Nokea
A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child?
- A. It is unnecessary because of childs age.
- B. It is essential because it will be an adjustment.
- C. Preparation is not needed because the colostomy is temporary.
- D. Preparation is important because the child needs to deal with negative body image.
Correct Answer: B
Rationale: Preparing a preschooler for a colostomy using simple explanations and visual aids helps them adjust to the procedure. Preparation is necessary despite age, temporary status doesn?t negate the need, and body image concerns are less relevant at this age.
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One of the major differences in clinical presentation between Crohn disease (CD) and ulcerative colitis (UC) is that UC is more likely to cause which clinical manifestation?
- A. Pain
- B. Rectal bleeding
- C. Perianal lesions
- D. Growth retardation
Correct Answer: B
Rationale: Rectal bleeding is more common in ulcerative colitis due to its exclusive involvement of the colon and rectum. Pain, perianal lesions, and growth retardation are more characteristic of Crohn disease, which can affect any part of the GI tract.
A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube?
- A. Prevent spread of infection.
- B. Monitor electrolyte balance.
- C. Prevent abdominal distention.
- D. Maintain accurate record of output.
Correct Answer: C
Rationale: The NG tube prevents abdominal distention by suctioning gastrointestinal secretions. It doesn?t prevent infection, electrolyte monitoring is secondary, and while output records are important, the primary purpose is distention prevention.
A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication?
- A. Hyperkalemia
- B. Hyperchloremia
- C. Metabolic acidosis
- D. Metabolic alkalosis
Correct Answer: D
Rationale: Excessive vomiting in pyloric stenosis leads to metabolic alkalosis due to loss of hydrogen ions. Potassium and chloride levels decrease, and acidosis is not typically associated with this condition.
Nutritional management of the child with Crohn disease includes a diet that has which component?
- A. High fiber
- B. Increased protein
- C. Reduced calories
- D. Herbal supplements
Correct Answer: B
Rationale: Increased protein in the diet supports healing and addresses growth failure in Crohn disease. High-fiber diets may cause obstruction, high-calorie diets are needed, and herbal supplements are not recommended without practitioner approval.
What clinical manifestation should be the most suggestive of acute appendicitis?
- A. Rebound tenderness
- B. Bright red or dark red rectal bleeding
- C. Abdominal pain that is relieved by eating
- D. Colicky, cramping, abdominal pain around the umbilicus
Correct Answer: D
Rationale: Colicky, periumbilical pain that becomes constant and may shift to the right lower quadrant is the hallmark of acute appendicitis. Rebound tenderness is unreliable and painful, bleeding is not typical, and pain relieved by eating is not associated with appendicitis.