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What information should the nurse include when teaching an adolescent with Crohn disease (CD)?
- A. How to cope with stress and adjust to chronic illness
- B. Preparation for surgical treatment and cure of CD
- C. Nutritional guidance and prevention of constipation
- D. Prevention of spread of illness to others and principles of high-fiber diet
Correct Answer: A
Rationale: Teaching stress management and coping with chronic illness helps adolescents manage Crohn disease?s variable course and complications. There?s no cure, constipation isn?t typical, CD isn?t infectious, and a low-fiber diet is recommended.
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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 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.
What statement is most descriptive of Meckel diverticulum?
- A. It is acquired during childhood.
- B. Intestinal bleeding may be mild or profuse.
- C. It occurs more frequently in females than in males.
- D. Medical interventions are usually sufficient to treat the problem.
Correct Answer: B
Rationale: Meckel diverticulum often presents with mild to profuse intestinal bleeding due to its congenital nature. It?s present at birth, not acquired, is more common in males, and typically requires surgical removal, not just medical management.
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.
A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child?
- A. It is unnecessary because of childs age.
- B. It is essential because it will be an adjustment.
- C. Preparation is not needed because the colostomy is temporary.
- D. Preparation is important because the child needs to deal with negative body image.
Correct Answer: B
Rationale: Preparing a preschooler for a colostomy using simple explanations and visual aids helps them adjust to the procedure. Preparation is necessary despite age, temporary status doesn?t negate the need, and body image concerns are less relevant at this age.