NRSG 1330 EXAM 3 2025 QUESTIONS
AND ANSWERS
What are physiologic differences in the GI system of infants and adults? - ANS - pyloric
sphincter of stomach is more relaxed
- perisaltic waves go in reverse
- stomach is smaller and empties more rapidly
- swallowing is a reflex for the first 3 months of life
- stools are looser due to liquid diet (until the introduction of solids around 4-6 months)
- GI tract secretes less enzymes and fluid
- GI tract more susceptible to infection
- liver is immature and more prone to hypoglycemia
- more prone to dehydration
- no control of defecation or urination (until 2-3 years of age)
How do we assess the GI system of a child? - ANS Inspection
Auscultation: normoactive bowel sounds x4Q
Palpate: soft or firm, pain or tenderness, masses
Nutrition: tolerance of feedings, emesis and characteristics, projectile, intake, growth, weight
gain
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,Stools: color, consistency, size, frequency
Family hx: celiac disease, Crohn's
What is a cleft lip or palate? - ANS Intrauterine incomplete fusion of the lip and/or hard or
soft palates of the mouth
How is a cleft lip or palate assessed/diagnosed? - ANS Before delivery
- ultrasound
After delivery
- inspection
- palpation
- feeding issues (cannot form a complete seal around the nipple)
Are bilateral or unilateral clefts more common? - ANS Unilateral
At what age is surgical intervention common for cleft lips and palates? - ANS Lips: age 2-3
mos
Palate: age 6-12 mos
What are post-op interventions for cleft lip or palate repair? - ANS - monitor pain
- decrease crying episodes
- possible soft board or elbow restraints (infants are likely to be touching an picking at sutures)
- assess site for infection
- apply antibiotic ointment to the suture line as ordered or indicated
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,- do not breastfeed or use a bottle, instead use a small pill cup or syringe to give small sips and
decrease tension on the suture line
- encourage mother to continue breastfeeding/pumping and educate on the need for frequent
pumping and bottle feeding breastmilk
What are possible complications of a cleft lip or palate? - ANS - speech/language deficits
- *higher risk for ear infections*
- dental issues
What is an inguinal hernia? - ANS Intrauterine incomplete closure of the abdominal wall near
the groin
Leads to bulging of the intestines and abdominal contents through the abdominal wall
What are clinical manifestations of an inguinal hernia? - ANS - painless swelling, bulging
- coughing, crying, straining
- redness
How are inguinal hernias treated? - ANS Surgical correction
What are post-op interventions for an inguinal hernia? - ANS - positioning
- wound care (the *surgical site will likely be inside the diaper*)
- *activity can resume in 6-8 weeks* (walking, climbing, crawling)
What is intestinal strangulation? - ANS A complication of inguinal hernias in which the
intestines become trapped in the protrusion from the abdominal wall and they are deprived of
oxygen
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, *Very painful, EMERGENCY*
What is an umbilical hernia? - ANS Intrauterine incomplete closure of the abdominal wall
near the belly button (umbilicus)
Leads to bulging of the intestines and abdominal contents through the abdominal wall
What are clinical manifestations of an umbilical hernia? - ANS - asymptomatic
- swelling/bulging at the belly button
- redness
S/s of severe pain (inconsolable crying, withdrawn position) indicate intestinal strangulation, *a
medical emergency*
How are umbilical hernias treated? - ANS Usually self resolve between age 3-5, but surgical
correction is indicated if the hernia pesists after age 5 or if significant enlargement of the hernia
occurs
What is gastroesophageal reflux? - ANS Effortless movement of stomach contents into
esophagus and mouth
Most common GI disorder in infants and children
Caused by *relaxation of the lower esophageal sphincter* (between the esophagus and
stomach) that should be contracting to keep food in the stomach until it breaks down and
enters the intestines
What is gastroesophageal reflux disease? S/s? - ANS Diagnosed based on symptoms or tissue
damage (biopsy) caused by repetitive reflux
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AND ANSWERS
