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What procedure is most appropriate for assessment of an abdominal circumference related to a bowel obstruction?
- A. Measuring the abdomen after feedings
- B. Marking the point of measurement with a pen
- C. Measuring the circumference at the symphysis pubis
- D. Using a new tape measure with each assessment to ensure accuracy
Correct Answer: B
Rationale: Marking the measurement point with a pen ensures consistent abdominal circumference assessment at the same location, typically the umbilicus. Measuring after feedings is inappropriate with NPO status, the symphysis pubis is too low, and a new tape measure is unnecessary.
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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.
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.
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.
What statement best describes Hirschsprung disease?
- A. The colon has an aganglionic segment.
- B. It results in frequent evacuation of solids, liquid, and gas.
- C. The neonate passes excessive amounts of meconium.
- D. It results in excessive peristaltic movements within the gastrointestinal tract.
Correct Answer: A
Rationale: Hirschsprung disease involves an aganglionic colon segment, causing mechanical obstruction and reduced evacuation. It leads to liquid stool leakage, not frequent evacuation, difficulty passing meconium, and decreased, not excessive, peristalsis.
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.