NUR328 Quiz 2 Questions With New
Update Solutions
/.A 2-year-old child has a chronic history of constipation and is brought to the clinic for
evaluation. What should the therapeutic plan initially include?
A. Bowel cleansing
B. Dietary modification
C. Structured toilet training
D. Behavior modification - Answer-✅ANS: A
The first step in the treatment of chronic constipation is to empty the bowel and allow
the distended rectum to return to normal size. Dietary modification is an important part
of the treatment. Increased fiber and fluids should be gradually added to the childs diet.
A 2-year-old child is too young for structured toilet training. For an older child, a regular
schedule for toileting should be established. Behavior modification is part of the overall
treatment plan. The child practices releasing the anal sphincter and recognizing cues for
defecation.
/.What statement best describes Hirschsprung disease?
A. The colon has an aganglionic segment.
B. It results in frequent evacuation of solids, liquid, and gas.
C. The neonate passes excessive amounts of meconium.
D. It results in excessive peristaltic movements within the gastrointestinal tract. -
Answer-✅ANS: A
Mechanical obstruction in the colon results from a lack of innervation. In most cases, the
aganglionic segment includes the rectum and some portion of the distal colon. There is
decreased evacuation of the large intestine secondary to the aganglionic segment.
Liquid stool may ooze around the blockage. The obstruction does not affect meconium
production. The infant may not be able to pass the meconium stool. There is decreased
movement in the colon.
/.What procedure is most appropriate for assessment of an abdominal circumference
related to a bowel obstruction?
A. Measuring the abdomen after feedings
B. Marking the point of measurement with a pen
C. Measuring the circumference at the symphysis pubis
D. Using a new tape measure with each assessment to ensure accuracy - Answer-
✅ANS: B
Pen marks on either side of the tape measure allow the nurse to measure the same
spot on the childs abdomen at each assessment. The child most likely will be kept NPO
(nothing by mouth) if a bowel obstruction is present. If the child is being fed, the
,assessment should be done before feedings. The symphysis pubis is too low. Usually
the largest part of the abdomen is at the umbilicus. Leaving the tape measure in place
reduces the trauma to the child.
/.A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary
colostomy will be necessary. How should the nurse prepare this child?
A. It is unnecessary because of childs age.
B. It is essential because it will be an adjustment.
C. Preparation is not needed because the colostomy is temporary.
D. Preparation is important because the child needs to deal with negative body image. -
Answer-✅ANS: B
The childs age dictates the type and extent of psychologic preparation. When a
colostomy is performed, it is necessary to prepare the child who is at least preschool
age by telling him or her about the procedure and what to expect in concrete terms, with
the use of visual aids. The preschooler is not yet concerned with body image.
/.A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is
the purpose of the NG tube?
A. Prevent spread of infection.
B. Monitor electrolyte balance.
C. Prevent abdominal distention.
D. Maintain accurate record of output. - Answer-✅ANS: C
The NG tube is placed to suction out gastrointestinal secretions and prevent abdominal
distention. The NG tube would not affect infection. Electrolyte content of the NG
drainage can be monitored. Without the NG tube, there would be no drainage. After the
NG tube is placed, it is important to maintain an accurate record of intake and output.
This is not the reason for placement of the tube.
/.A parent of an infant with gastroesophageal reflux asks how to decrease the number
and total volume of emesis. What recommendation should the nurse include in teaching
this parent?
A. Surgical therapy is indicated.
B. Place in prone position for sleep after feeding.
C. Thicken feedings and enlarge the nipple hole.
D. Reduce the frequency of feeding by encouraging larger volumes of formula. -
Answer-✅ANS: C
Thickened feedings decrease the childs crying and increase the caloric density of the
feeding. Although it does not decrease the pH, the number and volume of emesis are
reduced. Surgical therapy is reserved for children who have failed to respond to medical
therapy or who have an anatomic abnormality. The prone position is not recommended
because of the risk of sudden infant death syndrome. Smaller, more frequent feedings
are more effective than less frequent, larger volumes of formula.
, /.After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has
somehow removed the nasogastric (NG) tube. What nursing action is most appropriate
to perform at this time?