What are physiologic differences in the GI system of infants and adults? - ANS - pyloric
sphincter of stomach is more relaxed
- perisaltic waves go in reverse
- stomach is smaller and empties more rapidly
- swallowing is a reflex for the first 3 months of life
- stools are looser due to liquid diet (until the introduction of solids around 4-6 months)
- GI tract secretes less enzymes and fluid
- GI tract more susceptible to infection
- liver is immature and more prone to hypoglycemia
- more prone to dehydration
- no control of defecation or urination (until 2-3 years of age)
How do we assess the GI system of a child? - ANS Inspection
Auscultation: normoactive bowel sounds x4Q
Palpate: soft or firm, pain or tenderness, masses
Nutrition: tolerance of feedings, emesis and characteristics, projectile, intake, growth, weight
gain
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 1
,Stools: color, consistency, size, frequency
Family hx: celiac disease, Crohn's
What is a cleft lip or palate? - ANS Intrauterine incomplete fusion of the lip and/or hard or
soft palates of the mouth
How is a cleft lip or palate assessed/diagnosed? - ANS Before delivery
- ultrasound
After delivery
- inspection
- palpation
- feeding issues (cannot form a complete seal around the nipple)
Are bilateral or unilateral clefts more common? - ANS Unilateral
At what age is surgical intervention common for cleft lips and palates? - ANS Lips: age 2-3
mos
Palate: age 6-12 mos
What are post-op interventions for cleft lip or palate repair? - ANS - monitor pain
- decrease crying episodes
- possible soft board or elbow restraints (infants are likely to be touching an picking at sutures)
- assess site for infection
- apply antibiotic ointment to the suture line as ordered or indicated
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 2
,- do not breastfeed or use a bottle, instead use a small pill cup or syringe to give small sips and
decrease tension on the suture line
- encourage mother to continue breastfeeding/pumping and educate on the need for frequent
pumping and bottle feeding breastmilk
What are possible complications of a cleft lip or palate? - ANS - speech/language deficits
- *higher risk for ear infections*
- dental issues
What is an inguinal hernia? - ANS Intrauterine incomplete closure of the abdominal wall near
the groin
Leads to bulging of the intestines and abdominal contents through the abdominal wall
What are clinical manifestations of an inguinal hernia? - ANS - painless swelling, bulging
- coughing, crying, straining
- redness
How are inguinal hernias treated? - ANS Surgical correction
What are post-op interventions for an inguinal hernia? - ANS - positioning
- wound care (the *surgical site will likely be inside the diaper*)
- *activity can resume in 6-8 weeks* (walking, climbing, crawling)
What is intestinal strangulation? - ANS A complication of inguinal hernias in which the
intestines become trapped in the protrusion from the abdominal wall and they are deprived of
oxygen
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 3
, *Very painful, EMERGENCY*
What is an umbilical hernia? - ANS Intrauterine incomplete closure of the abdominal wall
near the belly button (umbilicus)
Leads to bulging of the intestines and abdominal contents through the abdominal wall
What are clinical manifestations of an umbilical hernia? - ANS - asymptomatic
- swelling/bulging at the belly button
- redness
S/s of severe pain (inconsolable crying, withdrawn position) indicate intestinal strangulation, *a
medical emergency*
How are umbilical hernias treated? - ANS Usually self resolve between age 3-5, but surgical
correction is indicated if the hernia pesists after age 5 or if significant enlargement of the hernia
occurs
What is gastroesophageal reflux? - ANS Effortless movement of stomach contents into
esophagus and mouth
Most common GI disorder in infants and children
Caused by *relaxation of the lower esophageal sphincter* (between the esophagus and
stomach) that should be contracting to keep food in the stomach until it breaks down and
enters the intestines
What is gastroesophageal reflux disease? S/s? - ANS Diagnosed based on symptoms or tissue
damage (biopsy) caused by repetitive reflux
COPYRIGHT © 2025 FYNDLAY ALL RIGHTS RESERVED 4
