The Child with Health Problems of the Upper Gastrointestinal TractThe Child with Health Problems of the Upper Gastrointestinal Tract

When developing the plan of care for an infant with a cleft lip before corrective surgery is performed, which of the following would be a priority?
1. Maintaining skin integrity in the oral cavity.
2. Using techniques to minimize crying.
3. Altering the usual method of feeding.
4. Preventing the infant from putting fingers in the mouth.
Which of the following measures would be most effective in helping the infant with a cleft lip and palate to retain oral feedings?
1. Bubble the infant at frequent intervals.
2. Feed the infant small amounts at one time.
3. Place the end of the nipple far to the back of the infant's tongue.
4. Maintain the infant in a lying position while feeding.
When teaching the mother of an infant who has undergone surgical repair of a cleft lip how to care for the suture line, the nurse demonstrates how to remove formula and drainage. Which of the following solutions would the nurse use?
1. Mouthwash.
2. Povidone-iodine (Betadine) solution.
3. A mild antiseptic solution.
4. Half-strength hydrogen peroxide.
After teaching the parent of an infant who has had a surgical repair for a cleft lip about the use of elbow restraints at home, the nurse determines that the teaching has been successful when the parent states which of the following?
1. "We will keep the restraints on continuously except when checking the skin under them for redness."
2. "We will keep the restraints on during the day while he is awake, but take them off when we put him to bed at night."
3. "After we get home, we won't have to use the restraints because our child does not suck on his hands or fingers."
4. "We will be sure to keep the restraints on all the time until we come to see the physician for a follow-up visit."
The parent of an infant with a cleft lip and palate asks the nurse when the infant's cleft palate will be repaired. The nurse responds by stating that the first repair of a cleft palate is usually done at which of the following times?
1. Before the eruption of teeth.
2. When the child weighs approximately 10 kg (22 pounds).
3. Before the development of speech.
4. After the child learns to drink from a cup.
On the second postoperative day after repair of a cleft palate, which of the following would the nurse expect as most appropriate to use with a toddler?
1. Cup.
2. Straw.
3. Rubber-tipped syringe.
4. Large-holed nipple.
Immediately on return to the nursing unit after surgical repair of a cleft palate, in which of the following positions would the nurse place the child?
1. On the back with the head in a position of comfort.
2. In low Fowler's position with the head turned to the side.
3. Lying on the abdomen with the head turned to the side.
4. In reverse Trendelenburg with the head tilted forward.
The parents of a child with a tracheoesophageal fistula (TEF) express feelings of guilt about their baby's anomaly. Which of the following approaches by the nurse would best support the parents?
1. Helping the parents accept their feelings as a normal reaction
2. Explaining that the parents did nothing to cause the newborn's defect.
3. Encouraging the parents to concentrate on planning their baby's care.
4. Urging the parents to visit their newborn as often as possible.
After teaching the parents of a neonate diagnosed with TEF about this anomaly, the nurse determines that the teaching was successful when the father describes the condition as which of the following?
1. "The muscle below the stomach is too tight, causing the baby to vomit forcefully."
2. . "There is a blind upper pouch and an opening from the esophagus into the airway."
3. "The lower bowel is lacking certain nerves to allow normal function."
4. "A part of the bowel is on the outside without anything covering it."
Which of the following nursing diagnoses would the nurse identify as a priority for the infant with TEF?
1. . Impaired Parenting related to newborn's illness.
2. Risk for Injury related to increased potential for aspiration.
3. Ineffective Breathing Pattern related to a weak diaphragm.
4. Imbalanced Nutrition: Less Than Body Requirements, related to poor sucking ability.
Which of the following would indicate that the infant with TEF needs suctioning?
1. Brassy cough.
2. Substernal retractions.
3. Decreased activity level.
4. Increased respiratory rate.
When administering gastrostomy feedings to an infant after surgery to correct a TEF, which of the following would be most appropriate to prevent air from entering the stomach once the syringe barrel is attached to the gastrostomy tube?
1. Unclamp the tube after pouring the complete amount of formula to be administered into the syringe barrel.
2. Pour all of the formula to be administered into the syringe barrel after opening the clamp.
3. Maintain a continuous flow of formula down the side of the syringe barrel once the clamp is opened.
4. Allow a small amount of formula to enter the stomach before pouring more formula into the syringe barrel.
After surgery to repair a TEF, an infant receives gastrostomy tube feedings. After feeding the infant by this method, the nurse cradles and rocks the infant for about 15 minutes, primarily to help accomplish which of the following?
1. Promote intestinal peristalsis.
2. Prevent regurgitation of formula.
3. Relieve pressure on the surgical site.
4. Associate eating with a pleasurable experience.
A newborn who had a surgical repair of a TEF is started on oral feedings. Which of the following would the nurse include in the teaching plan for the mother about oral feedings?
