GI Peds GI, GU, Musc (CP, Duchenne's)
Study Questions and Correct Answers
6.Which of the following should the nurse do first after noting that a child with
Hirschsprung disease has a fever and watery explosive diarrhea?
a. Notify the physician immediately
b. Administer antidiarrheal medications
c. Monitor child every 30 minutes
d. Nothing, this is characteristic ofHirschsprung disease ✅Answer A.
For the child with Hirschsprung disease, fever andexplosive diarrhea indicate
enterocolitis, a life-threatening situation. Therefore, the physicianshould be notified
immediately. Generally, becauseof the intestinal obstruction and inadequatepropulsive
intestinal movement, antidiarrheals arenot used to treat Hirschsprung disease. The child
isacutely ill and requires intervention, with monitoringmore frequently than every 30
minutes.Hirschsprung disease typically presents withchronic constipation.
18. A two-year-old child has sustained an injury to the leg and refuses to walk. The
nurse in the emergency department documents swelling of the lower affected leg.
Which of the following does the nurse suspect is the cause of the child's symptoms?
Possible fracture of the tibia.
Bruising of the gastrocnemius muscle.
Possible fracture of the radius.
No anatomic injury, the child wants his mother to carry him. ✅18. A
The child's refusal to walk, combined with swelling of the limb is suspicious for fracture.
Toddlers will often continue to walk on a muscle that is bruised or strained. The radius is
found in the lower arm and is not relevant to this question. Toddlers rarely feign injury to
be carried, and swelling indicates a physical injury.
20. A
19. A toddler has recently been diagnosed with cerebral palsy. Which of the following
information should the nurse provide to the parents? Note: More than one answer may
be correct.
Regular developmental screening is important to avoid secondary developmental
delays.
Cerebral palsy is caused by injury to the upper motor neurons and results in motor
dysfunction, as well as possible ocular and speech difficulties.
Developmental milestones may be slightly delayed but usually will require no additional
intervention.
,Parent support groups are helpful for sharing strategies and managing health care
issues. ✅19. A, B, D
Delayed developmental milestones are characteristic of cerebral palsy, so regular
screening and intervention is essential. Because of injury to upper motor neurons,
children may have ocular and speech difficulties. Parent support groups help families to
share and cope. Physical therapy and other interventions can minimize the extent of the
delay in developmental milestones.
20. A child has recently been diagnosed with Duchenne's muscular dystrophy. The
parents are receiving genetic counseling prior to planning another pregnancy. Which of
the following statements includes the most accurate information?
a. Duchenne's is an X-linked recessive disorder, so daughters have a 50% chance of
being carriers and sons a 50% chance of developing the disease.
b. Duchenne's is an X-linked recessive disorder, so both daughters and sons have a
50% chance of developing the disease.
c. Each child has a 1 in 4 (25%) chance of developing the disorder.
d. Sons only have a 1 in 4 (25%) chance of developing the disorder. ✅A.
The recessive Duchenne's gene is located on one of the two X chromosomes of a
female carrier. If her son receives the X bearing the gene he will be affected. Thus,
there is a 50% chance of a son being affected. Daughters are not affected, but 50% are
carriers because they inherit one copy of the defective gene from the mother. The other
X chromosome comes from the father, who cannot be a carrier.
When assessing a child for possible intussusception, which of the following would be
least likely to provide valuable information?
a.Stool inspection
b. Pain pattern
c. Family history
d. Abdominal palpation ✅Answer C
Because intussusception is not believed to have a familial tendency, obtaining a family
history would provide the least amount of information. Stooli nspection, pain pattern,
and abdominal palpation would reveal possible indicators of intussusception. Currant
jelly-like stools (bloody and mucoid) are an indication of intussusception. Acute,
episodic abdominal pain is characteristic of intussusception. A sausage-shaped mass
may be palpated in the right upper quadrant.
Which nursing action is a priority in the plan of care developed for a 7 year old child
hospitalized for acute glomerulonephritis?
A)Assess for generalized edema
B) Monitor for increased urinary output
C) Encourage rest during hyperactive periods
D) Note patterns of increased blood pressure ✅Answer D
,Note patterns of increased blood pressure. Hypertension is a key assessment in the
course of the disease.
