Maternity Nursing (OB Maternal &
Newborn) NCLEX Practice Quiz #4 |
75 Questions| 2021 Update
1. Question
Discharge teaching for a child with celiac disease would include
instructions about avoiding which of the following?
o A. Rice
o B. Milk
o C. Wheat
o D. Chicken
Correct Answer: C. Wheat
Children with celiac disease cannot tolerate or digest gluten.
Therefore, because of its gluten content, wheat and wheat-
containing products must be avoided.
Option A: Rice is one of the most popular gluten-free
grains for people with celiac disease. Many gluten-free
packaged goods are made with rice instead of wheat.
Option B: It’s also important to note that while milk is
gluten-free, for those newly diagnosed with celiac
disease, secondary lactose intolerance is common due
to the loss of lactase, an enzyme that digests milk
sugar along the lining of the small intestine.
Option D: There are many naturally gluten-free foods
to enjoy on the celiac disease diet, including: Animal
proteins: Beef, chicken, dairy products, eggs, game
meat, lamb, pork, seafood, and turkey.
2. 2. Question
Which of the following would the nurse expect to assess in a child
with celiac disease having a celiac crisis secondary to an upper
respiratory infection?
, A. Respiratory distress
B. Lethargy
C. Watery diarrhea
D. Weight gain
Correct Answer: C. Watery diarrhea
Episodes of celiac crises are precipitated by infections, ingestion
of gluten, prolonged fasting, or exposure to anticholinergic drugs.
Celiac crisis is typically characterized by severe watery diarrhea.
Celiac crisis is a rare initial presentation of CD characterized by
severe diarrhea, dehydration, weight loss, hypoproteinemia, and
metabolic and electrolyte disturbances. Although rare, it should
be considered in patients with apparently unexplained chronic
diarrhea.
Option A: Respiratory distress is unlikely in a routine
upper respiratory infection. Mainly present in children,
celiac crisis causes profuse intractable diarrhea with
severe metabolic disturbances (such as acidosis and
hypokalemia), hypotension, neuromuscular weakness,
cardiac arrhythmias, and respiratory failure.
Option B: Irritability, rather than lethargy, is more
likely. Due to the wide variety of symptoms that may
present themselves, it can sometimes be difficult to
diagnose celiac disease. One person might have
diarrhea and abdominal pain, while another person
has irritability or depression.
Option D: Because of the fluid loss associated with
severe watery diarrhea, the child’s weight is more
likely to be decreased.
3. 3. Question
Which of the following should the nurse do first after noting that
a child with Hirschsprung disease has a fever and watery
explosive diarrhea?
A. Notify the physician immediately.
, B. Administer antidiarrheal medications.
C. Monitor child every 30 minutes.
D. Nothing, this is characteristic of Hirschsprung
disease.
Correct Answer: A. Notify the physician immediately.
For the child with Hirschsprung disease, fever and explosive
diarrhea indicate enterocolitis, a life-threatening situation.
Therefore, the physician should be notified immediately.
Option B: Generally, because of the intestinal
obstruction and inadequate propulsive intestinal
movement, antidiarrheals are not used to treat
Hirschsprung disease.
Option C: The child is acutely ill and requires
intervention, with monitoring more frequently than
every 30 minutes.
Option D: Hirschsprung disease typically presents
with chronic constipation. Hirschsprung’s disease
(congenital megacolon) is caused by the failed
migration of colonic ganglion cells during gestation.
Varying lengths of the distal colon are unable to relax,
causing functional colonic obstruction.
4. 4. Question
A newborn’s failure to pass meconium within the first 24 hours
after birth may indicate which of the following?
A. Hirschsprung disease
B. Celiac disease
C. Intussusception
D. Abdominal wall defect
Correct Answer: A. Hirschsprung disease
Failure to pass meconium within the first 24 hours after birth may
be an indication of Hirschsprung disease, a congenital anomaly
, resulting in mechanical obstruction due to inadequate motility in
an intestinal segment.
Option B: Celiac disease is a serious autoimmune
disease that occurs in genetically predisposed people
where the ingestion of gluten leads to damage in the
small intestine. It is estimated to affect 1 in 100
people worldwide. Two and one-half million Americans
are undiagnosed and are at risk for long-term health
complications.
Option C: Intussusception is a process in which a
segment of intestine invaginates into the adjoining
intestinal lumen, causing bowel obstruction. With early
diagnosis, appropriate fluid resuscitation, and therapy,
the mortality rate from intussusception in children is
less than 1%. If left untreated, however, this condition
is uniformly fatal in 2-5 days.
Option D: Types of abdominal wall defects may
include gastroschisis. Contents of the abdomen
protrude out of the body through an opening in the
abdominal muscles near the umbilical cord. Without a
protective covering, the organs are exposed to
amniotic fluid and may swell or become damaged.
5. 5. Question
When assessing a child for possible intussusception, which of the
following would be least likely to provide valuable information?
A. Stool inspection
B. Pain pattern
C. Family history
D. Abdominal palpation
Correct Answer: C. Family history
Because intussusception is not believed to have a familial
tendency, obtaining a family history would provide the least
amount of information.
