Nokea
A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent?
- A. Surgical therapy is indicated.
- B. Place in prone position for sleep after feeding.
- C. Thicken feedings and enlarge the nipple hole.
- D. Reduce the frequency of feeding by encouraging larger volumes of formula.
Correct Answer: C
Rationale: Thickening feedings and enlarging the nipple hole reduces emesis volume and frequency by increasing caloric density and easing feeding. Surgery is for severe cases, prone positioning risks SIDS, and smaller, frequent feedings are better than larger volumes.
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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.
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.
An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent?
- A. A low-fiber diet is required.
- B. Stress management may be helpful.
- C. Milk products are a contributing factor.
- D. Pantoprazole (a proton pump inhibitor) is effective in treatment.
Correct Answer: B
Rationale: Stress management can reduce irritable bowel syndrome symptoms by addressing its psychologic and autonomic components. A high-fiber diet is beneficial, milk products may worsen symptoms in lactose intolerance, and proton pump inhibitors are ineffective for IBS.
What test is used to screen for carbohydrate malabsorption?
- A. Stool pH
- B. Urine ketones
- C. C urea breath test
- D. ELISA stool assay
Correct Answer: A
Rationale: Stool pH below 5.0 indicates carbohydrate malabsorption due to bacterial fermentation producing short-chain fatty acids. Urine ketones detect ketosis, not malabsorption; C urea breath test identifies Helicobacter pylori; and ELISA detects antigens or antibodies, not metabolic disorders.
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.