Peds week 15 - GI & GU

A nurse is assessing a 14-year-old with suspected appendicitis. Which finding is most consistent with appendicitis?

A. Left upper quadrant pain and diarrhea
B. Periumbilical pain migrating to the right lower quadrant
C. Intermittent cramping relieved by eating
D. Pain that increases with bowel movements

B. Periumbilical pain migrating to the right lower quadrant → McBurney’s point

A 12-year-old with suspected appendicitis reports sudden pain relief. What is the priority action by the nurse?

A. Document findings and notify provider during next rounds
B. Encourage fluid intake
C. Assess for signs of perforation and notify provider immediately
D. Administer PRN acetaminophen for comfort

C. Assess for signs of perforation and notify provider immediately

Which diagnostic findings support the diagnosis of appendicitis?

A. Low WBC and low CRP
B. Elevated WBC count and elevated CRP
C. Low WBC with positive stool culture
D. Decreased neutrophils with normal CRP

B. Elevated WBC count and elevated CRP

Which intervention is most important to avoid in a patient with suspected appendicitis?

A. Starting IV fluids
B. Keeping the patient NPO
C. Applying a heating pad to the abdomen
D. Administering laxatives or stool softeners

D. Administering laxatives or stool softeners → Laxatives and stimulants increase the risk of perforation

A nurse palpates the abdomen of a child with abdominal pain. When should the nurse assess the tender area?

A. First
B. After auscultation but before percussion
C. Last
D. Only if bowel sounds are absent

C. Last

A nurse is caring for a 5-year-old with suspected appendicitis. Why is this age group at higher risk for perforation?

A. They often present too early for diagnosis
B. They cannot mount a fever response
C. They have difficulty localizing or verbalizing symptoms
D. Their appendix is anatomically longer

C. They have difficulty localizing or verbalizing symptoms

A patient with confirmed appendicitis is scheduled for emergency surgery. Which order does the nurse anticipate?

A. Encourage oral fluids until transport
B. Start broad-spectrum IV antibiotics
C. Give magnesium citrate to empty the bowel
D. Apply heat to relax abdominal muscles

B. Start broad-spectrum IV antibiotics

A nurse is reviewing risk factors. Which patient is at highest risk for mortality from appendicitis?

A. A 17-year-old athletic male
B. A 3-year-old toddler
C. A 12-year-old with seasonal allergies
D. A 16-year-old female

B. A 3-year-old toddler

A nurse is educating a patient post-appendectomy with a sump drain. Which statement indicates understanding?

A. “This drain helps prevent fluid buildup while my incision heals.”
B. “I should lie only on my right side.”
C. “The drain means the appendix has grown back.”
D. “I should increase activity to speed recovery.”

A. “This drain helps prevent fluid buildup while my incision heals.”

Which symptom should the nurse recognize as early appendicitis?

A. Rigidity and rebound tenderness
B. Hypotension and bradypnea
C. Nausea, vomiting, and periumbilical pain
D. High fever and absent bowel sounds

C. Nausea, vomiting, and periumbilical pain

A nurse is assessing a child with suspected appendicitis. Which physical exam finding is most concerning for peritonitis?

A. Soft abdomen with active bowel sounds
B. Rigid, board-like abdomen
C. Pain relieved by positioning
D. Hyperactive bowel sounds

B. Rigid, board-like abdomen

A nurse is caring for a child with suspected appendicitis who vomits. What should the nurse do next?

A. Insert a nasogastric tube immediately
B. Provide ice chips for comfort
C. Maintain NPO status and continue monitoring
D. Encourage sips of electrolyte solution

C. Maintain NPO status and continue monitoring

Which order would the nurse question for a patient with appendicitis?

A. IV normal saline at 80 mL/hr
B. Acetaminophen 650 mg PO every 6 hrs
C. Heating pad to abdomen PRN for pain
D. Ceftriaxone IV every 24 hrs

C. Heating pad to abdomen PRN for pain → Heat increases blood flow and risk of rupture

A nurse is reviewing lab results for a patient with suspected appendicitis. Which result is expected?

