Nokea
A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?
- A. Bowel cleansing
- B. Dietary modification
- C. Structured toilet training
- D. Behavior modification
Correct Answer: A
Rationale: Initial treatment for chronic constipation involves bowel cleansing to empty the distended rectum, allowing it to return to normal size. Dietary modification follows, structured toilet training is unsuitable for a 2-year-old, and behavior modification is part of ongoing management.
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What is a high-fiber food that the nurse should recommend for a child with chronic constipation?
- A. White rice
- B. Popcorn
- C. Fruit juice
- D. Ripe bananas
Correct Answer: B
Rationale: Popcorn is a high-fiber food that helps relieve constipation. White rice is low in fiber, fruit juice lacks significant fiber, and ripe bananas have less fiber compared to raw fruits with skins or seeds.
The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?
- A. Gastrointestinal perforation may have occurred.
- B. The object may have been aspirated.
- C. The object may be lodged in the esophagus.
- D. The object may be embedded in stomach wall.
Correct Answer: C
Rationale: Esophageal obstruction from a foreign body causes gagging and drooling due to inability to swallow saliva. GI perforation causes pain and bleeding, aspiration leads to respiratory symptoms, and stomach embedding doesn?t typically cause gagging or drooling.
A toddlers mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurses response should be based on which premise?
- A. An emergency laparotomy is very likely.
- B. The location needs to be confirmed by radiographic examination.
- C. Surgery will be necessary if the battery has not passed in the stool in 48 hours.
- D. Careful observation is essential because an ingested battery cannot be accurately detected.
Correct Answer: B
Rationale: Radiographic examination is needed to confirm the battery?s location, as esophageal lodging risks acid burns, necrosis, or perforation, while stomach passage is usually benign. Surgery isn?t immediately likely, timing for intervention varies, and batteries are detectable on X-rays.
What statement best describes Hirschsprung disease?
- A. The colon has an aganglionic segment.
- B. It results in frequent evacuation of solids, liquid, and gas.
- C. The neonate passes excessive amounts of meconium.
- D. It results in excessive peristaltic movements within the gastrointestinal tract.
Correct Answer: A
Rationale: Hirschsprung disease involves an aganglionic colon segment, causing mechanical obstruction and reduced evacuation. It leads to liquid stool leakage, not frequent evacuation, difficulty passing meconium, and decreased, not excessive, peristalsis.
What information should the nurse include when teaching an adolescent with Crohn disease (CD)?
- A. How to cope with stress and adjust to chronic illness
- B. Preparation for surgical treatment and cure of CD
- C. Nutritional guidance and prevention of constipation
- D. Prevention of spread of illness to others and principles of high-fiber diet
Correct Answer: A
Rationale: Teaching stress management and coping with chronic illness helps adolescents manage Crohn disease?s variable course and complications. There?s no cure, constipation isn?t typical, CD isn?t infectious, and a low-fiber diet is recommended.