Chapter 28: The Child with a Gastrointestinal Condition Nursing School Test Banks

Chapter 28: The Child with a Gastrointestinal Condition

MULTIPLE CHOICE

1. Which finding in a newborn is suggestive of tracheoesophageal fistula?
a. Failure to pass meconium in 24 hours
b. Choking on the first feeding
c. Palpable mass in the sternal area
d. Visible peristalsis across abdomen
ANS: B
After birth, a newborn with tracheoesophageal fistula will vomit and choke when the first feeding is introduced.

DIF: Cognitive Level: Comprehension REF: Page 644 OBJ: 2
TOP: Esophageal Atresia KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

2. A child is brought to the pediatric clinic because he has been vomiting for the past 2 days. What acid-base imbalance would the nurse expect to occur from this persistent vomiting?
a. Hyperkalemia
b. Hypernatremia
c. Acidosis
d. Alkalosis
ANS: D
Hydrochloric acid and sodium chloride from the stomach are lost from persistent vomiting. This results in alkalosis.

DIF: Cognitive Level: Comprehension REF: Page 650-651 | Page 658, Table 28-5
OBJ: 9 TOP: Acid-Base Balance
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

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
c. Decreased skin turgor
d. Depressed fontanelle
ANS: A
Weight loss is the most significant indicator of dehydration because an infants weight comprises 77% water.

DIF: Cognitive Level: Application REF: Page 656, Table 28-2
OBJ: 9 TOP: Dehydration KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. Why are rapid respirations a possible cause of dehydration?
a. They prevent the child from drinking.
b. They increase circulation, thus increasing urine production.
c. They cause evaporation of fluid on the mucous membranes.
d. They often lead to vomiting.
ANS: C
Rapid respirations cause increased insensible fluid loss.

DIF: Cognitive Level: Comprehension REF: Page 656 OBJ: 9
TOP: Dehydration KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. Which is the most appropriate intervention for a 3-month-old infant who has gastroesophageal reflux?
a. Position the infant in the crib on his or her abdomen, with the head elevated.
b. Administer medication as ordered to stimulate the pyloric sphincter.
c. Give thin rice cereal with formula before feeding solid foods.
d. Place the infant in an infant seat after feedings.
ANS: A
After feedings, the infant is placed in a prone position to avoid increased intraabdominal pressure.

DIF: Cognitive Level: Application REF: Page 651 OBJ: 7
TOP: Gastroesophageal Reflux KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

6. The nurse is interviewing parents of an infant with pyloric stenosis. What would the nurse expect the parents to report?
a. Diarrhea
b. Projectile vomiting
c. Poor appetite
d. Constipation
ANS: B
Vomiting is the outstanding symptom of pyloric stenosis. Food is ejected with considerable force, which is described as projectile vomiting.

DIF: Cognitive Level: Comprehension REF: Page 645 OBJ: 3
TOP: Pyloric Stenosis KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

7. A mother reports that her child has been scratching the anal area and complaining of itching. What does the nurse suspect based on this information?
a. Pinworms
b. Giardiasis
c. Ringworm
d. Roundworm
ANS: A
With pinworms, the nurse or parent may notice that the child scratches the anal area and complains of itchiness. The other choices do not cause this reaction.

DIF: Cognitive Level: Application REF: Page 662 OBJ: 12
TOP: Worms KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

8. The nurse is teaching a parent about pyrvinium (Povan). What would be included in regard to potential side effects?
a. Diarrhea
b. Skin rash
c. Red stool
d. Metallic taste
ANS: C
The nurse should advise parents that pyrvinium stains clothing and turns stools red.

DIF: Cognitive Level: Knowledge REF: Page 662 OBJ: 12
TOP: Worms KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

9. What instruction will the nurse give to parents about preventing the spread and reinfection of pinworms?
a. Keep childrens nails short.
b. Dress child in loose-fitting underwear.
c. Clean the bathroom with bleach solution.
d. Wash bed linens in cold water.
ANS: A
One intervention to prevent the further spread of pinworms is to keep the childs fingernails short. Pinworms are not spread from person to person.

DIF: Cognitive Level: Comprehension REF: Page 662 OBJ: 12
TOP: Worms KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

10. A mother reports that her 2-year-old child experiences constipation frequently. Which food would the nurse recommend to include in the childs diet?
a. Cooked vegetables
b. Pretzels
c. Whole-grain cereal
d. Yogurt
ANS: C
Dietary modifications for constipation include eating more high-roughage foods such as whole-grain breads and cereals.