A. WBC of 17,000 with left shift
B. CRP within normal range
C. Hemoglobin of 7.5
D. Platelet count <100,000

A. WBC of 17,000 with left shift

A nurse suspects rupture of the appendix. Which assessment finding supports this?

A. Sudden relief of pain
B. Pain that worsens with coughing
C. Pain that migrates to RLQ
D. Constipation

A. Sudden relief of pain

Which finding in an infant is most suggestive of GERD?

A. Vomiting only in the morning
B. Weight gain above the 95th percentile
C. Irritability and poor weight gain after feedings
D. Projectile vomiting after every feeding

C. Irritability and poor weight gain after feedings → GERD infants often have irritability, poor feeding tolerance, and failure to thrive due to painful reflux.

A nurse is educating parents of a 4-month-old with GERD. Which instruction is appropriate?

A. Offer large feeds less frequently
B. Place the infant supine after feeding
C. Add thickener to feeds as prescribed
D. Avoid feeding the infant after 8 p.m.

C. Add thickener to feeds as prescribed → decrease reflux episodes

Which diagnostic test confirms esophageal damage in GERD?

A. Abdominal X-ray
B. Endoscopy with biopsy
C. pH probe alone
D. Upper GI series only

B. Endoscopy with biopsy

A child with GERD is prescribed a proton pump inhibitor. Which instruction should the nurse give?

A. “Give the medication with meals.”
B. “Give the medication 30 minutes before meals.”
C. “Give the medication at bedtime only.”
D. “Give the medication every other day.”

B. “Give the medication 30 minutes before meals.” → PPIs must be taken 30 minutes before meals for best acid suppression

Which child is at highest risk for GERD?

A. A term newborn with rapid weight gain
B. A premature infant
C. A toddler who prefers milk over solids
D. A school-age child with constipation

B. A premature infant → immature sphincter control

A nurse suspects an infant with GERD may be developing a complication. Which finding is most concerning?

A. Spitting up after feeds
B. Mild irritability in the evening
C. Chronic cough and wheezing
D. Decreased stool frequency

C. Chronic cough and wheezing

A parent asks why their baby’s GERD might go away by 1 year old. What is the best response?

A. “The esophagus becomes shorter with age.”
B. “The stomach becomes smaller and empties rapidly.”
C. “The lower esophageal sphincter matures over time.”
D. “The baby will eat fewer irritating foods.”

C. “The lower esophageal sphincter matures over time.”

Which dietary recommendation is appropriate for an adolescent with GERD?

A. Increase citrus intake
B. Avoid chocolate and caffeine
C. Drink carbonated soda with meals
D. Eat large meals before bedtime

B. Avoid chocolate and caffeine

Which intervention should the nurse expect after a Nissen fundoplication?

A. Strict NPO for 7 days
B. Placement of a GT or NGT for venting
C. Only oral feeds allowed immediately
D. No need to monitor for aspiration

B. Placement of a GT or NGT for venting

An infant with GERD continues to lose weight despite medical management. What is the priority action?

A. Increase feeding volume
B. Reduce feed frequency
C. Evaluate for failure to thrive
D. Switch to whole milk

C. Evaluate for failure to thrive

The nurse is caring for a child with chronic GERD. Which finding suggests esophageal stricture?

A. Excessive drooling
B. Difficulty swallowing solids
C. Increased appetite
D. Frequent hiccups

B. Difficulty swallowing solids

A baby with GERD experiences symptoms most after:

A. Early morning
B. After meals and at night
C. During naps only
D. After drinking water

B. After meals and at night

A nurse is assessing a newborn with a cleft palate. Which associated complication is the nurse MOST concerned about?

A. Difficulty maintaining body temperature
B. Feeding difficulties and risk for aspiration
C. Delayed onset of stooling
D. Hypertonicity during feeding

B. Feeding difficulties and risk for aspiration

Which child is MOST at risk for cleft lip or palate?

