Nokea
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.
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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.
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.
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.
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.
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.