1. They are better tolerated when small, frequent feedings are offered.
2. They should be offered on a feeding schedule to help the infant accept the feedings more readily.
3. They are best accepted by the infant when offered by the same nurse or by the infant's mother.
4. They are best planned in conjunction with observations of the infant's behavior.
A newborn with the diagnosis of imperforate anus is to be scheduled for a radiographic examination. The nurse explains to the parents that this examination is done to determine the distance between the anal dimple and which of the following?
1. Perineum.
2. Closed end of the rectum.
3. Colon
4. Rectovesical pouch.
Which of the following might the nurse assess in a newborn diagnosed with an anorectal malformation? Select all that apply.
1. Abdominal distension.
2. Loose stools.
3. Vomiting.
4. Meconium in the urine.
While caring for a neonate with an imperforate anus, the nurse assesses the neonate's urine output for which of the following?
1. Meconium.
2. Blood.
3. Bile.
4. Acetone.
After teaching the mother of a neonate who has successfully undergone surgery to repair a low anorectal anomaly, the mother indicates that she understands her child's prognosis when she states which of the following?
1. "My child will need to wear protective pads until puberty."
2. "My child will need extra fluids to prevent constipation."
3. "My child will probably always need a high-fiber diet."
4. "My child has a good chance of being potty trained."
When the infant returns to the unit after imperforate anus repair, the nurse places the infant in which of the following positions?
1. On the abdomen, with legs pulled up under the body.
2. On the back, with legs extended straight out.
3. Lying on the side with the hips elevated.
4. Lying on the back in a position of comfort.
The father of a neonate scheduled for gastrointestinal surgery asks the nurse how newborns respond to painful stimuli. Which of the following would be the nurse's best response?
1. "Newborns cry and cannot be distracted to stop crying."
2. "When faced with a pain, newborns try to roll away from it."
3. "Newborns typically move their whole body in response to pain."
4. "Pain causes the newborn to withdraw the affected part."
When developing the plan of care for a neonate who was diagnosed with an anorectal malformation and who subsequently underwent surgery, which of the following would be most helpful in facilitating parent–infant bonding?
1. Explaining to the parents that they can visit at any time.
2. Encouraging the parents to hold their infant.
3. Asking the parents to help monitor the infant's intake and output.
4. Helping the parents plan for their infant's discharge.
A 4-week-old infant admitted with the diagnosis of hypertrophic pyloric stenosis presents with a history of vomiting. The nurse would anticipate that the infant's vomitus would contain gastric contents and which of the following?
1. Bile and streaks of blood
2. Mucus and bile
3. Mucus and streaks of blood
4. Stool and bile.
An infant is admitted to the pediatric unit with a diagnosis of hypertrophic pyloric stenosis after vomiting for several days. Which of the following nursing diagnoses would be the priority?
1. Deficient Fluid Volume related to prolonged vomiting
2. Ineffective Airway Clearance to impaired swallowing.
3. Imbalanced Nutrition: Less Than Body Requirements related to prolonged vomiting.
4. Bowel Incontinence related to abdominal pain.
When an infant with pyloric stenosis is admitted to the hospital, which of the following would the nurse do first?
1. Weigh the infant.
2. Begin an intravenous infusion.
3. Switch the infant to an oral electrolyte solution
4. Orient the mother to the hospital unit.
After teaching the mother of an infant with pyloric stenosis about the disease, which of the following, if stated by the mother as a cause, indicates effective teaching?
1. "An enlarged muscle below the stomach sphincter."
2. "A telescoping of the large bowel into the smaller bowel."
3. "A result of giving the baby more formula than is necessary."
4. "My baby taking the formula too quickly."
Fluid replacement therapy is ordered for an infant diagnosed with pyloric stenosis. In addition to dextrose, water, and sodium chloride, which of the following would the nurse anticipate the physician to order as an additive to the intravenous solution?
1. Calcium chloride.
2. Bicarbonate chloride.
3. Potassium chloride.
4. Magnesium chloride.
When developing the plan of care for an infant with pyloric stenosis, the nurse identifies a nursing diagnosis of Deficient Fluid Volume related to prolonged vomiting. Which of the following parameters would the nurse expect to use when evaluating the client outcome?
1. Abdominal distention
2. Weight loss.
3. Vomiting.
4. Respiratory effort.
After undergoing surgical correction of pyloric stenosis, an infant is returned to the room in stable condition. While standing by the crib, the mother says, "Perhaps if I had brought my baby to the hospital sooner, the surgery could have been avoided." Which of the following would be the nurse's best response?
1. "Surgery is the most effective treatment for pyloric stenosis."
2. "Try not to worry; your baby will be fine."
3. "Do you feel that this problem indicates that you are not a good mother?"
4. "Do you think that earlier hospitalization could have avoided surgery?"