DIF: Cognitive Level: Comprehension REF: Page 654 OBJ: N/A
TOP: Constipation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

11. What description of a childs stool characteristic leads the nurse to suspect intussusception?
a. Currant jelly
b. Black and tarry
c. Green liquid
d. Greasy and foul-smelling
ANS: A
Bowel movements of blood and mucus that contain no feces (currant jelly stools) are common about 12 hours after the onset of the obstruction.

DIF: Cognitive Level: Comprehension REF: Page 649 OBJ: 6
TOP: Intussusception KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

12. What is the treatment of choice for a child with intussusception?
a. A barium enema
b. Immediate surgery
c. IV fluids until the spasms subside
d. Gastric lavage
ANS: A
A barium enema is the treatment of choice for intussusception because the passage of the barium frequently un-telescopes the bowel. Surgery is scheduled only if reduction is not achieved.

DIF: Cognitive Level: Knowledge REF: Page 649 OBJ: 6
TOP: Intussusception KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity

13. Parents ask the nurse how their infant developed a Meckels diverticulum. What condition, will the nurse explain, is present causing this diagnosis?
a. The yolk sac remains connected to the intestine.
b. There is inflammation of the ileocecal valve.
c. A pouch forms when the vitelline duct fails to disappear.
d. There is a weakness in the abdominal wall.
ANS: C
If the vitelline duct fails to disappear completely after birth, a blind pouch may form.

DIF: Cognitive Level: Knowledge REF: Page 649 OBJ: 2
TOP: Meckels Diverticulum KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

14. An infant is admitted to the hospital with severe isotonic dehydration. For what is this child at the highest risk?
a. Metabolic alkalosis
b. Hypocalcemia
c. Sepsis
d. Shock
ANS: D
Shock is the greatest threat to life in isotonic dehydration.

DIF: Cognitive Level: Comprehension REF: Page 657 OBJ: 9
TOP: Dehydration KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

15. A child is brought to the emergency department because he ingested an unknown quantity of acetaminophen (Tylenol). What does the nurse expect this child to receive following gastric lavage?
a. Activated charcoal
b. N-acetylcysteine
c. Vitamin K
d. Syrup of ipecac
ANS: B
Gastric lavage is followed by N-acetylcysteine (Mucomyst), the antidote for acetaminophen.

DIF: Cognitive Level: Comprehension REF: Page 663 OBJ: 14
TOP: Acetaminophen Poisoning KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

16. The nurse is planning a parent education program about lead poisoning prevention. What will be included regarding primary sources of lead in the community?
a. Increased lead content of air
b. Use of aluminum cookware
c. Deteriorating paint in older buildings
d. Inhaling smog
ANS: C
The primary source of lead is paint from old, deteriorating buildings.

DIF: Cognitive Level: Knowledge REF: Page 666 OBJ: 15
TOP: Lead Poisoning KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity

17. A frightened mother calls the pediatricians office because her child swallowed dishwashing detergent. What is the most appropriate action?
a. Induce vomiting by giving the child syrup of ipecac.
b. Take the child to the local emergency department.
c. Give the child activated charcoal mixed with juice.
d. Give the child milk to soothe affected mucous membranes.
ANS: B
Inducing vomiting is no longer recommended because it may pose additional problems. The child should be taken immediately to the nearest emergency department along with the packaging of the ingested substance.

DIF: Cognitive Level: Application REF: Page 662-663
OBJ: 13 TOP: Poisoning KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

18. A child has been diagnosed with ascariasis (roundworm). Which statement made by her mother that may suggest a cause for her condition?
a. Ive been airing out the house on these nice breezy days.
b. My child often goes out to the garden and pulls up a carrot to eat.
c. She runs barefoot so much I have to wash her feet at least twice a day.
d. We just remodeled our bathroom at home.
ANS: B
The child can ingest roundworm eggs from contaminated soil.

DIF: Cognitive Level: Comprehension REF: Page 662 OBJ: 12
TOP: Worms KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

19. What does the nurse expect the appearance of the stools of a child with celiac disease to be?
a. Ribbon like
b. Hard, constipated
c. Bulky, frothy
d. Loose, foul-smelling
ANS: C
Celiac disease causes malabsorption. Stools that are large, bulky, and frothy may indicate malabsorption.

