Nokea
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.
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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.
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 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.
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.
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.