediatric gastrointestinal nursing context, understanding the associations between certain conditions and inguinal hernias is crucial for early identification and intervention. Nurses need to be aware of risk factors and manifestations of inguinal hernias to provide appropriate care and support to pediatric patients. Educating families about potential risk factors and signs of hernias can help in early detection and management, thus preventing complications.
Question 4 of 5
The following might reflect physical features associated with obesity in a 10-year-old boy, EXCEPT
Correct Answer: D
Rationale: In this question, the correct answer is D) nocturia. Nocturia is not typically a physical feature directly associated with obesity in a 10-year-old boy. A) Hip pain can be a physical feature associated with obesity due to the extra weight putting strain on the joints. B) Delayed sleep can be linked to obesity in children due to various factors like sleep apnea or discomfort from excess weight. C) Polyuria, or increased urination, can be a symptom of conditions related to obesity like diabetes or hormonal imbalances. Educationally, understanding the physical features associated with obesity in pediatric patients is crucial for nurses to provide comprehensive care. By recognizing these signs, nurses can intervene early, promote healthy habits, and prevent further complications related to obesity in children. This knowledge helps in developing tailored nursing interventions and promoting overall well-being in pediatric patients.
Question 5 of 5
The following are characteristic features of acute hypervitaminosis A EXCEPT
Correct Answer: D
Rationale: In the context of pediatric gastrointestinal nursing interventions, understanding the characteristic features of acute hypervitaminosis A is crucial for providing safe and effective care to pediatric patients. In this case, the correct answer is D) nausea and vomiting. The correct answer is right because nausea and vomiting are not typically associated with acute hypervitaminosis A. Acute hypervitaminosis A is more commonly linked to symptoms such as diplopia (double vision), cranial nerve palsies, and seizures. These symptoms arise due to the toxic effects of excessive vitamin A levels in the body, which can lead to neurological complications and visual disturbances. Option A) diplopia and B) cranial nerve palsies are characteristic features of acute hypervitaminosis A. Diplopia occurs because of the impact of vitamin A toxicity on the optic nerve, leading to visual disturbances. Cranial nerve palsies can also result from the neurological effects of excessive vitamin A. Option C) seizures are another characteristic feature of acute hypervitaminosis A. High levels of vitamin A can disrupt the normal functioning of the central nervous system, potentially triggering seizure activity in affected individuals. Educationally, understanding the symptoms and complications of acute hypervitaminosis A is essential for nurses caring for pediatric patients who may be at risk of vitamin A toxicity. By recognizing these characteristic features, nurses can promptly identify potential cases of hypervitaminosis A, initiate appropriate interventions, and prevent further harm to pediatric patients.