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Chapter 28: The Child with a Gastrointestinal Condition

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MULTIPLE CHOICE 1. A child is brought to the emergency department because of ingesting an unknown quantity of acetaminophen (Tylenol). What does a nurse expect this child to most likely receive following gastric lavage? a. Activated charcoal b. N-acetylcysteine c. Vitamin K d. Syrup of ipecac ANS: B Gastric lavage is followed by N-acetylcysteine (Mucomyst), the antidote for acetaminophen. DIF: Cognitive Level: Comprehension REF: 681 OBJ: 16 TOP: Acetaminophen Poisoning KEY: Nursing Process Step: Implementation 2. A nurse is planning a parent education program about lead poisoning prevention. What will be included regarding primary sources of lead in the community? a. Increased lead content of air b. Use of aluminum cookware c. Food and drinking water d. Inhaling smog ANS: C Lead-based paint may still be present in older homes. For infants and children, ingestion of non-food items containing lead (such as dust, lead-based paint, soil and products), along with food and drinking water, are the greatest sources of exposure to lead in the environment. DIF: Cognitive Level: Knowledge REF: 683 OBJ: 17 TOP: Lead Poisoning KEY: Nursing Process Step: Planning 3. Which finding in a newborn is suggestive of tracheoesophageal fistula? a. Failure to pass meconium in 24 hours b. Choking on the first feeding c. Palpable mass in the sternal area d. Visible peristalsis across abdomen

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Keenan-Lindsay: Leifer’s Introduction to Maternity and Pediatric Nursing in Canada, 1st Edition



MULTIPLE CHOICE

1. A child is brought to the emergency department because of ingesting an unknown
quantity of acetaminophen (Tylenol). What does a nurse expect this child to most likely
receive following gastric lavage?
a. Activated charcoal
b. N-acetylcysteine
c. Vitamin K
d. Syrup of ipecac


ANS: B
Gastric lavage is followed by N-acetylcysteine (Mucomyst), the antidote for
acetaminophen.
DIF: Cognitive Level: Comprehension REF: 681 OBJ: 16
TOP: Acetaminophen Poisoning KEY: Nursing Process Step:
Implementation


2. A nurse is planning a parent education program about lead poisoning prevention. What
will be included regarding primary sources of lead in the community?
a. Increased lead content of air
b. Use of aluminum cookware
c. Food and drinking water
d. Inhaling smog


ANS: C
Lead-based paint may still be present in older homes. For infants and children,
ingestion of non-food items containing lead (such as dust, lead-based paint, soil and
products), along with food and drinking water, are the greatest sources of exposure to

, lead in the environment.
DIF: Cognitive Level: Knowledge REF: 683 OBJ: 17
TOP: Lead Poisoning KEY: Nursing Process Step: Planning


3. Which finding in a newborn is suggestive of tracheoesophageal fistula?
a. Failure to pass meconium in 24 hours
b. Choking on the first feeding
c. Palpable mass in the sternal area
d. Visible peristalsis across abdomen


ANS: B
After birth, a newborn with tracheoesophageal fistula will vomit and choke when the
first feeding is introduced.
DIF: Cognitive Level: Comprehension REF: 663 OBJ: 8
TOP: Esophageal Atresia KEY: Nursing Process Step: Data
Collection


4. A child is brought to the pediatric clinic due to vomiting for the past 2 days. What acid-
base imbalance would a nurse expect to occur from this persistent vomiting?
a. Hyperkalemia
b. Hypernatremia
c. Acidosis
d. Alkalosis


ANS: D
Hydrochloric acid and sodium chloride from the stomach are lost from persistent
vomiting. This results in alkalosis.
DIF: Cognitive Level: Comprehension REF: 668 OBJ: 11
TOP: Acid-Base Balance KEY: Nursing Process Step: Data
Collection


5. An 18-month-old child had a surgical repair of a cleft palate and is now allowed to eat a
regular diet. What nursing action is the most appropriate?
a. Feed solid foods with the spoon at the side of the mouth.

, b. Puree foods and offer them through a straw.
c. Place small bites of food in the mouth with a tongue blade.
d. Offer small, frequent meals of finger foods.


ANS: A
The primary concern with feeding is to protect the operative site. The child can be fed
with a spoon, but only the side of the spoon is placed into the mouth at the side of the
mouth. The spoon must not touch the roof of the mouth.
DIF: Cognitive Level: Application REF: 665 OBJ: 9
TOP: Cleft Lip and Palate KEY: Nursing Process Step: Implementation


6. A nurse is providing education to parents of a child with cleft palate. What will the nurse
instruct the parents to report immediately?
a. Facial paralysis
b. Ear infections
c. Increased intracranial pressure
d. Drooling


ANS: B
Children with cleft palate are at risk of ear infections and dental disorders. Parents
should be instructed to take the child to the health care provider at the first sign of
earache.
DIF: Cognitive Level: Application REF: 666 OBJ: 9
TOP: Complication of Cleft Palate KEY: Nursing Process Step:
Implementation


7. What does a nurse expect the appearance of the stools of a child with celiac disease to be?
a. Ribbon like
b. Hard, constipated
c. Bulky, frothy
d. Loose, foul-smelling


ANS: C
Celiac disease causes malabsorption. Stools that are large, bulky, and frothy may

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