1. A parent calls the after-hours clinic nurse’s line and describes a bulging mass in his 6-
month-old son’s scrotal area that used to disappear when the child was quiet. Now the
mass is constantly present. What action by the nurse is the most appropriate?
a. Ask the parent to call in the morning to make an appointment.
b. Have the father withhold all feedings for 24 hours.
c. Instruct the father to take the child to an emergency department.
d. Reassure the father the condition is benign unless bloody diarrhea occurs.
ANS: C
Chapter: Chapter 16 Caring for the Child with A Gastrointestinal Condition
Objective: #3. Prioritize developmentally appropriate and holistic nursing care for
common conditions of the gastrointestinal system.
Page: 527
Heading: Surgical Care
Integrated Processes: Nursing Process: Implementation
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Critical Thinking; Nursing Roles
Difficulty: Difficult
Feedback
A. This child has signs of an incarcerated hernia. Waiting to call for an
appointment in the morning increases the risk of complications.
B. This child has signs of an incarcerated hernia. Holding feedings would have no
effect on this condition.
C. This child has signs of an incarcerated hernia, which is a hernia that cannot be
returned to the abdominal cavity. This can lead to strangulation or necrosis of
the bowel if not treated promptly. Because it is after hours, the nurse should
instruct the father to take the child to an emergency department for treatment.
D. This child has signs of an incarcerated hernia. Bloody diarrhea is not related to
this condition.
2. A pediatric nurse listens while a mother describes her toddler’s eating habits. The mother
states that her daughter “refuses to eat vegetables at mealtime” and “wants peanut butter
sandwiches for every meal.” Which action by the nurse is the most appropriate?
a. Encourage the mom to keep trying to get the child to eat vegetables.
b. Reassure the mother that this behavior is normal for a toddler.
, c. Refer the mother to a pediatric dietician for unmet nutritional needs.
d. Teach the mother this behavior puts the child at risk for eating disorders.
ANS: B
Chapter: Chapter 16 Caring for the Child With A Gastrointestinal Condition
Objective: #3. Prioritize developmentally appropriate and holistic nursing care for
common conditions of the gastrointestinal system.
Page: 525
Heading: Nursing Insight> Appetite and Digestion
Integrated Processes: Teaching and Learning
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Nursing Roles; Nutrition
Difficulty: Moderate
Feedback
A. The parents should not force the child to eat foods he or she is not interested in.
Vegetables can be provided, along with a variety of nutritious foods, but the
parent should not pressure the child to eat.
B. The nurse should reassure parents that food jags are normal at this age and the
tendencies will pass; also stress that a little patience will keep both parents and
child from further gastrointestinal upsets.
C. Food jags are normal at this age and do not require referral to a pediatric
dietician.
D. Food jags are normal at this age. This behavior does not put the child at risk for
eating disorders.
3. A child is being discharged from the hospital after a pyloromyotomy. Which discharge
instruction does the nurse provide for the parents?
a. Keep child NPO for 48 hours.
b. Monitor the skin around the colostomy.
c. No pain control should be needed.
d. Report vomiting after 48 hours.
ANS: D
Chapter: Chapter 16 Caring for the Child With A Gastrointestinal Condition
Objective: #5. Develop teaching plans and discharge criteria for parents whose
children have common gastrointestinal conditions.
Page: 529
Heading: Surgical Care
Integrated Processes: Teaching and Learning
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Assessment; Nursing Roles
, Difficulty: Moderate
Feedback
A. Small feedings are usually started around 4–6 hours postoperatively.
B. A colostomy is not performed for this condition.
C. With any invasive surgical procedure, pain control will be needed based on
assessment of the patient.
D. A pyloromyotomy is performed for pyloric stenosis performed via laparoscopy.
Some vomiting may still occur for up to 36 hours postoperatively, but vomiting
persisting beyond 48 hours needs to be reported to the health-care provider.
4. A nurse is caring for an infant waiting for surgical correction of intussusception. The
child passes a diarrheal stool. Which action by the nurse is the most appropriate?
a. Document the findings.
b. Increase the IV fluid rate.
c. Notify the physician.
d. Weigh the child’s diaper.
ANS: C
Chapter: Chapter 16 Caring for the Child With A Gastrointestinal Condition
Objective: #2. Examine common conditions of the gastrointestinal system.
Page: 529
Heading: Nursing Care
Integrated Processes: Nursing Process: Implementation
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Assessment; Nursing Roles
Difficulty: Moderate
Feedback
A. Documentation should always occur, but this is not the only action the nurse
must take at this time.