A. A child of European descent
B. A child whose mother had adequate folic acid intake
C. A child with a family history of cleft defects
D. A child born at 42 weeks gestation

C. A child with a family history of cleft defects

A nurse teaches parents of an infant with a cleft palate about feeding. Which instruction is appropriate?

A. “Use a regular nipple to improve oral muscle strength.”
B. “Feed the infant in a fully supine position.”
C. “Use a Haberman, Pigeon, or Dr. Brown's specialty bottle.”
D. “Avoid burping to prevent airway obstruction.”

C. “Use a Haberman, Pigeon, or Dr. Brown's specialty bottle.”

Which prenatal finding is MOST likely to diagnose cleft lip?

A. Third-trimester nonstress test
B. Amniotic fluid index
C. Prenatal ultrasound
D. MRI only after birth

C. Prenatal ultrasound → Ultrasound can detect cleft lip prenatally

A mother of an infant with cleft palate expresses concern about future speech development. The nurse should respond by explaining that:

A. Speech delays rarely occur
B. Early palate repair and speech therapy improve outcomes
C. Speech will develop normally without interventions
D. Surgery is postponed until after age 5

B. Early palate repair and speech therapy improve outcomes → repair is around 9 months

After cleft lip repair, the nurse’s priority instruction to parents is:

A. “You may use a pacifier to soothe your baby.”
B. “Use elbow immobilizers as prescribed.”
C. “Feed with a hard-tipped spoon to avoid leakage.”
D. “Place the infant prone during sleep.”

B. “Use elbow immobilizers as prescribed.”

Which postoperative rule must the nurse reinforce for a child after cleft palate repair?

A. No straw, pacifier, or sippy cup
B. Allow any bottle nipple the child prefers
C. Avoid burping the infant
D. Provide solid foods to stimulate oral muscles

A. No straw, pacifier, or sippy cup

Which finding would the nurse expect in an infant with submucous cleft palate?

A. Bifid uvula
B. Elevated RBC count
C. Absence of hunger cues
D. Normal suck and swallow

A. Bifid uvula → hallmark for submucous cleft

A nurse is educating a parent about repairing a cleft palate. Which statement indicates correct understanding?

A. “The palate is usually repaired at around 9 months of age.”
B. “Surgery is delayed until school age.”
C. “The lip must be repaired at the same time as the palate.”
D. “Speech therapy is not needed after repair.”

A. “The palate is usually repaired at around 9 months of age.”

Which assessment is MOST important before feeding an infant with cleft lip/palate?

A. Presence of rooting reflex
B. Ability to form a seal around the nipple
C. Presence of the Babinski reflex
D. Number of wet diapers in the last 24 hrs

B. Ability to form a seal around the nipple

Which newborn finding represents a complete cleft lip?

A. A small notch in the upper lip
B. A split that extends into the nostril
C. A bifid uvula with intact lip
D. An opening only in the soft palate

B. A split that extends into the nostril

A nurse is assessing a newborn with a cleft lip that affects only one side of the mouth. How should this be documented?

A. Bilateral incomplete cleft lip
B. Unilateral complete cleft lip
C. Unilateral cleft lip
D. Midline cleft lip

C. Unilateral cleft lip

Which cleft condition is MOST likely to cause feeding difficulties?

A. Incomplete unilateral cleft lip
B. Complete bilateral cleft palate
C. Small lip notch only
D. Bifid uvula alone

B. Complete bilateral cleft palate

Which infant is at highest risk of being born with a cleft lip or palate?

A. Infant of African American parents
B. Infant of Asian descent
C. Infant born to a mother with high folic acid intake
D. Infant from a family with no history of birth defects

B. Infant of Asian descent → more frequently in Asian, Native American, and Hispanic populations.

The nurse is reviewing epidemiology for cleft lip and palate. Which statement is accurate?

A. Cleft lip is more common in females than males
B. Cleft lip with or without palate is more common in males
C. Cleft palate alone is more common in males
D. Only bilateral clefts occur more in males

C. Cleft palate alone is more common in males

An infant is diagnosed with a bilateral complete cleft lip. Which description is accurate?

