Nokea
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.
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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.
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.
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.
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.
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.