C HAPTER 23: A LTERATIONS IN
G ASTROINTESTINAL F UNCTION
1. A child with pyloric stenosis is having excessive vomiting. The nurse should
assess for what potential complication?
a. Hyperkalemia
b. Hyperchloremia
c. Metabolic acidosis
d. Metabolic alkalosis
ANS: D
Infants with excessive vomiting are prone to metabolic alkalosis from the loss
of hydrogen ions. Potassium and chloride ions are lost with vomiting.
Metabolic alkalosis, not acidosis, is likely.
2. What term describes invagination of one segment of bowel within another?
a. Atresia
b. Stenosis
c. Herniation
d. Intussusception
ANS: D
Intussusception occurs when a proximal section of the bowel telescopes into a
more distal segment, pulling the mesentery with it. The mesentery is
compressed and angled, resulting in lymphatic and venous obstruction.
Atresia is the absence or closure of a natural opening in the body. Stenosis is
, a narrowing or constriction of the diameter of a bodily passage or orifice.
Herniation is the protrusion of an organ or part through connective tissue or
through a wall of the cavity in which it is normally enclosed.
3. A school-age child with celiac disease asks for guidance about snacks that will
not exacerbate the disease. What snack should the n urse suggest?
a. Pizza
b. Pretzels
c. Popcorn
d. Oatmeal cookies
ANS: C
Celiac disease symptoms result from ingestion of gluten. Corn and rice do not
contain gluten. Popcorn or corn chips will not exacerbate the intestinal
symptoms. Pizza and pretzels are usually made from wheat flour that contains
gluten. Also, in the early stages of celiac disease, the child may be lactose
intolerant. Oatmeal contains gluten.
4. An infant with short bowel syndrome is receiving total parenteral nutrition
(TPN). The practitioner has added continuous enteral feedings through a
gastrostomy tube. The nurse recognizes this as important for which reason?
a. Wean the infant from TPN the next day
b. Stimulate adaptation of the small intestine
c. Give additional nutrients that cannot be included in th e TPN
d. Provide parents with hope that the child is close to discharge
ANS: B
, Long-term survival without TPN depends on the small intestines ability to
increase its absorptive capacity. Continuous enteral feedings facilitate the
adaptation. TPN is indicated until the child is able to receive all nutrition via
the enteral route. Before this is accomplished, the small intestine must adapt
and increase in cell number and cell mass per villus column. TPN is
formulated to meet the infants nutritional needs. Continuous enteral feedings
through a gastrostomy tube is a positive sign, but the infants ability to tolerate
increasing amounts of enteral nutrition is only one factor that determines
readiness for discharge.
5. Melena, the passage of black, tarry stools, suggests bleeding from which source?
a. The perianal or rectal area
b. The upper gastrointestinal (GI) tract
c. The lower GI tract
d. Hemorrhoids or anal fissures
ANS: B
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.
6. A child with acute gastrointestinal bleeding is admitted to the hospital. The nurse
observes which sign or symptom as an early manifestation of shock?
a. Restlessness
b. Rapid capillary refill
c. Increased temperature
d. Increased blood pressure
ANS: A
G ASTROINTESTINAL F UNCTION
1. A child with pyloric stenosis is having excessive vomiting. The nurse should
assess for what potential complication?
a. Hyperkalemia
b. Hyperchloremia
c. Metabolic acidosis
d. Metabolic alkalosis
ANS: D
Infants with excessive vomiting are prone to metabolic alkalosis from the loss
of hydrogen ions. Potassium and chloride ions are lost with vomiting.
Metabolic alkalosis, not acidosis, is likely.
2. What term describes invagination of one segment of bowel within another?
a. Atresia
b. Stenosis
c. Herniation
d. Intussusception
ANS: D
Intussusception occurs when a proximal section of the bowel telescopes into a
more distal segment, pulling the mesentery with it. The mesentery is
compressed and angled, resulting in lymphatic and venous obstruction.
Atresia is the absence or closure of a natural opening in the body. Stenosis is
, a narrowing or constriction of the diameter of a bodily passage or orifice.
Herniation is the protrusion of an organ or part through connective tissue or
through a wall of the cavity in which it is normally enclosed.
3. A school-age child with celiac disease asks for guidance about snacks that will
not exacerbate the disease. What snack should the n urse suggest?
a. Pizza
b. Pretzels
c. Popcorn
d. Oatmeal cookies
ANS: C
Celiac disease symptoms result from ingestion of gluten. Corn and rice do not
contain gluten. Popcorn or corn chips will not exacerbate the intestinal
symptoms. Pizza and pretzels are usually made from wheat flour that contains
gluten. Also, in the early stages of celiac disease, the child may be lactose
intolerant. Oatmeal contains gluten.
4. An infant with short bowel syndrome is receiving total parenteral nutrition
(TPN). The practitioner has added continuous enteral feedings through a
gastrostomy tube. The nurse recognizes this as important for which reason?
a. Wean the infant from TPN the next day
b. Stimulate adaptation of the small intestine
c. Give additional nutrients that cannot be included in th e TPN
d. Provide parents with hope that the child is close to discharge
ANS: B
, Long-term survival without TPN depends on the small intestines ability to
increase its absorptive capacity. Continuous enteral feedings facilitate the
adaptation. TPN is indicated until the child is able to receive all nutrition via
the enteral route. Before this is accomplished, the small intestine must adapt
and increase in cell number and cell mass per villus column. TPN is
formulated to meet the infants nutritional needs. Continuous enteral feedings
through a gastrostomy tube is a positive sign, but the infants ability to tolerate
increasing amounts of enteral nutrition is only one factor that determines
readiness for discharge.
5. Melena, the passage of black, tarry stools, suggests bleeding from which source?
a. The perianal or rectal area
b. The upper gastrointestinal (GI) tract
c. The lower GI tract
d. Hemorrhoids or anal fissures
ANS: B
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.
6. A child with acute gastrointestinal bleeding is admitted to the hospital. The nurse
observes which sign or symptom as an early manifestation of shock?
a. Restlessness
b. Rapid capillary refill
c. Increased temperature
d. Increased blood pressure
ANS: A
