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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.
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What statement is most descriptive of Meckel diverticulum?
- A. It is acquired during childhood.
- B. Intestinal bleeding may be mild or profuse.
- C. It occurs more frequently in females than in males.
- D. Medical interventions are usually sufficient to treat the problem.
Correct Answer: B
Rationale: Meckel diverticulum often presents with mild to profuse intestinal bleeding due to its congenital nature. It?s present at birth, not acquired, is more common in males, and typically requires surgical removal, not just medical management.
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.
The nurse is caring for a child admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation?
- A. Place in the Trendelenburg position.
- B. Apply moist heat to the abdomen.
- C. Allow the child to assume a position of comfort.
- D. Administer a saline enema to cleanse the bowel.
Correct Answer: C
Rationale: Allowing the child to assume a position of comfort, typically with legs flexed, eases abdominal pain. Trendelenburg position doesn?t help, heat or enemas increase perforation risk by stimulating bowel motility, and both are contraindicated in suspected appendicitis.
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.
When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation?
- A. Anorexia
- B. Bradycardia
- C. Sudden relief from pain
- D. Decreased abdominal distention
Correct Answer: C
Rationale: Sudden pain relief after perforation indicates peritonitis, a critical complication. Anorexia is a pre-existing appendicitis symptom, tachycardia (not bradycardia) accompanies peritonitis, and abdominal distention typically increases with perforation.