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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.
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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.
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.
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.
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 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.