DIF: Cognitive Level: Comprehension REF: Page 647 OBJ: 4
TOP: Celiac Disease KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. The nurse has reviewed dietary restrictions for celiac disease with concerned parents. Which grain will the nurse explain can be eaten with celiac disease?
a. Wheat
b. Oats
c. Barley
d. Rice
ANS: D
Rice is a gluten-free grain that can be eaten by children afflicted with celiac disease. These children will have a lifelong restriction of wheat, oats, barley, and rye.

DIF: Cognitive Level: Knowledge REF: Page 647 OBJ: 4
TOP: Celiac Disease KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

21. A 7-month-old infant is admitted to the hospital with a diagnosis of acute gastroenteritis. What will be the nursess priority goal of the infants care?
a. Prevent fluid and electrolyte imbalance.
b. Prevent nutritional deficiency.
c. Prevent skin breakdown.
d. Prevent malabsorption.
ANS: A
The priority goal of care in gastroenteritis is preventing fluid and electrolyte imbalance.

DIF: Cognitive Level: Application REF: Page 650 OBJ: N/A
TOP: Gastroenteritis KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

22. The nurse is speaking to the parent of a 3-year-old child who has mild diarrhea. What dietary modification would the nurse advise?
a. Soft foods with rice, bananas, toast, and applesauce
b. Small amounts of clear fluids such as gelatin
c. An oral rehydrating solution, such as Pedialyte
d. Chicken soup because it is high in sodium
ANS: C
An oral rehydrating solution is recommended to replace fluids and electrolytes lost from frequent bowel movements.

DIF: Cognitive Level: Application REF: Page 652 OBJ: 9
TOP: Diarrhea KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

23. What would the nurse expect to find in a child admitted to the hospital for nonorganic failure to thrive?
a. Cry to be picked up
b. Be limp like a rag doll
c. Be responsive to cuddling
d. Weigh in the 10th percentile for age
ANS: B
Some children with failure to thrive have rag-doll limpness (hypotonia) and appear wary of their caregivers.

DIF: Cognitive Level: Comprehension REF: Page 659 OBJ: N/A
TOP: Failure to Thrive KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

24. Which nursing interventions will be implemented for the mother of a 10-month-old infant with nonorganic failure to thrive?
a. Pointing out errors that the nurse observes when the mother is caring for the infant
b. Discussing negative characteristics of the infant with the mother
c. Having the nurse provide as much of the infants care as possible
d. Teaching the mother about the developmental milestones to expect in the next few months
ANS: D
The nurse can increase parents knowledge of growth and development by providing anticipatory guidance about normal developmental milestones.

DIF: Cognitive Level: Application REF: Page 659-660
OBJ: N/A TOP: Failure to Thrive
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

25. Which statement by a mother may indicate a cause of her sons vitamin C deficiency?
a. We get our fruits from homemade preserves.
b. We use milk from our own goats.
c. We grow all our own vegetables.
d. Were not big meat eaters.
ANS: A
Vitamin C is destroyed by heat.

DIF: Cognitive Level: Comprehension REF: Page 660 OBJ: N/A
TOP: Scurvy KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

26. The nurse is instructing a mother how to administer oral nystatin suspension prescribed to treat thrush. What will the nurse include?
a. Pour the prescribed amount into a nipple and have the infant suck the medication.
b. Squirt the prescribed dose into the back of the mouth and have the infant swallow.
c. Give the medication mixed with a small amount of juice in a bottle.
d. Use a sterile applicator to swab the medication on the oral mucosa.
ANS: D
An appropriate way to administer nystatin is to moisten a sterile applicator with the medication and then swab it on the inside of the mouth.

DIF: Cognitive Level: Application REF: Page 661 OBJ: 11
TOP: Thrush KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

27. Why are infants more vulnerable to fluid and electrolyte imbalances than adults?
a. They have a smaller surface area than adults in proportion to body weight.
b. Water needs and losses per kilogram are lower than those for adults.
c. A greater percentage of body water in infants is extracellular.
d. Infants have a lower metabolic turnover of water.
ANS: C
A greater percentage of body water is contained in the extracellular compartment of children under 2 years of age.

