PEDIATRICS 51 - 52 GI GU EXAM
QUESTIONS WITH NEW UPDATE
SOLUTIONS
/.A nurse is caring for an 11-month-old infant admitted for watery, green diarrhea;
vomiting; and fever. He is diagnosed with gastroenteritis with no known source at this
time. Which nursing diagnosis should be the highest priority?
a. Altered Nutrition
b. Anxiety related to hospitalization
c. Fluid Volume and Electrolyte Imbalance
d. Altered Family Coping - Answer-✅Answer: c. Fluid Volume and Electrolyte
Imbalance
Feedback: Fluid and electrolyte imbalance is a safety issue and a potentially life-
threatening event. Although all of the diagnoses should be addressed, this takes
precedence.
/.Which intervention would the nurse include in the care of an infant following surgical
repair of a cleft lip?
a. Let the infant touch the suture lines as a means of self-comforting.
b. Position the infant in the supine position for feedings to avoid aspiration.
c. Administer pain medications as ordered.
d. Use a special feeding device with shorter nipples. - Answer-✅Answer: c. Administer
pain medications as ordered.
Feedback: Special feeding devices with long nipples usually are used, and the infant is
fed in the sitting position to avoid aspiration. Some soft restraints may be used to
prevent the infant from touching the suture line.
/.Which assessment finding would lead the nurse to suspect esophageal atresia in an
infant?
a. Hypotonicity
b. Excessive crying
c. Abdominal distention
d. Excessive drooling - Answer-✅Answer: d. Excessive drooling
,Feedback: The classic symptoms in an infant with esophageal atresia are excessive
drooling often accompanied by cyanosis, choking, and coughing. Low blood pressure,
excessive crying, and hypotonicity are not common signs of esophageal atresia.
/.Which client would the nurse suspect to have pyloric stenosis?
a. A 7-month-old with choking episodes
b. An 11-year-old with an olive-shaped abdominal mass
c. A 5-week-old infant with projectile vomiting
d. A 2-year-old with a harsh cough - Answer-✅Answer: c. A 5-week-old infant with
projectile vomiting
Feedback: The most likely incidence of pyloric stenosis is in a 2- to 8-week-old infant.
The common symptoms are nonbilious projectile vomiting, irritability, and failure to gain
weight.
/.A nurse is discharging an infant after a pyloric stenosis repair. Which statement by the
mother would indicate the need for further instructions prior to discharge?
a. "I should call the doctor if my infant's temperature rises above 101 degrees."
b. "I should fold the diaper down so it does not irritate the incision."
c. "My infant's incision will need to be observed for redness, swelling, or discharge."
d. "If my infant vomits, I should hold feedings for 6 hours." - Answer-✅Answer: d. "If my
infant vomits, I should hold feedings for 6 hours."
Feedback: It is normal for an infant to vomit occasionally after having surgery for pyloric
stenosis. The infant should be fed on a normal feeding schedule. All other statements
about checking the incision site, folding the diaper, and calling the doctor if there is a
fever are true.
/.The nurse is preparing a pediatric client for a barium enema. Which diagnosis would
support the need for this diagnostic test?
a. Gastroschisis
b. Intussusception
c. Appendicitis
d. Pyloric stenosis - Answer-✅Answer: b. Intussusception
Feedback: Intussusception occurs when the intestine invaginates into another, causing
pain with vomiting and passage of brown stool. The stools eventually can resemble
currant jelly. Pyloric stenosis is a stenosis between the stomach and duodenum.
Gastroschisis is a congenital defect where there is herniation of abdominal contents
outside the abdominal wall. Appendicitis is an inflammatory process of the appendix
/.Which intervention would not be included in the preoperative plan of care for an infant
with an omphalocele?
, a. Push the exposed abdominal contents back into the abdomen.
b. Administer intravenous fluids.
c. Assess for signs of other congenital anomalies.
d. Care for the infant in a radiant warmer. - Answer-✅Answer: a. Push the exposed
abdominal contents back into the abdomen.
Feedback: Care of an infant with an omphalocele (congenital malformation where
abdominal contents herniate through the umbilical cord covered by a translucent sac) is
aimed at protection of abdominal contents. Aggressive attempts at replacing abdominal
contents can lead to numerous problems, including increased abdominal pressure,
impaired respiratory status, and bowel perforation. The goals should be to protect the
infant from hypothermia, replace fluids, prevent infection, and look for other associated
anomalies.
/.The nurse is caring for a group of infants in the neonatal intensive care unit. Which
infant would require preparation for immediate surgery due to risk of life-threatening
respiratory distress?
a. An infant with an umbilical hernia
b. An infant with a diaphragmatic hernia
c. An infant with a cleft palate
d. An infant with gastroesophageal reflux - Answer-✅Answer: b. An infant with a
diaphragmatic hernia
Feedback: Gastroesophageal reflux, cleft palate, and umbilical hernia do not cause
respiratory distress and are not considered surgical emergencies. A diaphragmatic
hernia will cause the abdominal organs to extend into the chest, causing pressure on
the thoracic cavity. Only 50% of afflicted infants survive.
/.Which instruction should be provided to the parents of an infant with gastroesophageal
reflux?
a. "Feed every 4-5 hours to prevent overfeeding."
b. "Place in a seated position for 10 minutes after feedings."
c. "Elevate the head of the crib at all times."
d. "Burp every 3-4 ounces with feeding." - Answer-✅Answer: c. "Elevate the head of the
crib at all times."
Feedback: Management of gastroesophageal reflux includes administering small,
frequent feedings and burping every 1-2 ounces. Elevating the head of the bed and
holding the infant upright for 30 minutes after feeding help minimize the reflux. Putting
the infant in a seated position can increase the pressure on the abdomen, causing
reflux to increase.