Newborn) NCLEX Practice Quiz #4 |
75 Questions| 2021 Update
1. Question
Discharge teaching for a child with celiac disease would include
instructions about avoiding which of the following?
o A. Rice
o B. Milk
o C. Wheat
o D. Chicken
Correct Answer: C. Wheat
Children with celiac disease cannot tolerate or digest gluten.
Therefore, because of its gluten content, wheat and wheat-
containing products must be avoided.
Option A: Rice is one of the most popular gluten-free
grains for people with celiac disease. Many gluten-free
packaged goods are made with rice instead of wheat.
Option B: It’s also important to note that while milk is
gluten-free, for those newly diagnosed with celiac
disease, secondary lactose intolerance is common due
to the loss of lactase, an enzyme that digests milk
sugar along the lining of the small intestine.
Option D: There are many naturally gluten-free foods
to enjoy on the celiac disease diet, including: Animal
proteins: Beef, chicken, dairy products, eggs, game
meat, lamb, pork, seafood, and turkey.
2. 2. Question
Which of the following would the nurse expect to assess in a child
with celiac disease having a celiac crisis secondary to an upper
respiratory infection?
, A. Respiratory distress
B. Lethargy
C. Watery diarrhea
D. Weight gain
Correct Answer: C. Watery diarrhea
Episodes of celiac crises are precipitated by infections, ingestion
of gluten, prolonged fasting, or exposure to anticholinergic drugs.
Celiac crisis is typically characterized by severe watery diarrhea.
Celiac crisis is a rare initial presentation of CD characterized by
severe diarrhea, dehydration, weight loss, hypoproteinemia, and
metabolic and electrolyte disturbances. Although rare, it should
be considered in patients with apparently unexplained chronic
diarrhea.
Option A: Respiratory distress is unlikely in a routine
upper respiratory infection. Mainly present in children,
celiac crisis causes profuse intractable diarrhea with
severe metabolic disturbances (such as acidosis and
hypokalemia), hypotension, neuromuscular weakness,
cardiac arrhythmias, and respiratory failure.
Option B: Irritability, rather than lethargy, is more
likely. Due to the wide variety of symptoms that may
present themselves, it can sometimes be difficult to
diagnose celiac disease. One person might have
diarrhea and abdominal pain, while another person
has irritability or depression.
Option D: Because of the fluid loss associated with
severe watery diarrhea, the child’s weight is more
likely to be decreased.
3. 3. Question
Which of the following should the nurse do first after noting that
a child with Hirschsprung disease has a fever and watery
explosive diarrhea?
A. Notify the physician immediately.
, B. Administer antidiarrheal medications.
C. Monitor child every 30 minutes.
D. Nothing, this is characteristic of Hirschsprung
disease.
Correct Answer: A. Notify the physician immediately.
For the child with Hirschsprung disease, fever and explosive
diarrhea indicate enterocolitis, a life-threatening situation.
Therefore, the physician should be notified immediately.
Option B: Generally, because of the intestinal
obstruction and inadequate propulsive intestinal
movement, antidiarrheals are not used to treat
Hirschsprung disease.
Option C: The child is acutely ill and requires
intervention, with monitoring more frequently than
every 30 minutes.
Option D: Hirschsprung disease typically presents
with chronic constipation. Hirschsprung’s disease
(congenital megacolon) is caused by the failed
migration of colonic ganglion cells during gestation.
Varying lengths of the distal colon are unable to relax,
causing functional colonic obstruction.
4. 4. Question
A newborn’s failure to pass meconium within the first 24 hours
after birth may indicate which of the following?
A. Hirschsprung disease
B. Celiac disease
C. Intussusception
D. Abdominal wall defect
Correct Answer: A. Hirschsprung disease
Failure to pass meconium within the first 24 hours after birth may
be an indication of Hirschsprung disease, a congenital anomaly
, resulting in mechanical obstruction due to inadequate motility in
an intestinal segment.
Option B: Celiac disease is a serious autoimmune
disease that occurs in genetically predisposed people
where the ingestion of gluten leads to damage in the
small intestine. It is estimated to affect 1 in 100
people worldwide. Two and one-half million Americans
are undiagnosed and are at risk for long-term health
complications.
Option C: Intussusception is a process in which a
segment of intestine invaginates into the adjoining
intestinal lumen, causing bowel obstruction. With early
diagnosis, appropriate fluid resuscitation, and therapy,
the mortality rate from intussusception in children is
less than 1%. If left untreated, however, this condition
is uniformly fatal in 2-5 days.
Option D: Types of abdominal wall defects may
include gastroschisis. Contents of the abdomen
protrude out of the body through an opening in the
abdominal muscles near the umbilical cord. Without a
protective covering, the organs are exposed to
amniotic fluid and may swell or become damaged.
5. 5. Question
When assessing a child for possible intussusception, which of the
following would be least likely to provide valuable information?
A. Stool inspection
B. Pain pattern
C. Family history
D. Abdominal palpation
Correct Answer: C. Family history
Because intussusception is not believed to have a familial
tendency, obtaining a family history would provide the least
amount of information.