DIF: Cognitive Level: Knowledge REF: Page 656 OBJ: 8
TOP: Dehydration KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

28. An infant is admitted to the hospital with severe dehydration. Laboratory results show pH 7.32, PaCO2 40, HCO3 21. How does the nurse interpret these values?
a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
ANS: A
A pH lower than 7.35 indicates acidosis. If the childs pH falls in the same line as the HCO3, the problem is metabolic (see Table 27-4).

DIF: Cognitive Level: Analysis REF: Page 658, Table 28-5
OBJ: 9 TOP: Fluid and Electrolyte Imbalance
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

29. Following surgery for pyloric stenosis, an infant awoke from anesthesia hungry and crying. What is the most appropriate nursing action?
a. Delay feeding the child for 6 hours.
b. Offer regular formula thinned with water.
c. Give small amounts of regular formula thickened with cereal.
d. Allow 1 ounce of glucose water at frequent intervals.
ANS: D
Small oral feedings of glucose water are given after recovery from anesthesia. Feedings are gradually increased to larger amounts of regular formula.

DIF: Cognitive Level: Application REF: Page 645 OBJ: 9
TOP: Postoperative Pyloric Stenosis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

30. The nurse is caring for an 18-pound child who has had one stool of diarrhea. The nurse knows that the child needs to consume how many milliliters of oral fluid to make up for the fluid loss?
a. 18
b. 36
c. 64
d. 81
ANS: D
The formula for oral fluid replacement is 10 mL/kg. 18 pounds = 8.1 kg 10 = 81 mL.

DIF: Cognitive Level: Analysis REF: Page 655 OBJ: 9
TOP: Oral Fluid Replacement KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

31. Which statement made by a parent alerts the nurse to the need for additional education about poison prevention?
a. I keep the poison control center phone number easily accessible.
b. All medication is kept out of reach in a locked cabinet.
c. I keep a bottle of syrup of ipecac handy.
d. Our garden is free from marigolds.
ANS: C
Traditionally, syrup of ipecac was the treatment of choice to remove some types of poisons from a childs system and parents were advised to keep a supply on hand in the home. However, the American Academy of Pediatrics (AAP) revised this policy in 2003. Parents are now advised to call the poison control center and bring the container of the substance ingested to the hospital emergency department as quickly as possible because stomach lavage is rarely effective 1 hour or more after ingestion. Ipecac syrup should not be kept in the home. Uncontrolled vomiting can cause serious complications.

DIF: Cognitive Level: Comprehension REF: Page 663 OBJ: 13
TOP: Poison Control KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

32. Which assessment would the nurse report to the physician immediately?
a. 2-month-old with a urine output of 150 mL in 24 hours
b. 3-year-old with a urine output of 650 mL in 24 hours
c. 8-year-old with a urine output of over 1000 mL in 24 hours
d. 14-year-old with a urine output of 800 mL in 24 hourse
ANS: A
The urine output of a 2-month-old should be between 400 and 500 mL/24 hours.

DIF: Cognitive Level: Application REF: Page 657 OBJ: 9
TOP: Dehydration KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Adaptation: Physiological Integrity

MULTIPLE RESPONSE

33. What interventions will the nurse perform when feeding a child with pyloric stenosis? (Select all that apply.)
a. Give a formula thinned with water.
b. Burp the infant before and during feeding.
c. Give the feeding slowly.
d. Refeed if the infant vomits.
e. Position infant on left side after feeding.
ANS: B, C, D
Children with pyloric stenosis are given formula thickened with cereal; the infant is burped before and during feeding to get rid of any gas in the stomach; the infant is fed slowly and refed if vomiting occurs. The infant is positioned on the right side to allow the weight of the feeding to stay in the stomach against the pyloric valve.

DIF: Cognitive Level: Application REF: Page 645 OBJ: 3
TOP: Pyloric Stenosis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

34. What assessment(s) would lead a nurse to suspect Hirschsprungs disease in a 1-month-old infant? (Select all that apply.)
a. Ribbon-like stools
b. Fever
c. Failure to thrive
d. Vomiting
e. Diminished peristalsis
ANS: A, B, C, D, E
All options are significant indicators of Hirschsprungs disease.

DIF: Cognitive Level: Comprehension REF: Page 648 OBJ: 5
TOP: Hirschsprungs Disease KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

35. What sign(s) indicate(s) moderate dehydration? (Select all that apply.)
a. 10% weight loss
b. Dry mucous membranes
c. Normal anterior fontanel
d. Increased urinary output
e. Lethargy
ANS: A, B, C
The child that is moderately dehydrated will have lost 10% of his body weight, will have dry mucous membranes, normal (nonsunken) anterior fontanelle, decreased urine output, and will be irritable.