B. Increasing the IV fluid rate based on passing a stool is not needed.
C. Intussusception is a condition in which a portion of the bowel invaginates or
telescopes into another portion of bowel, creating a partial bowel obstruction.
Spontaneous passage of stool may indicate resolution of the obstruction, so the
nurse should contact the provider immediately.
D. Weighing the child’s diaper is not the priority.
5. A child is taking azathioprine (Imuran) for moderate Crohn’s disease. Which assessment
finding best indicates that an important goal related to this medication has been met?
a. The child has not developed seasonal illnesses.
b. Edema and fluid retention have been eliminated.
c. Stools are more solid and passed less often.
, d. Weight gain has been consistent at each visit.
ANS: A
Chapter: Chapter 16 Caring for the Child With A Gastrointestinal Condition
Objective: #4. Explore diagnostic, laboratory testing and medications for common
conditions of the gastrointestinal system.
Page: 532-533
Heading: Medical Care
Integrated Processes: Nursing Process: Evaluation
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Critical Thinking; Medication
Difficulty: Difficult
Feedback
A. Imuran is an immunosuppressive drug. Patients taking this medication (and
others like it) are more prone to catching seasonal illnesses to which they are
exposed in the community. A lack of such illnesses indicates that a goal for the
diagnosis of risk for infection (important when using this drug) has been met.
B. Edema and fluid retention are not symptoms related to this drug.
C. Stool character is not related to this drug.
D. Weight gain would indicate better absorption of nutrients, which is a problem
in Crohn’s disease, but it is not most closely correlated to this drug.
6. A nurse in a community clinic assesses children for signs of failure to thrive (FTT).
Which child’s assessment finding is most concerning to this nurse?
a. Child’s parent asking questions about feeding
b. Mother demonstrating improper burping technique
c. Weight for age and sex at the 4th percentile
d. Weight for length at 86% of ideal weight
ANS: C
Chapter: Chapter 16 Caring for the Child With A Gastrointestinal Condition
Objective: #4. Explore diagnostic, laboratory testing and medications for common
conditions of the gastrointestinal system.
Page: 523-524
Heading: Nutrition for the Child with a GI Condition
Integrated Processes: Nursing Process: Assessment
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Assessment; Critical Thinking; Nutrition
Difficulty: Moderate
Feedback
month-old son’s scrotal area that used to disappear when the child was quiet. Now the
mass is constantly present. What action by the nurse is the most appropriate?
a. Ask the parent to call in the morning to make an appointment.
b. Have the father withhold all feedings for 24 hours.
c. Instruct the father to take the child to an emergency department.
d. Reassure the father the condition is benign unless bloody diarrhea occurs.
ANS: C
Chapter: Chapter 16 Caring for the Child with A Gastrointestinal Condition
Objective: #3. Prioritize developmentally appropriate and holistic nursing care for
common conditions of the gastrointestinal system.
Page: 527
Heading: Surgical Care
Integrated Processes: Nursing Process: Implementation
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Critical Thinking; Nursing Roles
Difficulty: Difficult
Feedback
A. This child has signs of an incarcerated hernia. Waiting to call for an
appointment in the morning increases the risk of complications.
B. This child has signs of an incarcerated hernia. Holding feedings would have no
effect on this condition.
C. This child has signs of an incarcerated hernia, which is a hernia that cannot be
returned to the abdominal cavity. This can lead to strangulation or necrosis of
the bowel if not treated promptly. Because it is after hours, the nurse should
instruct the father to take the child to an emergency department for treatment.
D. This child has signs of an incarcerated hernia. Bloody diarrhea is not related to
this condition.
2. A pediatric nurse listens while a mother describes her toddler’s eating habits. The mother
states that her daughter “refuses to eat vegetables at mealtime” and “wants peanut butter
sandwiches for every meal.” Which action by the nurse is the most appropriate?
a. Encourage the mom to keep trying to get the child to eat vegetables.
b. Reassure the mother that this behavior is normal for a toddler.
, c. Refer the mother to a pediatric dietician for unmet nutritional needs.
d. Teach the mother this behavior puts the child at risk for eating disorders.
ANS: B
Chapter: Chapter 16 Caring for the Child With A Gastrointestinal Condition
Objective: #3. Prioritize developmentally appropriate and holistic nursing care for
common conditions of the gastrointestinal system.
Page: 525
Heading: Nursing Insight> Appetite and Digestion
Integrated Processes: Teaching and Learning
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Nursing Roles; Nutrition
Difficulty: Moderate
Feedback
A. The parents should not force the child to eat foods he or she is not interested in.
Vegetables can be provided, along with a variety of nutritious foods, but the
parent should not pressure the child to eat.
