Exam (elaborations)
Chapter 22. The Child with Gastrointestinal Dysfunction
- Course
- Pediatric nursing
- Institution
- Baylor College Of Medicine
Chapter 22. The Child with Gastrointestinal Dysfunction
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Chapter 22. The Child with Gastrointestinal DysfunctionMULTIPLE CHOICE
1. What test is used to screen for carbohydrate malabsorption?
a. Stool pH
b. Urine ketones
c. C urea breath test
d. ELISA stool assay
ANS: A
The anticipated pH of a stool specimen is 7.0. A stool pH of less than 5.0 is indicative of
carbohydrate malabsorption. The bacterial fermentation of carbohydrates in the colon produces
short-chain fatty acids, which lower the stool pH. Urine ketones detect the presence of ketones
in the urine, which indicates the use of alternative sources of energy to glucose. The C urea
breath test measures the amount of carbon dioxide exhaled. It is used to determine the presence
of Helicobacter pylori. ELISA (enzyme-linked immunosorbent assay) detects the presence of
antigens and antibodies. It is not useful for disorders of metabolism.
DIF: Cognitive Level: Understanding REF: dl. 1055
,TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
2. A toddlers mother calls the nurse because she thinks her son has swallowed a button type of
battery. He has no signs of respiratory distress. The nurses response should be based on which
premise?
a. An emergency laparotomy is very likely.
b. The location needs to be confirmed by radiographic examination.
c. Surgery will be necessary if the battery has not passed in the stool in 48 hours.
d. Careful observation is essential because an ingested battery cannot be accurately
detected. ANS: B
Button batteries can cause severe damage if lodged in the esophagus. If both poles of the battery
come in contact with the wall of the esophagus, acid burns, necrosis, and perforation can occur.
If the battery is in the stomach, it will most likely be passed without incident. Surgery is not
indicated. The battery is metallic and is readily seen on radiologic examination.
DIF: Cognitive Level: Applying REF: dl. 1068 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
3. The mother of a child with cognitive impairment calls the nurse because her son has been
gagging and drooling all morning. The nurse suspects foreign body ingestion. What
physiologic occurrence is most likely responsible for the presenting signs?
, a. Gastrointestinal perforation may have occurred.
b. The object may have been aspirated.
c. The object may be lodged in the esophagus.
d. The object may be embedded in stomach
wall. ANS: C
Gagging and drooling may be signs of esophageal obstruction. The child is unable to swallow
saliva, which contributes to the drooling. Signs of gastrointestinal (GI) perforation include chest
or abdominal pain and evidence of bleeding in the GI tract. If the object was aspirated, the child
would most likely have coughing, choking, inability to speak, or difficulty breathing. If the
object was embedded in the stomach wall, it would not result in symptoms of gagging and
drooling.
DIF: Cognitive Level: Applying REF: dl. 1071
TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity
4. What is a high-fiber food that the nurse should recommend for a child with
chronic constipation?
a. White rice
b. Popcorn
c. Fruit juice
d. Ripe bananas
ANS: B
Popcorn is a high-fiber food. Refined rice is not a significant source of fiber. Unrefined brown
rice is a fiber source. Fruit juices are not a significant source of fiber. Raw fruits, especially those
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