Which is not a finding of compartment syndrome? Select all that apply.
a. Increased pain that is unrelieved with elevation or analgesics
b. Intense pain when passively moved
c. Paresthesia/numbness
d. Weak pulse distal to the fracture
e. Reduced ability to move digits ✅D, E
Findings of compartment syndrome include: increasing pain, unrelieved with elevation
or analgesics; intense pain when passively moved; paresthesia/numbness; no pulse
distal to the fracture; inability to move digits; warm digits with skin that is tight and shiny;
pallor.
A nurse is assigned to the pediatric rheumatology clinic and is assessing a child who
has just been diagnosed with juvenile idiopathic arthritis. Which of the following
statements about the disease is most accurate?
1. The child has a poor chance of recovery without joint deformity.
2. Most children progress to adult rheumatoid arthritis.
3. Nonsteroidal anti-inflammatory drugs are the first choice in treatment.
4. Physical activity should be minimized. ✅3
Nonsteroidal anti-inflammatory drugs are important first line treatment for juvenile
idiopathic arthritis (formerly known as juvenile rheumatoid arthritis). NSAIDs require 3-4
weeks for the therapeutic anti-inflammatory effects to be realized. Half of children with
the disorder recover without joint deformity, and about a third will continue with
symptoms into adulthood. Physical activity is an integral part of therapy.
2. A teen patient is admitted to the hospital by his physician who suspects a diagnosis
of acute glomerulonephritis. Which of the following findings is consistent with this
diagnosis? Note: More than one answer may be correct.
Urine specific gravity of 1.040.
Urine output of 350 ml in 24 hours.
Brown ("tea-colored") urine.
Generalized edema. ✅2. A, B, and C
Acute glomerulonephritis is characterized by high urine specific gravity related to
oliguria as well as dark "tea colored" urine caused by large amounts of red blood cells.
There is periorbital edema, but generalized edema is seen in nephrotic syndrome, not
acute glomerulonephritis.
3. Which of the following conditions most commonly causes acute glomerulonephritis?
A congenital condition leading to renal dysfunction.
, Prior infection with group A Streptococcus within the past 10-14 days.
Viral infection of the glomeruli.
Nephrotic syndrome. ✅3. B
Acute glomerulonephritis is most commonly caused by the immune response to a prior
upper respiratory infection with group A Streptococcus. Glomerular inflammation occurs
about 10-14 days after the infection, resulting in scant, dark urine and retention of body
fluid. Periorbital edema and hypertension are common signs at diagnosis.
20. A school-aged client admitted to thehospital because of decreased urine outputand
periorbital edema is diagnosed withglomerulonephritis. Which of the
followinginterventions would receive the highestpriority?
a)assessing vital signs every four hours
b) monitoring intake and output every 12hours
c) obtaining daily weight measurements
d) obtaining serum electrolyte levels daily ✅Answer C
The child will glomerulonephritis experiences aproblem with renal function that
ultimatelyaffects fluid balance. Because weight is thebest indicator of fluid balance,
obtaining dailyweights would be the highest priority.
When assessing a 12 year old child withWilm's tumor, the nurse should keep in
mindthat it most important to avoid which of thefollowing?
a)measuring the child's chestcircumference
b) palpating the child's abdomen
c) placing the child in an uprignt position
d) measuring the child's occipitofrontalcircumference ✅Answer B
The abdomen of the child with Wilm's tumorshould not be palpated because of the
dangerof disseminating tumor cells. The child withWilm's tumor should always be
handled gentlyand carefully
A nurse is caring for a child who sustained a fracture. What are appropriate nursing
interventions? Select all that apply.
a. Elevate the affected limb
b. Assess neurovascular status frequently
c. Stabilize the injury
d. Apply a cold pack on the site of the injury to reduce swelling
e. Establish IV access ✅ANS: A, B, C, D
IV needs an order, it is a collaborative intervention.
3. On the second day of hospitalization for a 3-month-old brought in for treatment for
gastroenteritis, the nurse makes all of the assessments listed below. Which assessment
finding indicates ineffectiveness of treatment?
a. Weight loss of 4 ounces
b. Dry mucous membranes