B. The nurse should reassure parents that food jags are normal at this age and the
tendencies will pass; also stress that a little patience will keep both parents and
child from further gastrointestinal upsets.
C. Food jags are normal at this age and do not require referral to a pediatric
dietician.
D. Food jags are normal at this age. This behavior does not put the child at risk for
eating disorders.
3. A child is being discharged from the hospital after a pyloromyotomy. Which discharge
instruction does the nurse provide for the parents?
a. Keep child NPO for 48 hours.
b. Monitor the skin around the colostomy.
c. No pain control should be needed.
d. Report vomiting after 48 hours.
ANS: D
Chapter: Chapter 16 Caring for the Child With A Gastrointestinal Condition
Objective: #5. Develop teaching plans and discharge criteria for parents whose
children have common gastrointestinal conditions.
Page: 529
Heading: Surgical Care
Integrated Processes: Teaching and Learning
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Assessment; Nursing Roles
, Difficulty: Moderate
Feedback
A. Small feedings are usually started around 4–6 hours postoperatively.
B. A colostomy is not performed for this condition.
C. With any invasive surgical procedure, pain control will be needed based on
assessment of the patient.
D. A pyloromyotomy is performed for pyloric stenosis performed via laparoscopy.
Some vomiting may still occur for up to 36 hours postoperatively, but vomiting
persisting beyond 48 hours needs to be reported to the health-care provider.
4. A nurse is caring for an infant waiting for surgical correction of intussusception. The
child passes a diarrheal stool. Which action by the nurse is the most appropriate?
a. Document the findings.
b. Increase the IV fluid rate.
c. Notify the physician.
d. Weigh the child’s diaper.
ANS: C
Chapter: Chapter 16 Caring for the Child With A Gastrointestinal Condition
Objective: #2. Examine common conditions of the gastrointestinal system.
Page: 529
Heading: Nursing Care
Integrated Processes: Nursing Process: Implementation
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Assessment; Nursing Roles
Difficulty: Moderate
Feedback
A. Documentation should always occur, but this is not the only action the nurse
must take at this time.
B. Increasing the IV fluid rate based on passing a stool is not needed.
C. Intussusception is a condition in which a portion of the bowel invaginates or
telescopes into another portion of bowel, creating a partial bowel obstruction.
Spontaneous passage of stool may indicate resolution of the obstruction, so the
nurse should contact the provider immediately.
D. Weighing the child’s diaper is not the priority.
5. A child is taking azathioprine (Imuran) for moderate Crohn’s disease. Which assessment
finding best indicates that an important goal related to this medication has been met?
a. The child has not developed seasonal illnesses.
b. Edema and fluid retention have been eliminated.
c. Stools are more solid and passed less often.
, d. Weight gain has been consistent at each visit.
ANS: A
Chapter: Chapter 16 Caring for the Child With A Gastrointestinal Condition
Objective: #4. Explore diagnostic, laboratory testing and medications for common
conditions of the gastrointestinal system.
Page: 532-533
Heading: Medical Care
Integrated Processes: Nursing Process: Evaluation
Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies
Cognitive Level: Application [Applying]
Concept: Critical Thinking; Medication
Difficulty: Difficult
Feedback
A. Imuran is an immunosuppressive drug. Patients taking this medication (and
others like it) are more prone to catching seasonal illnesses to which they are
exposed in the community. A lack of such illnesses indicates that a goal for the
diagnosis of risk for infection (important when using this drug) has been met.
B. Edema and fluid retention are not symptoms related to this drug.
C. Stool character is not related to this drug.
D. Weight gain would indicate better absorption of nutrients, which is a problem
in Crohn’s disease, but it is not most closely correlated to this drug.
6. A nurse in a community clinic assesses children for signs of failure to thrive (FTT).
Which child’s assessment finding is most concerning to this nurse?
a. Child’s parent asking questions about feeding
b. Mother demonstrating improper burping technique
c. Weight for age and sex at the 4th percentile
d. Weight for length at 86% of ideal weight
ANS: C
Chapter: Chapter 16 Caring for the Child With A Gastrointestinal Condition
Objective: #4. Explore diagnostic, laboratory testing and medications for common
conditions of the gastrointestinal system.
Page: 523-524
Heading: Nutrition for the Child with a GI Condition
Integrated Processes: Nursing Process: Assessment
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Application [Applying]
Concept: Assessment; Critical Thinking; Nutrition
Difficulty: Moderate
Feedback
