Chapter 43: The Child with a Gastrointestinal Alteration
Test Bank
MULTIPLE CHOICE
1. What is the best response by the nurse to a mother asking about the cause of her infant’s
bilateral cleft lip?
a. “Did you use alcohol during your pregnancy?”
b. “Do you know of anyone in your family or the baby’s father’s family who was
born with cleft lip or palate problems?”
c. “This defect is associated with intrauterine infection during the second trimester.”
d. “The prevalent of cleft lip is higher in Caucasians”
ANS: B
Feedback
A Tobacco during pregnancy has been associated with bilateral cleft lip.
B Cleft lip and palate result from embryonic failure resulting from multiple genetic
and environmental factors. A genetic pattern or familial risk seems to exist.
C The defect occurred at approximately 6 to 8 weeks of gestation. Second-
trimester intrauterine infection is not a known cause of bilateral cleft lip.
D The prevalence of cleft lip and palate is higher in Asian and Native American
populations.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 1069-1070
OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
2. The postoperative care plan for an infant with surgical repair of a cleft lip includes
a. A clear liquid diet for 72 hours
b. Nasogastric feedings until the sutures are removed
c. Elbow restraints to keep the infant’s fingers away from the mouth
d. Rinsing the mouth after every feeding
ANS: C
Feedback
A The infant’s diet is advanced from clear liquid to soft foods within 48 hours of
surgery.
B After surgery, the infant can resume preoperative feeding techniques.
C Keeping the infant’s hands away from the incision reduces potential
complications at the surgical site.
D Rinsing the mouth after feeding is an inappropriate intervention. Feeding a small
amount of water after feedings will help keep the mouth clean. A cleft lip repair
site should be cleansed with a wet sterile cotton swab after feedings.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1073
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
,3. The nurse is caring for a neonate with a suspected tracheoesophageal fistula (TEF). Nursing
care should include
a. Elevating the head but give nothing by mouth
b. Elevating the head for feedings
c. Feeding glucose water only
d. Avoiding suction unless infant is cyanotic
ANS: A
Feedback
A When a newborn is suspected of having TEF, the most desirable position is
supine with the head elevated on an incline plane of at least 30 degrees. It is
imperative that any source of aspiration be removed at once; oral feedings are
withheld.
B Feedings should not be given to infants suspected of having TEF.
C Feedings should not be given to infants suspected of having TEF.
D The oral pharynx should be kept clear of secretion by oral suctioning. This is to
avoid cyanosis that is usually the result of laryngospasm caused by overflow of
saliva into the larynx.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1074
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
4. A nurse is teaching a group of parents about TEF. Which statement made by the nurse is
accurate about TEF?
a. This defect results from an embryonal failure of the foregut to differentiate into the
trachea and esophagus.
b. It is a fistula between the esophagus and stomach that results in the oral intake
being refluxed and aspirated.
c. An extra connection between the esophagus and trachea develops because of
genetic abnormalities.
d. The defect occurs in the second trimester of pregnancy.
ANS: A
Feedback
A When the foregut does not differentiate into the trachea and esophagus during
the fourth to fifth week of gestation, a TEF occurs.
B TEF is an abnormal connection between the esophagus and trachea.
C There is no connection between the trachea and esophagus in normal fetal
development.
D This defect occurs early in pregnancy during the fourth to fifth week of
gestation.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1071
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
5. What maternal assessment is related to an infant’s diagnosis of TEF?
, a. Maternal age more than 40 years
b. First term pregnancy for the mother
c. Maternal history of polyhydramnios
d. Complicated pregnancy
ANS: C
Feedback
A Advanced maternal age is not a risk factor for TEF.
B The first term pregnancy is not a risk factor for an infant with TEF.
C A maternal history of polyhydramnios is associated with TEF.
D Complicated pregnancy is not a risk factor for TEF.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1071
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
6. What clinical manifestation should a nurse be alert for when suspecting a diagnosis of
esophageal atresia?
a. A radiograph in the prenatal period indicates abnormal development.
b. It is visually identified at the time of delivery.
c. A nasogastric tube fails to pass at birth.
d. The infant has a low birth weight.
ANS: C
Feedback
A Prenatal radiographs do not provide a definitive diagnosis.
B The defect is not externally visible. Bronchoscopy and endoscopy can be used to
identify this defect.
C Atresia is suspected when a nasogastric tube fails to pass 10 to 11 cm beyond the
gum line. Abdominal radiographs will confirm the diagnosis.
D Infants with esophageal atresia may have been born prematurely and with a low
birth weight, but neither is suggestive of the presence of an esophageal atresia.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1071
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
7. What is the most important information to be included in the discharge planning for an infant
with gastroesophageal reflux?
a. Teach parents to position the infant on the left side.
b. Reinforce the parents’ knowledge of the infant’s developmental needs.
c. Teach the parents how to do infant cardiopulmonary resuscitation (CPR).
d. Have the parents keep an accurate record of intake and output.