QUESTIONS WITH NEW UPDATE
SOLUTIONS
/.A nurse is caring for an 11-month-old infant admitted for watery, green diarrhea;
vomiting; and fever. He is diagnosed with gastroenteritis with no known source at this
time. Which nursing diagnosis should be the highest priority?
a. Altered Nutrition
b. Anxiety related to hospitalization
c. Fluid Volume and Electrolyte Imbalance
d. Altered Family Coping - Answer-✅Answer: c. Fluid Volume and Electrolyte
Imbalance
Feedback: Fluid and electrolyte imbalance is a safety issue and a potentially life-
threatening event. Although all of the diagnoses should be addressed, this takes
precedence.
/.Which intervention would the nurse include in the care of an infant following surgical
repair of a cleft lip?
a. Let the infant touch the suture lines as a means of self-comforting.
b. Position the infant in the supine position for feedings to avoid aspiration.
c. Administer pain medications as ordered.
d. Use a special feeding device with shorter nipples. - Answer-✅Answer: c. Administer
pain medications as ordered.
Feedback: Special feeding devices with long nipples usually are used, and the infant is
fed in the sitting position to avoid aspiration. Some soft restraints may be used to
prevent the infant from touching the suture line.
/.Which assessment finding would lead the nurse to suspect esophageal atresia in an
infant?
a. Hypotonicity
b. Excessive crying
c. Abdominal distention
d. Excessive drooling - Answer-✅Answer: d. Excessive drooling
,Feedback: The classic symptoms in an infant with esophageal atresia are excessive
drooling often accompanied by cyanosis, choking, and coughing. Low blood pressure,
excessive crying, and hypotonicity are not common signs of esophageal atresia.
/.Which client would the nurse suspect to have pyloric stenosis?
a. A 7-month-old with choking episodes
b. An 11-year-old with an olive-shaped abdominal mass
c. A 5-week-old infant with projectile vomiting
d. A 2-year-old with a harsh cough - Answer-✅Answer: c. A 5-week-old infant with
projectile vomiting
Feedback: The most likely incidence of pyloric stenosis is in a 2- to 8-week-old infant.
The common symptoms are nonbilious projectile vomiting, irritability, and failure to gain
weight.
/.A nurse is discharging an infant after a pyloric stenosis repair. Which statement by the
mother would indicate the need for further instructions prior to discharge?
a. "I should call the doctor if my infant's temperature rises above 101 degrees."
b. "I should fold the diaper down so it does not irritate the incision."
c. "My infant's incision will need to be observed for redness, swelling, or discharge."
d. "If my infant vomits, I should hold feedings for 6 hours." - Answer-✅Answer: d. "If my
infant vomits, I should hold feedings for 6 hours."
Feedback: It is normal for an infant to vomit occasionally after having surgery for pyloric
stenosis. The infant should be fed on a normal feeding schedule. All other statements
about checking the incision site, folding the diaper, and calling the doctor if there is a
fever are true.
/.The nurse is preparing a pediatric client for a barium enema. Which diagnosis would
support the need for this diagnostic test?
a. Gastroschisis
b. Intussusception
c. Appendicitis
d. Pyloric stenosis - Answer-✅Answer: b. Intussusception
Feedback: Intussusception occurs when the intestine invaginates into another, causing
pain with vomiting and passage of brown stool. The stools eventually can resemble
currant jelly. Pyloric stenosis is a stenosis between the stomach and duodenum.
Gastroschisis is a congenital defect where there is herniation of abdominal contents
outside the abdominal wall. Appendicitis is an inflammatory process of the appendix
/.Which intervention would not be included in the preoperative plan of care for an infant
with an omphalocele?
, a. Push the exposed abdominal contents back into the abdomen.
b. Administer intravenous fluids.
c. Assess for signs of other congenital anomalies.
d. Care for the infant in a radiant warmer. - Answer-✅Answer: a. Push the exposed
abdominal contents back into the abdomen.
Feedback: Care of an infant with an omphalocele (congenital malformation where
abdominal contents herniate through the umbilical cord covered by a translucent sac) is
aimed at protection of abdominal contents. Aggressive attempts at replacing abdominal
contents can lead to numerous problems, including increased abdominal pressure,
impaired respiratory status, and bowel perforation. The goals should be to protect the
infant from hypothermia, replace fluids, prevent infection, and look for other associated
anomalies.
/.The nurse is caring for a group of infants in the neonatal intensive care unit. Which
infant would require preparation for immediate surgery due to risk of life-threatening
respiratory distress?
a. An infant with an umbilical hernia
b. An infant with a diaphragmatic hernia
c. An infant with a cleft palate
d. An infant with gastroesophageal reflux - Answer-✅Answer: b. An infant with a
diaphragmatic hernia
Feedback: Gastroesophageal reflux, cleft palate, and umbilical hernia do not cause
respiratory distress and are not considered surgical emergencies. A diaphragmatic
hernia will cause the abdominal organs to extend into the chest, causing pressure on
the thoracic cavity. Only 50% of afflicted infants survive.
/.Which instruction should be provided to the parents of an infant with gastroesophageal
reflux?
a. "Feed every 4-5 hours to prevent overfeeding."
b. "Place in a seated position for 10 minutes after feedings."
c. "Elevate the head of the crib at all times."
d. "Burp every 3-4 ounces with feeding." - Answer-✅Answer: c. "Elevate the head of the
crib at all times."
Feedback: Management of gastroesophageal reflux includes administering small,
frequent feedings and burping every 1-2 ounces. Elevating the head of the bed and
holding the infant upright for 30 minutes after feeding help minimize the reflux. Putting
the infant in a seated position can increase the pressure on the abdomen, causing
reflux to increase.
