Chapter 24: The Child with
Gastrointestinal Dysfunction
1. Which condition in a child should alert a nurse for increased fluid requirements? a. Fever
b. Mechanical ventilation
c. Congestive heart failure
d. Increased intracranial pressure (ICP) - ANS: A
Fever leads to great insensible fluid loss in young children because of increased body surface area
relative to fluid volume. Respiratory rate influences insensible fluid loss and should be monitored in the
mechanically ventilated child. Congestive heart failure is a case of fluid overload in children. Increased
ICP does not lead to increased fluid requirements in children.
PTS: 1 DIF: Cognitive Level: Understand REF: 763
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
2. A nurse is conducting an in-service on gastrointestinal disorders. The nurse includes that melena, the
passage of black, tarry stools, suggests bleeding from which area? a. Perianal or rectal area
b. Hemorrhoids or anal fissures
c. Upper gastrointestinal (GI) tract
d. Lower GI tract - ANS: C
Melena is denatured blood from the upper GI tract or bleeding from the right colon. Blood from the
perianal or rectal area, hemorrhoids, or lower GI tract would be bright red.
PTS: 1 DIF: Cognitive Level: Apply REF: 792
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
,3. Which type of dehydration is defined as "dehydration that occurs in conditions in which electrolyte
and water deficits are present in approximately balanced proportion"? a. Isotonic dehydration
b. Hypotonic dehydration
c. Hypertonic dehydration
d. All types of dehydration in infants and small children - ANS: A
Isotonic dehydration is the correct term for this definition and is the most frequent form of dehydration
in children. Hypotonic dehydration occurs when the electrolyte deficit exceeds the water deficit, leaving
the serum hypotonic. Hypertonic dehydration results from water loss in excess of electrolyte loss and is
usually caused by a proportionately larger loss of water or a larger intake of electrolytes. This definition
is specific to isotonic dehydration.
PTS: 1 DIF: Cognitive Level: Understand REF: 767
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
4. A nurse is admitting an infant with dehydration caused from water loss in excess of electrolyte loss.
Which type of dehydration is this infant experiencing? a. Isotonic
b. Isosmotic
c. Hypotonic
d. Hypertonic - ANS: D
Hypertonic dehydration results from water loss in excess of electrolyte loss. This is the most dangerous
type of dehydration. It is caused by feeding children fluids with high amounts of solute. Isotonic
dehydration occurs in conditions in which electrolyte and water deficits are present in balanced
proportion and is another term for isotonic dehydration. Hypotonic dehydration occurs when the
electrolyte deficit exceeds the water deficit, leaving the serum hypotonic.
PTS: 1 DIF: Cognitive Level: Understand REF: 767
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
5. An infant is brought to the emergency department with dehydration. Which physical assessment
finding does the nurse expect? a. Weight gain
b. Bradycardia
, c. Poor skin turgor
d. Brisk capillary refill - ANS: C
Clinical manifestations of dehydration include poor skin turgor, weight loss, lethargy, and tachycardia.
The infant would have prolonged capillary refill, not brisk.
PTS: 1 DIF: Cognitive Level: Understand REF: 767
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
6. Parents call the clinic and report that their toddler has had acute diarrhea for 24 hours. The nurse
should further ask the parents if the toddler has which associated factor that is causing the acute
diarrhea? a. Celiac disease
b. Antibiotic therapy
c. Immunodeficiency
d. Protein malnutrition - ANS: B
Acute diarrhea is a sudden increase in frequency and change in consistency of stools and may be
associated with antibiotic therapy. Celiac disease is a problem with gluten intolerance and may cause
chronic diarrhea if not identified and managed appropriately. Immunodeficiency would occur with
chronic diarrhea. Protein malnutrition or kwashiorkor causes chronic diarrhea from lowered resistance
to infection.