DIF: Cognitive Level: Comprehension REF: Page 657, Table 28-4
OBJ: 9 TOP: Moderate Dehydration
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

36. A child is brought into the ED with suspected appendicitis. What signs and symptoms does the nurse expect to assess? (Select all that apply.)
a. Left lower quandrant pain
b. Guarding
c. Rebound tenderness
d. Decreased C-reactive protein
e. Pain on lifting thigh when supine
ANS: B, C, E
With appendicitis on examination, characteristic tenderness in the right lower quadrant known as McBurneys point will occur. Other diagnostic signs include guarding (tightening of the abdominal muscles or rigidity of the abdomen on palpation); rebound tenderness (pressing the RLQ with rapid release of pressure causes severe pain); pain on lifting the thigh while in the supine position is caused by muscle irritation. C-reactive protein levels will be increased after 12 hours if any infection is present.

DIF: Cognitive Level: Comprehension REF: Page 660-670
OBJ: 1 TOP: Appendicitis KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

37. Parents have adopted a child with the diagnosis of kwashiorkor. What is most likely to be observed when assessing this child? (Select all that apply.)
a. Hyperactivity
b. White streak in hair
c. Edematous abdomen
d. Slowed growth
e. Thick, oily hair
ANS: B, C, D
Kwashiorkor means, in native dialect, the disease of the deposed baby when the next one is born, indicating that the child no longer breastfeeds because a sibling is born and takes over the breast of the mother. Oral intake then is deficient in protein. The child fails to grow normally. The muscles become weak and wasted. There is edema of the abdomen that may become generalized. Diarrhea, skin infections, irritability, anorexia, and vomiting may be present. The hair becomes thin and dry. Because protein is the basis of melanin, a substance that provides color to hair, melanin becomes deficient. This is the reason the earliest sign of this protein malnutrition is a white streak in the hair of the child (depigmentation). The child looks apathetic and weak.

DIF: Cognitive Level: Comprehension REF: Page 660 OBJ: 10
TOP: Nutritional Deficiencies KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

COMPLETION

38. The nurse, assessing an elevated erythrocyte sedimentation rate (ESR) for an infant with gastroenteritis, recognizes that this confirms the _______________ process that is part of this disease.

ANS:
inflammatory

The ESR elevates in the presence of an inflammatory response.

DIF: Cognitive Level: Comprehension REF: Page 650 OBJ: 9
TOP: Gastroenteritis KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

39. The nurse explains that because _________________ beverages cause diuresis, they are not good choices for fluid replacement in a child who is dehydrated.

ANS:
caffeinated

Cola or other caffeinated drinks cause diuresis and will further dehydrate an already dehydrated child.

DIF: Cognitive Level: Knowledge REF: Page 652 OBJ: 9
TOP: Dehydration KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

40. The nurse explains that rickets, a deficiency disease that causes bony deformities, is caused by the inadequate supply of vitamin ______.

ANS:
D

Rickets is caused by a deficiency of vitamin D.

DIF: Cognitive Level: Knowledge REF: Page 660 OBJ: N/A
TOP: Rickets KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

41. The nurse reminds parents of a child allergic to cows milk that they should avoid foods that list ______________ as part of their contents.

ANS:
casein

Food labels that list casein contain cows milk.

DIF: Cognitive Level: Comprehension REF: Page 650, Table 28-1
OBJ: 2 TOP: Casein KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

42. The nurse explains the medically accepted definition of constipation is fewer than _____ bowel movements in a 2-week period.

ANS:
seven

The medically accepted definition of constipation is fewer than seven bowel movements in a 2-week period.

DIF: Cognitive Level: Knowledge REF: Page 654 OBJ: N/A
TOP: Constipation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

43. Hernias are successfully repaired by the surgical operation called a _____________.

ANS:
herniorrhaphy

Hernias are successfully repaired by the surgical operation called a herniorrhaphy. This is a relatively simple procedure and is well tolerated by the child. Most children are scheduled for procedures in same-day surgery units. The benefits of this method are both economic and psychological.

DIF: Cognitive Level: Knowledge REF: Page 650 OBJ: 1
TOP: Hernias KEY: Nursing Process Step: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

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