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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.
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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.
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 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.
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.
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.