A. Notify the practitioner.
B. Insert the NG tube so feedings can be given.
C. Replace the NG tube to maintain gastric decompression.
D. Leave the NG tube out because it has probably been in long enough. - Answer-
✅ANS: A
When surgery is performed on the upper gastrointestinal tract, usually the surgical team
replaces the NG tube because of potential injury to the operative site. The decision to
replace the tube or leave it out is made by the surgical team. Replacing the tube is also
usually done by the practitioner because of the surgical site.
/.An adolescent with irritable bowel syndrome comes to see the school nurse. What
information should the nurse share with the adolescent?
A. A low-fiber diet is required.
B. Stress management may be helpful.
C. Milk products are a contributing factor.
D. Pantoprazole (a proton pump inhibitor) is effective in treatment. - Answer-✅ANS: B
Irritable bowel syndrome is believed to involve motor, autonomic, and psychologic
factors. Stress management, environmental modification, and psychosocial intervention
may reduce stress and gastrointestinal symptoms. A high-fiber diet with psyllium
supplement is often beneficial. Milk products can exacerbate bowel problems caused by
lactose intolerance. Antispasmodic drugs, antidiarrheal drugs, and simethicone are
beneficial for some individuals. Proton pump inhibitors have no effect.
/.What clinical manifestation should be the most suggestive of acute appendicitis?
A. Rebound tenderness
B. Bright red or dark red rectal bleeding
C. Abdominal pain that is relieved by eating
D. Colicky, cramping, abdominal pain around the umbilicus - Answer-✅ANS: D
Pain is the cardinal feature. It is initially generalized, usually periumbilical. The pain
becomes constant and may shift to the right lower quadrant. Rebound tenderness is not
a reliable sign and is extremely painful to the child. Bright or dark red rectal bleeding
and abdominal pain that is relieved by eating are not signs of acute appendicitis.
/.When caring for a child with probable appendicitis, the nurse should be alert to
recognize which sign or symptom as a manifestation of perforation?
A. Anorexia
B. Bradycardia
C. Sudden relief from pain
D. Decreased abdominal distention - Answer-✅ANS: C
Update Solutions
/.A 2-year-old child has a chronic history of constipation and is brought to the clinic for
evaluation. What should the therapeutic plan initially include?
A. Bowel cleansing
B. Dietary modification
C. Structured toilet training
D. Behavior modification - Answer-✅ANS: A
The first step in the treatment of chronic constipation is to empty the bowel and allow
the distended rectum to return to normal size. Dietary modification is an important part
of the treatment. Increased fiber and fluids should be gradually added to the childs diet.
A 2-year-old child is too young for structured toilet training. For an older child, a regular
schedule for toileting should be established. Behavior modification is part of the overall
treatment plan. The child practices releasing the anal sphincter and recognizing cues for
defecation.
/.What statement best describes Hirschsprung disease?
A. The colon has an aganglionic segment.
B. It results in frequent evacuation of solids, liquid, and gas.
C. The neonate passes excessive amounts of meconium.
D. It results in excessive peristaltic movements within the gastrointestinal tract. -
Answer-✅ANS: A
Mechanical obstruction in the colon results from a lack of innervation. In most cases, the
aganglionic segment includes the rectum and some portion of the distal colon. There is
decreased evacuation of the large intestine secondary to the aganglionic segment.
Liquid stool may ooze around the blockage. The obstruction does not affect meconium
production. The infant may not be able to pass the meconium stool. There is decreased
movement in the colon.
/.What procedure is most appropriate for assessment of an abdominal circumference
related to a bowel obstruction?
A. Measuring the abdomen after feedings
B. Marking the point of measurement with a pen
C. Measuring the circumference at the symphysis pubis
D. Using a new tape measure with each assessment to ensure accuracy - Answer-
✅ANS: B
Pen marks on either side of the tape measure allow the nurse to measure the same
spot on the childs abdomen at each assessment. The child most likely will be kept NPO
(nothing by mouth) if a bowel obstruction is present. If the child is being fed, the
,assessment should be done before feedings. The symphysis pubis is too low. Usually
the largest part of the abdomen is at the umbilicus. Leaving the tape measure in place
reduces the trauma to the child.
