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NCLEX Peds Ch 33
Metabolic, Endocrine, and Gastrointestinal Disorders
| Question | Answer |
|---|---|
| A nurse reviews a 3wk old infant’s record and notes the physician documented a Dx of suspected Hirschsprung’s disease. The nurse knows which symptom led mom to seek health care? A.Diarrhea,B.Vomiting,C.Regurgitation,D.Foul smelling, ribbon like stool | D–Hirschsprugs’s manifestations=Chronic constipation beginning in the 1st month and results in foul smelling, ribbon like stool, Bowel obstruction, Abdominal pain, Distention, Failure to thrive-Delayed passage or absence of meconium is the cardinal sign |
| A nurse is caring for a child with a diagnosis of intussesception. Which of the following symptoms would the nurse expect to note in this child? A.watery diarrhea,B.Ribbon like stool,C.Profuse projectile vomiting,D.Blood and mucus in the stools | D-classically presents with severe crampy, intermittent abdominal pain drawing knees to chest, bright red blood and mucus pass and are described as currant jelly like stools |
| A child diagnosed with a hernia is scheduled for surgical repair in 2 weeks.The nurse instructs parents about hernial strangulation signs.The nurse tells the parents which would require physician notification? A.Fever,B.Diarrhea,C.Vomiting,D.Constipation | C-signs=vomiting, pain, irreducible mass |
| Parents of a child with hepatitis learn about care & transmission prevention.Which needs more instruction? A.Handwashing is important,B.Provide a high fat diet,C.Clean contaminated surfaces with bleach,D.Diapers won’t be changed near food’s surfaces | B-should consume a low fat diet to allow the liver to rest |
| An instructor asks about phenylketonuria(PKU).Which statement indicates understanding? A.PKU is an autosomal-dominant disorder,B.PKU primarily affects the GI system,C.Treatment of PKU includes restriction of tyramine,D.All states require screening for PKU | D-PKU is an autosomal recessive disorder, treatment includes phenylalanine restriction, results in CNS damage – all states do require screening |
| A child with type1 diabetes has ball practice.Nurse teaching to prevent hypoglycemia @ practice tells the child:A.Have juice before practice,B.Eat more at lunch,C.Take less insulin on practice days,D.Take insulin at lunch instead of breakfast | A – an extra snack of 10-15g carbs before and for every 30-45 min. during activity will prevent hypoglycemia. |
| A mother of a child with type 1 DM calls, says the child is sick, and that she checked the urine and it showed positive ketones.The nurse says? A.Hold the next insulin dose,B.Come in immediately,C.Give an extra dose of insulin,D.Push calorie free drinks | D-during illness, urine should be checked for ketones with each void - when present, fluids will help clear them - drinks should be calorie free - never change insulin doses without orders |
| A nurse is caring for an 18month old who has been vomiting. The appropriate sleeping position is: A.Supine, B.Side lying, C.Prone with head elevated, D.Prone with face turned sideways | B - a vomiting child should be upright or side lying to prevent aspiration |
| A nurse is monitoring a 1 year old who has diarrhea for dehydration and needs to take the child’s temp. Which method should be avoided? A.Rectal, B. Axillary, C. Electronic, D.Tympanic | A - because, DUH |
| An infant returns to the unit after surgical repair of a cleft lip located on the right side. The best position is: A.Prone, B.Supine, C.Left side, D.Right side | C - on the side opposite the repair to prevent contact of suture lines with linens, supine runs the risk of aspiration from vomiting |
| A nurse reviews the record of an infant and notes a suspected diagnosis of esophageal atresia with tracheoesophageal fistula (TEF). What clinical manifestation is likely? A.Incessant crying, B.Night coughing, C.Choking with feeding, D.Projectile vomiting | C - suspect TEF with the 3 C's = Coughing and Choking during feeding and Cyanosis |
| A nurse reviewing a child’s chart with a diagnosis of phyloric stenosis would expect to note what as having been documented in the chart? A.Watery diarrhea, B.Projectile vomiting, C.Increased urine output, D.Vomiting large amounts of bile | B - clinical manifestations = projectile, nonbilious vomiting, irritability, hunger, crying, constipation, dehydration, decreased urine output |
| A nurse reinforcing instructions about diet to a mother of a 5 year old lactose intolerant child would tell the mother which supplement will be required? A.Fats, B.Zinc, C.Protein, D.Calcium | D - Calcium, DUH |
| A nurse reinforces home care instructions to parents of a child with celiac disease. Which would the nurse advise to include in the diet? A.Rice, B.Oatmeal, C.Rye toast, D.Wheat bread | A - all wheat, rye, barley, and oats should be eliminated and replaced with corn and rice. Fat soluable vitamins may be supplemented |
| A nurse is assigned to care for a child who is scheduled for an appendectomy. Which are likely to be prescribed: A.Enema, B.IV line, C.NPO, D.IV antibiotics, E.Preoperative meds, F.Heating pad on the abdomen | B,C,D,E - no enemas or laxitives, no heat |
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