C HAPTER 5: G ASTROENTERITIS , F EVER ,
AND D EHYDRATION
MULTIPLE CHOICE
1. Which intervention should be included in the nurses plan of care for a 7 -year-old
child with encopresis who has cleared the initial impaction?
a. Have the child sit on the toilet 30 minutes when he gets up in the morning
and at bedtime.
b. Increase sugar in the childs diet to promote bowel elimination.
c. Use a Fleet enema daily.
d. Give the child a choice of beverage to mix with a laxative.
ANS: D
Offering realistic choices is helpful in meeting the school -age childs sense of
control. To facilitate bowel elimination, the child should sit on the toilet for 5
to 10 minutes after breakfast and dinner. Decreasing the amount of sugar in
the diet will help keep stools soft. Daily Fleet enemas can result in
hypernatremia and hyperphosphatemia and are used only during periods of
fecal impaction.
2. A nurse is assisting a child with inflammatory bowel disease to choose items
from the dietary menu. Which dietary item should be avoided because it is high
in residue?
a. Eggs
b. Cheese
c. Grapes
, d. Jello
ANS: C
Fruits with skins or seeds should be avoided because they are high in residue.
Cooked or canned fruits and vegetables without skins are allowed. Eggs,
cheese, and Jello would be allowed on a low residue diet.
3. What is an expected outcome for the child with irritable bowel disease?
a. Decreasing symptoms
b. Adherence to a low-fiber diet
c. Increasing milk products in the diet
d. Adapting the lifestyle to the lifelong problems
ANS: A
Management of irritable bowel disease is aimed at identifying and decreasing
exposure to triggers and decreasing bowel spasms, which will decrease
symptoms. Management includes maintenance of a healthy, well -balanced,
moderate-fiber, lower-fat diet. A moderate amount of fiber in the diet is
indicated for the child with irritable bowel disease. No modification in dairy
products is necessary unless the child is lactose intolerant. Irritable bowel
syndrome is typically self-limiting and resolves by age 20 years.
4. An infant has been admitted to the Neonatal Intensive Care Unit (NICU) with a
congenital gastroschisis. Which intervention should the nurse perform first upon
admission to the unit?
a. Place the infant flat and prone.
b. Cover the defect with sterile warm, moist gauze and wrap with plastic.
c. Begin a gestational age assessment.
, d. Wrap the infant in a warm blanket and allow the father to hold the infant
briefly.
ANS: B
Gastroschisis is the protrusion of intraabdominal contents through a defect in
the abdominal wall lateral to the umbilical ring. There is no peritoneal sac.
The defect should be immediately wrapped in warm, moist, sterile gauze and
covered with plastic to keep moist. The infant cannot be placed prone as more
damage could occur to the defect. Movement of the infant should be
minimized so gestational age assessment and parental holding would be done
after the infant is stabilized.
5. What is an appropriate statement for the nurse to make to parents of a child who
has had a barium enema to correct an intussusception?
a. I will call the physician when the baby passes his first stool.
b. I am going to dilate the anal sphincter with a gloved finger to help the
baby pass the barium.
c. I would like you to save all the soiled diapers so I can inspect them.
d. Add cereal to the babys formula to help him pass the barium.
ANS: C
The nurse needs to inspect diapers after a barium enema because it is
important to document the passage of barium and note the characteristics of
the stool. The physician does not need to be notified when the infant passes
the first stool. Dilating the anal sphincter is not appropriate for the child after
a barium enema. After reduction, the infant is given clear liquids and the diet
is gradually increased.
AND D EHYDRATION
MULTIPLE CHOICE
1. Which intervention should be included in the nurses plan of care for a 7 -year-old
child with encopresis who has cleared the initial impaction?
a. Have the child sit on the toilet 30 minutes when he gets up in the morning
and at bedtime.
b. Increase sugar in the childs diet to promote bowel elimination.
c. Use a Fleet enema daily.
d. Give the child a choice of beverage to mix with a laxative.
ANS: D
Offering realistic choices is helpful in meeting the school -age childs sense of
control. To facilitate bowel elimination, the child should sit on the toilet for 5
to 10 minutes after breakfast and dinner. Decreasing the amount of sugar in
the diet will help keep stools soft. Daily Fleet enemas can result in
hypernatremia and hyperphosphatemia and are used only during periods of
fecal impaction.
2. A nurse is assisting a child with inflammatory bowel disease to choose items
from the dietary menu. Which dietary item should be avoided because it is high
in residue?
a. Eggs
b. Cheese
c. Grapes
, d. Jello
ANS: C
Fruits with skins or seeds should be avoided because they are high in residue.
Cooked or canned fruits and vegetables without skins are allowed. Eggs,
cheese, and Jello would be allowed on a low residue diet.
3. What is an expected outcome for the child with irritable bowel disease?
a. Decreasing symptoms
b. Adherence to a low-fiber diet
c. Increasing milk products in the diet
d. Adapting the lifestyle to the lifelong problems
ANS: A
Management of irritable bowel disease is aimed at identifying and decreasing
exposure to triggers and decreasing bowel spasms, which will decrease
symptoms. Management includes maintenance of a healthy, well -balanced,
moderate-fiber, lower-fat diet. A moderate amount of fiber in the diet is
indicated for the child with irritable bowel disease. No modification in dairy
products is necessary unless the child is lactose intolerant. Irritable bowel
syndrome is typically self-limiting and resolves by age 20 years.
4. An infant has been admitted to the Neonatal Intensive Care Unit (NICU) with a
congenital gastroschisis. Which intervention should the nurse perform first upon
admission to the unit?
a. Place the infant flat and prone.
b. Cover the defect with sterile warm, moist gauze and wrap with plastic.
c. Begin a gestational age assessment.
, d. Wrap the infant in a warm blanket and allow the father to hold the infant
briefly.
ANS: B
Gastroschisis is the protrusion of intraabdominal contents through a defect in
the abdominal wall lateral to the umbilical ring. There is no peritoneal sac.
The defect should be immediately wrapped in warm, moist, sterile gauze and
covered with plastic to keep moist. The infant cannot be placed prone as more
damage could occur to the defect. Movement of the infant should be
minimized so gestational age assessment and parental holding would be done
after the infant is stabilized.
5. What is an appropriate statement for the nurse to make to parents of a child who
has had a barium enema to correct an intussusception?
a. I will call the physician when the baby passes his first stool.
b. I am going to dilate the anal sphincter with a gloved finger to help the
baby pass the barium.
c. I would like you to save all the soiled diapers so I can inspect them.
d. Add cereal to the babys formula to help him pass the barium.
ANS: C
The nurse needs to inspect diapers after a barium enema because it is
important to document the passage of barium and note the characteristics of
the stool. The physician does not need to be notified when the infant passes
the first stool. Dilating the anal sphincter is not appropriate for the child after
a barium enema. After reduction, the infant is given clear liquids and the diet
is gradually increased.