/.A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary
colostomy will be necessary. How should the nurse prepare this child?
A. It is unnecessary because of childs age.
B. It is essential because it will be an adjustment.
C. Preparation is not needed because the colostomy is temporary.
D. Preparation is important because the child needs to deal with negative body image. -
Answer-✅ANS: B
The childs age dictates the type and extent of psychologic preparation. When a
colostomy is performed, it is necessary to prepare the child who is at least preschool
age by telling him or her about the procedure and what to expect in concrete terms, with
the use of visual aids. The preschooler is not yet concerned with body image.
/.A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is
the purpose of the NG tube?
A. Prevent spread of infection.
B. Monitor electrolyte balance.
C. Prevent abdominal distention.
D. Maintain accurate record of output. - Answer-✅ANS: C
The NG tube is placed to suction out gastrointestinal secretions and prevent abdominal
distention. The NG tube would not affect infection. Electrolyte content of the NG
drainage can be monitored. Without the NG tube, there would be no drainage. After the
NG tube is placed, it is important to maintain an accurate record of intake and output.
This is not the reason for placement of the tube.
/.A parent of an infant with gastroesophageal reflux asks how to decrease the number
and total volume of emesis. What recommendation should the nurse include in teaching
this parent?
A. Surgical therapy is indicated.
B. Place in prone position for sleep after feeding.
C. Thicken feedings and enlarge the nipple hole.
D. Reduce the frequency of feeding by encouraging larger volumes of formula. -
Answer-✅ANS: C
Thickened feedings decrease the childs crying and increase the caloric density of the
feeding. Although it does not decrease the pH, the number and volume of emesis are
reduced. Surgical therapy is reserved for children who have failed to respond to medical
therapy or who have an anatomic abnormality. The prone position is not recommended
because of the risk of sudden infant death syndrome. Smaller, more frequent feedings
are more effective than less frequent, larger volumes of formula.
, /.After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has
somehow removed the nasogastric (NG) tube. What nursing action is most appropriate
to perform at this time?
A. Notify the practitioner.
B. Insert the NG tube so feedings can be given.
C. Replace the NG tube to maintain gastric decompression.
D. Leave the NG tube out because it has probably been in long enough. - Answer-
✅ANS: A
When surgery is performed on the upper gastrointestinal tract, usually the surgical team
replaces the NG tube because of potential injury to the operative site. The decision to
replace the tube or leave it out is made by the surgical team. Replacing the tube is also
usually done by the practitioner because of the surgical site.
/.An adolescent with irritable bowel syndrome comes to see the school nurse. What
information should the nurse share with the adolescent?
A. A low-fiber diet is required.
B. Stress management may be helpful.
C. Milk products are a contributing factor.
D. Pantoprazole (a proton pump inhibitor) is effective in treatment. - Answer-✅ANS: B
Irritable bowel syndrome is believed to involve motor, autonomic, and psychologic
factors. Stress management, environmental modification, and psychosocial intervention
may reduce stress and gastrointestinal symptoms. A high-fiber diet with psyllium
supplement is often beneficial. Milk products can exacerbate bowel problems caused by
lactose intolerance. Antispasmodic drugs, antidiarrheal drugs, and simethicone are
beneficial for some individuals. Proton pump inhibitors have no effect.
/.What clinical manifestation should be the most suggestive of acute appendicitis?
A. Rebound tenderness
B. Bright red or dark red rectal bleeding
C. Abdominal pain that is relieved by eating
D. Colicky, cramping, abdominal pain around the umbilicus - Answer-✅ANS: D
Pain is the cardinal feature. It is initially generalized, usually periumbilical. The pain
becomes constant and may shift to the right lower quadrant. Rebound tenderness is not
a reliable sign and is extremely painful to the child. Bright or dark red rectal bleeding
and abdominal pain that is relieved by eating are not signs of acute appendicitis.
/.When caring for a child with probable appendicitis, the nurse should be alert to
recognize which sign or symptom as a manifestation of perforation?
A. Anorexia
B. Bradycardia
C. Sudden relief from pain
D. Decreased abdominal distention - Answer-✅ANS: C