A. Both sides of the lip are partially separated
B. One side is fully separated; the other is intact
C. Both sides of the lip extend fully into the nostrils
D. Only the palate is affected

C. Both sides of the lip extend fully into the nostrils

A nurse notes a small indentation on one side of a newborn’s upper lip. Which finding is this?

A. Bilateral complete cleft lip
B. Unilateral incomplete cleft lip
C. Submucous cleft palate
D. Complete cleft lip and palate

B. Unilateral incomplete cleft lip

Which statement best describes esophageal atresia (EA) with tracheoesophageal fistula (TEF)?

A. A condition in which the esophagus ends in a blind pouch and/or forms an abnormal connection with the trachea
B. A narrowing of the trachea that occurs due to cardiac anomalies
C. A congenital absence of the stomach that prevents swallowing
D. A developmental failure of the diaphragm, causing abdominal organs to migrate into the chest

A. A condition in which the esophagus ends in a blind pouch and/or forms an abnormal connection with the trachea

A newborn with suspected Tracheoesophageal Fistula begins to cough, choke, and turn cyanotic during the first feeding. What is the PRIORITY action?

A. Administer a bottle with slower-flow nipple
B. Suction the airway and stop feeding immediately
C. Place the infant in a flat supine position
D. Give 10 mL of sterile water to clear the esophagus

B. Suction the airway and stop feeding immediately

Which newborn assessment finding is MOST suggestive of esophageal atresia?

A. Loud crying after feeds
B. Frothy saliva and excessive drooling
C. Constipation and abdominal distention
D. Absent Moro reflex

B. Frothy saliva and excessive drooling → hallmark signs

A nurse caring for an infant with suspected Tracheoesophageal Fistula should anticipate which immediate order?

A. Begin oral formula feeds
B. Place infant on strict NPO
C. Provide a pacifier during crying
D. Administer iron supplements

B. Place infant on strict NPO

Which infant is at the highest risk for esophageal atresia or Tracheoesophageal Fistula?

A. Full-term female infant with no anomalies
B. Premature male infant with cardiac defects
C. Infant with history of macrosomia
D. Infant of a mother with gestational hypertension

B. Premature male infant with cardiac defects

A nurse caring for an infant with Tracheoesophageal Fistula notes stridor and a barking cough. What complication does this suggest?

A. Asthma exacerbation
B. Tracheomalacia
C. Laryngospasm
D. Croup

B. Tracheomalacia → cartilage is weak and collapses when trying to breathe causing difficulty

Which diagnostic test is most appropriate for confirming Tracheoesophageal Fistula?

A. Fasting blood glucose
B. Chest X-ray
C. Rapid strep test
D. EEG

B. Chest X-ray

A nurse prepares a newborn with EA/TEF for surgery. Which is the PRIORITY preoperative intervention?

A. Place infant in a low Fowler’s position
B. Provide frequent oral hydration
C. Continuous suctioning of the upper pouch
D. Begin oral feeding trials

C. Continuous suctioning of the upper pouch

Which postoperative order should the nurse question in a patient recovering from Tracheoesophageal Fistula repair?

A. Slowly advance feeds when cleared
B. Maintain NPO until anastomosis is confirmed intact
C. Provide non-nutritive sucking
D. Insert a nasogastric tube without surgeon approval

D. Insert a nasogastric tube without surgeon approval

Which finding after Tracheoesophageal Fistula repair requires immediate intervention?

A. Mild drooling
B. Difficulty swallowing solids
C. Cyanosis and coughing during feeds
D. Occasional irritability

C. Cyanosis and coughing during feeds

A nurse teaches parents about long-term complications after Tracheoesophageal Fistula repair. Which issue should the nurse emphasize?

A. Increased risk of type 1 diabetes
B. Feeding aversion and swallowing difficulties
C. Excessive weight gain
D. Decreased risk of respiratory problems

B. Feeding aversion and swallowing difficulties

The nurse caring for a postoperative Tracheoesophageal Fistula patient explains that total parenteral nutrition is used because:

A. It prevents aspiration by bypassing oral feeding
B. It improves gastric emptying
C. It reduces reflux symptoms
D. It increases oral motor skills

A. It prevents aspiration by bypassing oral feeding

Which intervention reduces aspiration risk in infants with EA/TEF preoperatively?

