NR602-Final Questions And Correct Answers
Chapter 40 - GI Disorders - Correct Answer
The parent of a colicky infant asks about using a probiotic medication.
What will you tell them? - Correct Answer There is no conclusive evidence about using
probiotics to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor weight gain. A
barium swallow study reveals a normal esophagus.
What will the primary care pediatric nurse practitioner consider next to manage this child's
nutritional needs? - Correct Answer Video fluoroscopy swallowing study
A toddler is seen in the clinic after a 2 day history of intermittent vomiting and diarrhea. An
assessment reveals an irritable child with dry mucous membranes, 3 second capillary refill, 2
second recoil of skin, mild tachycardia and tachypnea, and cool hands and feet. The child has
had two wet diapers in the past 24 hours.
What will the primary care pediatric nurse practitioner recommend? - Correct Answer Oral
rehydration solution with follow-up in 24 hours.
,A 9-year-old girl has a history of frequent vomiting, and her mother has frequent migraine
headaches. The child has recently begun having more frequent and prolonged episodes
accompanied by headaches. An exam reveals abnormal eye movements and mild ataxia.
What is the correct action? - Correct Answer Refer to a pediatric gastroenterologist for further
workup.
The parent of a 3-month-old reports that the infant arches and gags while feeding and spits up
undigested formula frequently. The infant's weight gain has dropped to the 5th percentile from
the 12 th percentile.
What is the best course of treatment for this infant? - Correct Answer Begin a trial of
extensively hydrolyzed protein formula for 2-4 weeks.
A school age child has a 3-month history of dull, aching epigastric pain that worsens with eating
and awakens the child from sleep. A complete blood count shows a hemoglobin of 8 mg/dL.
What is the next step in management? - Correct Answer Refer for EGD.
A 2-month-old infant cries up to 4 hours each day and, according to the parents, is inconsolable
during crying episodes with fists and legs noted to be tense and stiff. The infant is breastfeeding
frequently but is often fussy during feedings. The physical exam is normal, and the infant is
gaining weight normally.
What will the primary care pediatric nurse practitioner recommend? - Correct Answer
Eliminating certain foods from the mother's diet.
A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract shows a 6 mm
cylindrical object in the child's stomach. The child is able to swallow without difficulty and is not
experiencing pain.
,What is the correct course of treatment? - Correct Answer Have the parents watch for the
object in the child's stool.
A 10-year-old child has had abdominal pain for 2 days, which began in the
periumbilical area and then localized to the right lower quadrant. The child vomited once today
and then experienced relief from pain followed by an increased fever.
What is the likely diagnosis? - Correct Answer Appendicitis with perforation
An 18-month-old child has a 1 day history of intermittent, cramping abdominal pain with
nonbilious vomiting. The child is observed to scream and draw up his legs during pain episodes
and becomes lethargic in between. The primary care pediatric nurse practitioner notes a small
amount of bloody, mucous stool in the diaper.
What is the most likely diagnosis? - Correct Answer Intussusception
A school age child has had abdominal pain for 3 months that occurs once or twice weekly and is
associated with a headache and occasional difficulty sleeping, often causing the child to stay
home from school. The child does not have vomiting or diarrhea and is gaining weight normally.
The physical exam is normal.
According to Bishop, what is included in the initial diagnostic workup for this child? - Correct
Answer CBC
ESR
Amylase
Lipase
UA
Abdominal ultrasound
, An adolescent is diagnosed with functional abdominal pain (FAP). The child's symptoms worsen
during stressful events, especially with school anxiety.
What will be an important part of treatment for this child? - Correct Answer Teaching about the
brain gut interaction causing symptoms.
A school age child has recurrent diarrhea with foul smelling stools, excessive
flatus, abdominal distension, and failure to thrive. A 2-week lactose free trial failed to reduce
symptoms.
What is the next step in diagnosing this condition? - Correct Answer Serologic testing for celiac
disease.
A child is diagnosed with Crohn's disease.
What are likely complications? - Correct Answer Intestinal obstruction with scarring and
strictures.
A 12 month old infant exhibits poor weight gain after previously normal growth patterns. There
is no history of vomiting, diarrhea, or irregular bowel movements, and the physical exam is
normal.
What is the next step in evaluating these findings? - Correct Answer Feeding hx
Stooling history
and a 3-day diet history
A 2-year-old child has an acute diarrheal illness. The child is afebrile and, with oral rehydration
measures, has remained well hydrated. The parent asks what can be done to help shorten the
Chapter 40 - GI Disorders - Correct Answer
The parent of a colicky infant asks about using a probiotic medication.