ANS: C
Feedback
A Correct positioning minimizes aspiration. The correct position for the infant is
Test Bank
MULTIPLE CHOICE
1. What is the best response by the nurse to a mother asking about the cause of her infant’s
bilateral cleft lip?
a. “Did you use alcohol during your pregnancy?”
b. “Do you know of anyone in your family or the baby’s father’s family who was
born with cleft lip or palate problems?”
c. “This defect is associated with intrauterine infection during the second trimester.”
d. “The prevalent of cleft lip is higher in Caucasians”
ANS: B
Feedback
A Tobacco during pregnancy has been associated with bilateral cleft lip.
B Cleft lip and palate result from embryonic failure resulting from multiple genetic
and environmental factors. A genetic pattern or familial risk seems to exist.
C The defect occurred at approximately 6 to 8 weeks of gestation. Second-
trimester intrauterine infection is not a known cause of bilateral cleft lip.
D The prevalence of cleft lip and palate is higher in Asian and Native American
populations.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 1069-1070
OBJ: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
2. The postoperative care plan for an infant with surgical repair of a cleft lip includes
a. A clear liquid diet for 72 hours
b. Nasogastric feedings until the sutures are removed
c. Elbow restraints to keep the infant’s fingers away from the mouth
d. Rinsing the mouth after every feeding
ANS: C
Feedback
A The infant’s diet is advanced from clear liquid to soft foods within 48 hours of
surgery.
B After surgery, the infant can resume preoperative feeding techniques.
C Keeping the infant’s hands away from the incision reduces potential
complications at the surgical site.
D Rinsing the mouth after feeding is an inappropriate intervention. Feeding a small
amount of water after feedings will help keep the mouth clean. A cleft lip repair
site should be cleansed with a wet sterile cotton swab after feedings.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1073
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
,3. The nurse is caring for a neonate with a suspected tracheoesophageal fistula (TEF). Nursing
care should include
a. Elevating the head but give nothing by mouth
b. Elevating the head for feedings
c. Feeding glucose water only
d. Avoiding suction unless infant is cyanotic
ANS: A
Feedback
A When a newborn is suspected of having TEF, the most desirable position is
supine with the head elevated on an incline plane of at least 30 degrees. It is
imperative that any source of aspiration be removed at once; oral feedings are
withheld.
B Feedings should not be given to infants suspected of having TEF.
C Feedings should not be given to infants suspected of having TEF.
D The oral pharynx should be kept clear of secretion by oral suctioning. This is to
avoid cyanosis that is usually the result of laryngospasm caused by overflow of
saliva into the larynx.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1074
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
4. A nurse is teaching a group of parents about TEF. Which statement made by the nurse is
accurate about TEF?
a. This defect results from an embryonal failure of the foregut to differentiate into the
trachea and esophagus.
b. It is a fistula between the esophagus and stomach that results in the oral intake
being refluxed and aspirated.
c. An extra connection between the esophagus and trachea develops because of
genetic abnormalities.
d. The defect occurs in the second trimester of pregnancy.
ANS: A
Feedback
A When the foregut does not differentiate into the trachea and esophagus during
the fourth to fifth week of gestation, a TEF occurs.
B TEF is an abnormal connection between the esophagus and trachea.
C There is no connection between the trachea and esophagus in normal fetal
development.
D This defect occurs early in pregnancy during the fourth to fifth week of
gestation.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1071
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
5. What maternal assessment is related to an infant’s diagnosis of TEF?
, a. Maternal age more than 40 years
b. First term pregnancy for the mother
c. Maternal history of polyhydramnios
d. Complicated pregnancy
ANS: C
Feedback
A Advanced maternal age is not a risk factor for TEF.
B The first term pregnancy is not a risk factor for an infant with TEF.
C A maternal history of polyhydramnios is associated with TEF.
D Complicated pregnancy is not a risk factor for TEF.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1071
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
6. What clinical manifestation should a nurse be alert for when suspecting a diagnosis of
esophageal atresia?
a. A radiograph in the prenatal period indicates abnormal development.
b. It is visually identified at the time of delivery.
c. A nasogastric tube fails to pass at birth.
d. The infant has a low birth weight.
ANS: C
Feedback
A Prenatal radiographs do not provide a definitive diagnosis.
B The defect is not externally visible. Bronchoscopy and endoscopy can be used to
identify this defect.
C Atresia is suspected when a nasogastric tube fails to pass 10 to 11 cm beyond the
gum line. Abdominal radiographs will confirm the diagnosis.
D Infants with esophageal atresia may have been born prematurely and with a low
birth weight, but neither is suggestive of the presence of an esophageal atresia.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1071
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
7. What is the most important information to be included in the discharge planning for an infant
with gastroesophageal reflux?
a. Teach parents to position the infant on the left side.
b. Reinforce the parents’ knowledge of the infant’s developmental needs.
c. Teach the parents how to do infant cardiopulmonary resuscitation (CPR).
d. Have the parents keep an accurate record of intake and output.
ANS: C
Feedback
A Correct positioning minimizes aspiration. The correct position for the infant is