A. Prone positioning
B. Elevate the head of bed
C. Provide continuous oral feeding
D. Offer thickened formula

B. Elevate the head of bed

The nurse recognizes that EA/TEF most commonly occurs in which population?

A. Full-term female newborns
B. Preterm infants, more often males
C. Infants born via cesarean section only
D. Newborns with maternal gestational diabetes

B. Preterm infants, more often males

Which combination of symptoms in a newborn is most consistent with EA/TEF?

A. Projectile vomiting, olive-shaped mass, dehydration
B. Cyanosis during feeding, frothy secretions, choking
C. Hypotonia, absent reflexes, apnea only during sleep
D. Persistent diarrhea, abdominal distention, fever

B. Cyanosis during feeding, frothy secretions, choking

Which statement best describes pyloric stenosis?

A. An inflammation of the pylorus caused by viral infection
B. A thickening of the pyloric muscle that narrows the gastric outlet
C. A congenital absence of the pylorus leading to bowel obstruction
D. A twisting of the stomach resulting in acute pain

B. A thickening of the pyloric muscle that narrows the gastric outlet

Pyloric stenosis occurs most commonly in which population?

A. Toddlers who recently transitioned to solid foods
B. Neonates, especially males
C. Infants of diabetic mothers only
D. Premature infants with respiratory distress syndrome

B. Neonates, especially males

A nurse palpates a small, firm mass in the right upper quadrant of an infant with vomiting. What does this finding most likely indicate?

A. Enlarged spleen
B. Distended bowel loop
C. “Olive-shaped” mass typical of pyloric stenosis
D. Enlarged liver

C. “Olive-shaped” mass typical of pyloric stenosis

Which symptom is most characteristic of pyloric stenosis?

A. Projectile, non-bilious vomiting after feeding
B. Bilious vomiting with abdominal distention
C. Bloody emesis and severe diarrhea
D. Vomiting relieved by position changes

A. Projectile, non-bilious vomiting after feeding

Which diagnostic test is most commonly used to confirm pyloric stenosis?

A. Abdominal X-ray
B. CT scan
C. Ultrasound
D. Upper GI endoscopy

C. Ultrasound

The priority preoperative intervention for an infant with pyloric stenosis is:

A. Encourage frequent feedings
B. Administer oral rehydration solutions
C. Maintain NPO status and correct electrolyte imbalances
D. Massage the abdomen to relieve the obstruction

C. Maintain NPO status and correct electrolyte imbalances

After surgical correction of pyloric stenosis, which nursing action is MOST appropriate?

A. Offer formula ad lib immediately
B. Advance feedings slowly from clear liquids to full liquids
C. Keep the infant NPO for 7 days
D. Expect immediate cessation of all vomiting

B. Advance feedings slowly from clear liquids to full liquids

What is the priority nursing consideration for a child hospitalized with pyloric stenosis?

A. Daily calorie counts
B. Strict intake and output monitoring
C. Encouraging large-volume feeds
D. Maintaining a warm environment

B. Strict intake and output monitoring

A nurse suspects constipation in a 5-year-old child. Which finding best supports this diagnosis?

A. Two soft stools per day
B. At least one stool daily but with mucus
C. Fewer than three stools per week
D. Stools that are green and watery

C. Fewer than three stools per week

Which symptom would most likely be associated with constipation in a school-age child?

A. Frequent diarrhea
B. Lower abdominal distension and decreased appetite
C. High fever and rash
D. Sudden weight gain

B. Lower abdominal distension and decreased appetite

Which child is at greatest risk for developing constipation?

A. A child taking iron supplements
B. A child with a viral infection
C. A child who recently began toilet training
D. A child on a high-fiber diet

A. A child taking iron supplements

A parent asks how to improve their child’s constipation. Which recommendation is most appropriate?