PTS: 1 DIF: Cognitive Level: Apply REF: 772
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
7. Which pathogen is the viral pathogen that frequently causes acute diarrhea in young children? a.
Giardia organisms
b. Shigella organisms
c. Rotavirus
d. Salmonella organisms - ANS: C
Gastrointestinal Dysfunction
1. Which condition in a child should alert a nurse for increased fluid requirements? a. Fever
b. Mechanical ventilation
c. Congestive heart failure
d. Increased intracranial pressure (ICP) - ANS: A
Fever leads to great insensible fluid loss in young children because of increased body surface area
relative to fluid volume. Respiratory rate influences insensible fluid loss and should be monitored in the
mechanically ventilated child. Congestive heart failure is a case of fluid overload in children. Increased
ICP does not lead to increased fluid requirements in children.
PTS: 1 DIF: Cognitive Level: Understand REF: 763
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
2. A nurse is conducting an in-service on gastrointestinal disorders. The nurse includes that melena, the
passage of black, tarry stools, suggests bleeding from which area? a. Perianal or rectal area
b. Hemorrhoids or anal fissures
c. Upper gastrointestinal (GI) tract
d. Lower GI tract - ANS: C
Melena is denatured blood from the upper GI tract or bleeding from the right colon. Blood from the
perianal or rectal area, hemorrhoids, or lower GI tract would be bright red.
PTS: 1 DIF: Cognitive Level: Apply REF: 792
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
,3. Which type of dehydration is defined as "dehydration that occurs in conditions in which electrolyte
and water deficits are present in approximately balanced proportion"? a. Isotonic dehydration
b. Hypotonic dehydration
c. Hypertonic dehydration
d. All types of dehydration in infants and small children - ANS: A
Isotonic dehydration is the correct term for this definition and is the most frequent form of dehydration
in children. Hypotonic dehydration occurs when the electrolyte deficit exceeds the water deficit, leaving
the serum hypotonic. Hypertonic dehydration results from water loss in excess of electrolyte loss and is
usually caused by a proportionately larger loss of water or a larger intake of electrolytes. This definition
is specific to isotonic dehydration.
PTS: 1 DIF: Cognitive Level: Understand REF: 767
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
4. A nurse is admitting an infant with dehydration caused from water loss in excess of electrolyte loss.
Which type of dehydration is this infant experiencing? a. Isotonic
b. Isosmotic
c. Hypotonic
d. Hypertonic - ANS: D
Hypertonic dehydration results from water loss in excess of electrolyte loss. This is the most dangerous
type of dehydration. It is caused by feeding children fluids with high amounts of solute. Isotonic
dehydration occurs in conditions in which electrolyte and water deficits are present in balanced
proportion and is another term for isotonic dehydration. Hypotonic dehydration occurs when the
electrolyte deficit exceeds the water deficit, leaving the serum hypotonic.
PTS: 1 DIF: Cognitive Level: Understand REF: 767
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
5. An infant is brought to the emergency department with dehydration. Which physical assessment
finding does the nurse expect? a. Weight gain
b. Bradycardia
, c. Poor skin turgor
d. Brisk capillary refill - ANS: C
Clinical manifestations of dehydration include poor skin turgor, weight loss, lethargy, and tachycardia.
The infant would have prolonged capillary refill, not brisk.
PTS: 1 DIF: Cognitive Level: Understand REF: 767
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
6. Parents call the clinic and report that their toddler has had acute diarrhea for 24 hours. The nurse
should further ask the parents if the toddler has which associated factor that is causing the acute
diarrhea? a. Celiac disease
b. Antibiotic therapy
c. Immunodeficiency
d. Protein malnutrition - ANS: B
Acute diarrhea is a sudden increase in frequency and change in consistency of stools and may be
associated with antibiotic therapy. Celiac disease is a problem with gluten intolerance and may cause
chronic diarrhea if not identified and managed appropriately. Immunodeficiency would occur with
chronic diarrhea. Protein malnutrition or kwashiorkor causes chronic diarrhea from lowered resistance
to infection.
PTS: 1 DIF: Cognitive Level: Apply REF: 772
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
7. Which pathogen is the viral pathogen that frequently causes acute diarrhea in young children? a.
Giardia organisms
b. Shigella organisms
c. Rotavirus
d. Salmonella organisms - ANS: C