What will you tell them? - Correct Answer There is no conclusive evidence about using
probiotics to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor weight gain. A
barium swallow study reveals a normal esophagus.
What will the primary care pediatric nurse practitioner consider next to manage this child's
nutritional needs? - Correct Answer Video fluoroscopy swallowing study
A toddler is seen in the clinic after a 2 day history of intermittent vomiting and diarrhea. An
assessment reveals an irritable child with dry mucous membranes, 3 second capillary refill, 2
second recoil of skin, mild tachycardia and tachypnea, and cool hands and feet. The child has
had two wet diapers in the past 24 hours.
What will the primary care pediatric nurse practitioner recommend? - Correct Answer Oral
rehydration solution with follow-up in 24 hours.
,A 9-year-old girl has a history of frequent vomiting, and her mother has frequent migraine
headaches. The child has recently begun having more frequent and prolonged episodes
accompanied by headaches. An exam reveals abnormal eye movements and mild ataxia.
What is the correct action? - Correct Answer Refer to a pediatric gastroenterologist for further
workup.
The parent of a 3-month-old reports that the infant arches and gags while feeding and spits up
undigested formula frequently. The infant's weight gain has dropped to the 5th percentile from
the 12 th percentile.
What is the best course of treatment for this infant? - Correct Answer Begin a trial of
extensively hydrolyzed protein formula for 2-4 weeks.
A school age child has a 3-month history of dull, aching epigastric pain that worsens with eating
and awakens the child from sleep. A complete blood count shows a hemoglobin of 8 mg/dL.
What is the next step in management? - Correct Answer Refer for EGD.
A 2-month-old infant cries up to 4 hours each day and, according to the parents, is inconsolable
during crying episodes with fists and legs noted to be tense and stiff. The infant is breastfeeding
frequently but is often fussy during feedings. The physical exam is normal, and the infant is
gaining weight normally.
What will the primary care pediatric nurse practitioner recommend? - Correct Answer
Eliminating certain foods from the mother's diet.
A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract shows a 6 mm
cylindrical object in the child's stomach. The child is able to swallow without difficulty and is not
experiencing pain.
,What is the correct course of treatment? - Correct Answer Have the parents watch for the
object in the child's stool.
A 10-year-old child has had abdominal pain for 2 days, which began in the
periumbilical area and then localized to the right lower quadrant. The child vomited once today
and then experienced relief from pain followed by an increased fever.
What is the likely diagnosis? - Correct Answer Appendicitis with perforation
An 18-month-old child has a 1 day history of intermittent, cramping abdominal pain with
nonbilious vomiting. The child is observed to scream and draw up his legs during pain episodes
and becomes lethargic in between. The primary care pediatric nurse practitioner notes a small
amount of bloody, mucous stool in the diaper.
What is the most likely diagnosis? - Correct Answer Intussusception
A school age child has had abdominal pain for 3 months that occurs once or twice weekly and is
associated with a headache and occasional difficulty sleeping, often causing the child to stay
home from school. The child does not have vomiting or diarrhea and is gaining weight normally.
The physical exam is normal.
According to Bishop, what is included in the initial diagnostic workup for this child? - Correct
Answer CBC
ESR
Amylase
Lipase
UA
Abdominal ultrasound
, An adolescent is diagnosed with functional abdominal pain (FAP). The child's symptoms worsen
during stressful events, especially with school anxiety.
What will be an important part of treatment for this child? - Correct Answer Teaching about the
brain gut interaction causing symptoms.
A school age child has recurrent diarrhea with foul smelling stools, excessive
flatus, abdominal distension, and failure to thrive. A 2-week lactose free trial failed to reduce
symptoms.
What is the next step in diagnosing this condition? - Correct Answer Serologic testing for celiac
disease.
A child is diagnosed with Crohn's disease.
What are likely complications? - Correct Answer Intestinal obstruction with scarring and
strictures.
A 12 month old infant exhibits poor weight gain after previously normal growth patterns. There
is no history of vomiting, diarrhea, or irregular bowel movements, and the physical exam is
normal.
What is the next step in evaluating these findings? - Correct Answer Feeding hx
Stooling history
and a 3-day diet history
A 2-year-old child has an acute diarrheal illness. The child is afebrile and, with oral rehydration
measures, has remained well hydrated. The parent asks what can be done to help shorten the