A. Limit fluids to avoid abdominal cramps
B. Switch to an all-dairy diet
C. Increase fiber, water, and physical activity
D. Give antidiarrheal medications daily

C. Increase fiber, water, and physical activity

A nurse reviews the chart of a child with constipation. Which cause should be investigated further?

A. Hypothyroidism
B. Mild dehydration
C. Recent viral illness
D. Use of acetaminophen

A. Hypothyroidism → slows gastric modility

Which treatment would the nurse expect to see prescribed for a child with persistent constipation?

A. Antiemetics and antihistamines
B. Stool softeners or laxatives
C. IV antibiotics
D. High-dose diuretics

B. Stool softeners or laxatives

A child with severe constipation is hospitalized. Which intervention is the priority?

A. Initiate a bowel program with scheduled toileting
B. Encourage prolonged bed rest
C. Discourage all rectal interventions
D. Keep the child NPO for 24 hours

A. Initiate a bowel program with scheduled toileting

The nurse is teaching a parent about home management of constipation. Which statement indicates the need for further teaching?

A. “I will encourage my child to drink plenty of water.”
B. “We will add fruits, vegetables, and whole grains to meals.”
C. “I will have my child rest in bed until their bowels return to normal.”
D. “Physical activity can help stimulate bowel movements.”

C. “I will have my child rest in bed until their bowels return to normal.”

A nurse prepares a child for an enema ordered for constipation. What is the nurse's priority action?

A. Explain the procedure using age-appropriate terms
B. Limit fluid intake before the procedure
C. Place the child flat with legs extended
D. Avoid all therapeutic communication

A. Explain the procedure using age-appropriate terms

Which assessment finding most strongly suggests complications from constipation?

A. Mild cramping during stooling
B. Blood in the stool with abdominal distension
C. Increased appetite
D. Increased bowel sounds

B. Blood in the stool with abdominal distension

Hirschsprung’s disease is characterized by which primary pathophysiology?

A. Hyperactive ganglion cells causing diarrhea
B. Absence of ganglion cells in a segment of the colon causing decreased motility
C. Overproduction of gastric acid leading to bowel obstruction
D. Immature sphincter tone leading to incontinence

B. Absence of ganglion cells in a segment of the colon causing decreased motility

Which infant is at highest risk for Hirschsprung’s disease?

A. Full-term female with no family history
B. Male infant with familial history of Hirschsprung’s disease
C. Premature infant with normal meconium passage
D. Infant born to a mother with gestational diabetes

B. Male infant with familial history of Hirschsprung’s disease

Which finding in a neonate would most strongly suggest Hirschsprung’s disease?

A. Passage of meconium within 12 hours of birth
B. Delayed passage of meconium >48 hours, abdominal distension, vomiting
C. Frequent watery stools since birth
D. Bilious vomiting without abdominal distension

B. Delayed passage of meconium >48 hours, abdominal distension, vomiting

An older child with Hirschsprung’s disease may present with:

A. Chronic constipation and ribbon-like stools
B. Diarrhea and explosive stools
C. Sudden weight gain and abdominal pain
D. Persistent vomiting only

A. Chronic constipation and ribbon-like stools

Which diagnostic test is definitive for Hirschsprung’s disease?

A. Abdominal ultrasound
B. Complete blood count
C. Biopsy of the affected bowel
D. MRI of the spine

C. Biopsy of the affected bowel

What is the primary treatment for Hirschsprung’s disease?

A. High-fiber diet and laxatives
B. Removal of the aganglionic portion of the colon
C. Long-term antibiotic therapy
D. Continuous NG decompression

B. Removal of the aganglionic portion of the colon

Which preoperative nursing action is MOST important for a child undergoing surgery for Hirschsprung’s disease?

A. Bowel preparation and monitoring for enterocolitis
B. Encourage high-fiber diet immediately before surgery
C. Limit fluid intake to prevent distension
D. Avoid abdominal assessments

A. Bowel preparation and monitoring for enterocolitis

Which complication must the nurse monitor for in children with Hirschsprung’s disease?

