Nokea
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.
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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.
After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time?
- A. Notify the practitioner.
- B. Insert the NG tube so feedings can be given.
- C. Replace the NG tube to maintain gastric decompression.
- D. Leave the NG tube out because it has probably been in long enough.
Correct Answer: A
Rationale: Notifying the practitioner is critical, as replacing an NG tube after upper GI surgery risks injury to the surgical site and requires surgical team evaluation. Inserting or replacing the tube independently or assuming it?s no longer needed bypasses necessary medical oversight.
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.
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 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.