After surgery to correct pyloric stenosis, the nurse instructs the parents about the postoperative feeding schedule for their infant. The parents exhibit understanding of these instructions when they state that they can start feeding the child within which of the following time frames?
1. 6 hours.
2. 8 hours
3. 10 hours.
4. 12 hours.
Immediately after the first oral feeding after corrective surgery for pyloric stenosis, a 4-week-old infant is fussy and restless. Which of the following actions would be most appropriate at this time?
1. Encourage the parents to hold the infant.
2. Hang a mobile over the infant's crib.
3. Give the infant more to eat.
4. Give the infant a pacifier to suck on.
Which of the following behaviors exhibited by the parents of an infant with pyloric stenosis would the nurse correctly interpret as a positive indication of parental coping?
1. Telling the nurse that they have to get away for a while.
2. Discussing the infant's care realistically.
3. Repeatedly asking if their child is normal.
4. Exhibiting fear that they will disturb the infant.
When assessing a 4-month-old infant diagnosed with possible intussusception, the nurse would expect the mother to relate which of the following about the infant's crying and episodes of pain?
1. Constant accompanied by leg extension.
2. Intermittent with knees drawn to the chest.
3. Shrill during ingestion of solids.
4. Intermittent while being held in the mother's arms.
When obtaining the nursing history from the mother of an infant with suspected intussusception, which of the following questions would be most helpful?
1. "What do the stools look like?"
2. "When was the last time your child urinated?"
3. "Is your child eating normally?"
4. "Has your child had any episodes of vomiting?"
A nasogastric tube inserted during surgery to correct an infant's intussusception is no longer freely removing gastric secretions. Which of the following would the nurse do next?
1. Aspirate the tube with a syringe.
2. Irrigate the tube with distilled water.
3. Increase the level of suction.
4. Rotate the tube.
Which of the following assessments would be the priority for an infant who has had surgery to correct an intussusception and is now at risk for development of a paralytic ileus postoperatively?
1. Measurement of urine specific gravity.
2. Auscultation of bowel sounds.
3. Inspection of the first stool passed.
4. Measurement of gastric output.
An infant is to be discharged after surgery for intussusception. Which of the following would the nurse expect to include in the discharge teaching plan for the mother?
1. The infant will experience a change in the normal home routine.
2. The infant can return to the prehospital routine immediately.
3. The infant needs to ingest more calories at home than what was consumed in the hospital.
4. The infant will continue to experience abdominal cramping for a few days.
When assessing an infant with suspected inguinal hernia, which of the following findings would be most significant?
1. The inguinal swelling is reddened, and the abdomen is distended.
2. The infant is irritable, and a thickened spermatic cord is palpable.
3. The inguinal swelling can be reduced, and the infant has a stool in the diaper.
4. The infant's diaper is wet with urine, and the abdomen is nontender.
The physician is able to reduce an infant's hernia and schedules the infant for a herniorrhaphy in 2 days. The mother asks the nurse why the surgery is not performed now. Which of the following responses indicates that the nurse understands the rationale for delaying the surgery?
1. "Delaying the surgery ensures that your infant will receive the proper preoperative preparation."
2. "We need to make sure that your infant receives nothing by mouth for at least 24 hours before the surgery."
3. "Waiting these 2 days helps to allow any edema and inflammation in the area to subside."
4. Your infant needs to wear a truss for at least 24 hours before any surgery can be attempted."
Preoperatively, the nurse develops a plan to prepare a 7-month-old infant psychologically for a scheduled herniorrhaphy the next day. Which of the following would the nurse expect to implement to accomplish this goal?
1. Explaining the preoperative and postoperative procedures to the mother.
2. Having the mother stay with the infant.
3. Making sure the infant's favorite toy is available.
4. Allowing the infant to play with surgical equipment.
Which of the following instructions would the nurse expect to include in the discharge teaching plan for the parent of an infant who has had an inguinal herniorrhaphy?
1. Change diapers as soon as they become soiled.
2. Apply an abdominal binder.
3. Keep the incision covered with a sterile dressing.
4. Restrain the infant's hands.
A mother asks, "How should I bathe my baby now that he's had surgery for his inguinal hernia?" Which of the following instructions would the nurse give the mother?
1. "Clean his face and diaper area for 2 weeks."
2. Use sterile sponges to cleanse the inguinal incision."
3. "Give him a sponge bath daily for 1 week."
4. "Give the infant full tub baths every day."
A male adolescent who underwent repair of an inguinal hernia earlier today and is getting ready to go home receives instructions about resuming physical activities. Which of the following statements would indicate that he has understood the instructions?
1. "I can start riding my bike next week."
2. "I have to skip physical education classes for 2 weeks."
3. "I can start wrestling again in 3 weeks."
4. "I can return to my weight-lifting class in 2 weeks."

The Child with Health Problems of the Upper Gastrointestinal Tract

The Child with Health Problems of the Upper Gastrointestinal Tract

Quiz