Nokea
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.
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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 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.
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.
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.
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.