ATI RN
Pediatric Gastrointestinal Disorders NCLEX Questions Questions
Question 1 of 5
The nurse is administering Prilosec (omeprazole) to a 3-month-old with gastro-esophageal reflux (GER). The child's parents ask the nurse how the medication works. Select the nurse's best response.
Correct Answer: A
Rationale: The correct answer is A) Prilosec is a proton pump inhibitor that decreases stomach acid production, thereby reducing reflux irritation. This response is accurate because Prilosec works by inhibiting the proton pump in the stomach's cells, which reduces the production of acid. By decreasing stomach acid levels, Prilosec helps to alleviate the symptoms of GER in infants by reducing the irritation to the esophagus. Option B) is incorrect because it oversimplifies the mechanism of action by only focusing on the reduction of stomach acid without explaining how it helps with reflux irritation. Option C) is incorrect as Prilosec does not affect the speed at which food moves through the stomach but rather reduces acid production. Option D) is incorrect because Prilosec does not directly affect the lower esophageal sphincter's pressure. Educationally, understanding the mechanism of action of medications is crucial for nurses to provide accurate information to parents and ensure safe medication administration. By knowing how Prilosec works, nurses can better educate parents on the rationale behind the treatment and set appropriate expectations for its effectiveness in managing GER symptoms in infants.
Question 2 of 5
The nurse is caring for a 5-year-old who has just returned from an appendectomy. Which is the optimal way to manage pain?
Correct Answer: C
Rationale: The optimal way to manage pain for a 5-year-old post-appendectomy is by administering morphine through a PCA pump (Option C). This method allows for precise dosing based on the child's individual needs and pain levels, providing effective pain relief while minimizing the risk of overdose or underdosing. Liquid Tylenol with codeine (Option B) may not provide adequate pain control for post-appendectomy pain in a child, as the pain intensity may require stronger analgesia. Intravenous morphine as needed (Option A) and intramuscular morphine as needed (Option D) are less preferable than a PCA pump because they do not offer the same level of controlled, continuous pain management tailored to the child's specific pain requirements. Educationally, it is important to understand the principles of pediatric pain management, including the use of age-appropriate pain assessment tools and individualized treatment plans. Using a PCA pump in pediatric patients allows for titration of medication to achieve optimal pain control while minimizing adverse effects, empowering children to have some control over their pain management within safe parameters.
Question 3 of 5
The nurse is caring for a newborn with a cleft lip and palate. The mother states, 'I will not be able to breastfeed my baby.' Select the nurse's best response.
Correct Answer: C
Rationale: The best response for the nurse in this scenario is option C: "Although breastfeeding may be challenging, some mothers are able to breastfeed their infants with a cleft lip and palate. Let's discuss your options." This response is the most supportive and informative. It acknowledges the mother's concerns while also providing hope and encouragement. Option A is not the best response because it focuses more on the emotional aspect and does not provide accurate information or support. Option B is not ideal as it lacks reassurance and guidance, simply offering more information without addressing the mother's feelings. Option D is incorrect because it provides misleading information. While breastfeeding a baby with a cleft lip and palate can be challenging, it is still a viable option with proper support and guidance. In an educational context, it is crucial for nurses to provide accurate information, support, and encouragement to parents facing challenges such as caring for a newborn with a cleft lip and palate. Understanding the nuances of breastfeeding in this situation and being able to guide parents effectively can make a significant difference in their confidence and ability to care for their child.
Question 4 of 5
The nurse is caring for an infant diagnosed with Hirschsprung disease. The mother states she is pregnant with a boy and wants to know if her new baby will likely have the disorder. Select the nurse's best response.
Correct Answer: A
Rationale: In this scenario, the nurse's best response is option A) "Genetics play a small role in Hirschsprung disease, so there is a chance the baby will develop it as well." This response is accurate because Hirschsprung disease has been associated with genetic factors, specifically mutations in certain genes that are involved in the development of nerve cells in the intestine. While genetics are not the sole determinant, they do play a role in predisposing individuals to this condition. Option B) "There is no evidence to support a genetic link, so it is very unlikely the baby will also have it," is incorrect because there is indeed evidence supporting a genetic component in the development of Hirschsprung disease, as mentioned earlier. Option C) "It is rarely seen in boys, so it is not likely your new baby will have Hirschsprung disease," is also incorrect. While the condition may be more common in males, it can still affect females and is not exclusive to one gender. Option D) "Hirschsprung disease is seen only in girls, so your new baby will not be at risk," is incorrect as well, as Hirschsprung disease can affect both males and females. Educationally, this question highlights the importance of understanding the genetic component of certain diseases and the need for accurate information when addressing patient concerns. It also emphasizes the role of nurses in providing evidence-based explanations to patients and families, helping them make informed decisions about their health and the health of their children.
Question 5 of 5
The nurse is giving discharge instructions to the parent of a 1-month-old infant with tracheoesophageal fistula and a gastrostomy tube (GT). The nurse knows the mother understands the discharge teaching when she states:
Correct Answer: B
Rationale: The correct answer is B) "I will flush the GT with 2 ounces of water after each feeding to prevent it from clogging." This answer is correct because flushing the gastrostomy tube (GT) with water after feedings helps prevent clogging and ensures proper functioning of the tube, which is essential for delivering nutrition to the infant. Option A is incorrect because liquid medications should be administered through the GT to ensure proper delivery and absorption, rather than placing them in the corner of the mouth. Option C is incorrect as cleaning the area around the GT with soap and water every day may increase the risk of infection. The focus should be on maintaining cleanliness and proper care of the GT itself. Option D is incorrect because petroleum jelly should not be used around the GT if redness develops. It is important to consult healthcare providers for proper assessment and management of any skin issues around the GT. In an educational context, understanding the correct care and maintenance of a gastrostomy tube is crucial for parents and caregivers of infants with tracheoesophageal fistula. Proper education and demonstration of these care techniques by healthcare providers can help ensure the well-being and safety of the infant.