A. Enterocolitis and shock
B. Diabetes mellitus
C. Hypothyroidism
D. Respiratory infection

A. Enterocolitis and shock

A nurse is assessing a child with chronic constipation. Which stool characteristic is suggestive of Hirschsprung’s disease?

A. Soft, well-formed stools
B. Ribbon-like, narrow stools
C. Liquid stools with mucus
D. Hard pellets alternating with soft stools

B. Ribbon-like, narrow stools

Postoperative care for a child with Hirschsprung’s disease includes:

A. Early oral feeding with large meals
B. Monitoring abdominal circumference and stool output
C. Avoiding all bowel assessments
D. Restricting fluids for 24 hours

B. Monitoring abdominal circumference and stool output

Which statement best describes intussusception?

A. Twisting of the intestine on itself causing obstruction
B. Telescoping of one part of the intestine into an adjacent section
C. Inflammation of the small intestine from infection
D. Partial obstruction from congenital atresia

B. Telescoping of one part of the intestine into an adjacent section

Which age group is most commonly affected by intussusception?

A. Adolescents 12–18 years
B. Children 3 months to 6 years, most <2 years
C. Adults over 50 years
D. Neonates <1 month

B. Children 3 months to 6 years, most <2 years

A nurse is assessing a child with intussusception. Which symptom is most characteristic?

A. Chronic diarrhea
B. Steatorrhea
C. Continuous mild abdominal discomfort
D. Currant jelly stools and intermittent severe abdominal pain

D. Currant jelly stools and intermittent severe abdominal pain

Which diagnostic test is commonly used to confirm intussusception?

A. Abdominal ultrasound
B. Abdominal X-ray
C. CT scan of the brain
D. Upper endoscopy

A. Abdominal ultrasound

Which nonsurgical treatment is first-line for most children with intussusception?

A. Laparoscopic reduction
B. Gas (air) or contrast enema
C. Oral laxatives
D. IV corticosteroids

B. Gas (air) or contrast enema

Which symptom requires immediate intervention in a child with intussusception?

A. Mild intermittent abdominal pain
B. Vomiting with abdominal distension
C. Passage of normal soft stool
D. Mild fussiness

B. Vomiting with abdominal distension

Which postoperative nursing assessment is most important in a child treated for intussusception?

A. Presence of “normal” stool passage
B. Blood pressure only
C. Appetite for solid foods
D. Ability to walk

A. Presence of “normal” stool passage

Which complication should the nurse monitor for after treatment of intussusception?

A. Recurrence and perforation
B. Hyperglycemia
C. Pneumothorax
D. Urinary tract infection

A. Recurrence and perforation

A parent asks why their child’s stool appeared “red and jelly-like.” The nurse explains this occurs due to:

A. Infection with E. coli
B. Sloughed intestinal mucosa and blood from intussusception
C. Hemorrhoids
D. Milk allergy

B. Sloughed intestinal mucosa and blood from intussusception

Which is an important nursing intervention preoperatively for a child with intussusception?

A. Encourage oral feeding
B. Maintain NPO status, IV fluids, antibiotics, and NG decompression if needed
C. Administer high-fiber diet
D. Perform rectal temperature only

B. Maintain NPO status, IV fluids, antibiotics, and NG decompression if needed

Which statement best describes short gut syndrome?

A. Inflammation of the colon due to infection
B. Malabsorption of nutrients due to decreased small intestine surface area
C. Overproduction of digestive enzymes in the small intestine
D. Complete obstruction of the small intestine

B. Malabsorption of nutrients due to decreased small intestine surface area

Which patient is at highest risk for developing short gut syndrome?

A. A child with recent appendectomy
B. A toddler with constipation
C. An infant with prior small intestine resection
D. A school-age child with lactose intolerance

C. An infant with prior small intestine resection

Which symptom is most characteristic of short gut syndrome?

A. Constipation and hard stools
B. Diarrhea, weight loss, dehydration, pale or greasy stools
C. Blood in stool without diarrhea
D. Abdominal pain relieved by defecation

B. Diarrhea, weight loss, dehydration, pale or greasy stools