41. Which observation made of the exposed abdomen is most indicative of pyloric stenosis?

a. Abdominal rigidity

b. Substernal retraction

c. Palpable olive-like mass

d. Marked distention of lower abdomen

42. The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

a. Abdominal rigidity and pain on palpation

b. Rounded abdomen and hypoactive bowel sounds

c. Visible peristalsis and weight loss

d. Distention of lower abdomen and constipation

43. An infant with pyloric stenosis experiences excessive vomiting that can result in:

a. hyperchloremia.

b. hypernatremia.

c. metabolic acidosis.

d. metabolic alkalosis.

44. Invagination of one segment of bowel within another is called:

a. atresia.

b. stenosis.

c. herniation.

d. intussusception.

45. The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate?

a. Notify practitioner.

b. Measure abdominal girth.

c. Auscultate for bowel sounds.

d. Take vital signs, including blood pressure.

46. Which is an important nursing consideration in the care of a child with celiac disease?

a. Refer to a nutritionist for detailed dietary instructions and education.

b. Help child and family understand that diet restrictions are usually only temporary.

c. Teach proper hand washing and standard precautions to prevent disease transmission.

d. Suggest ways to cope more effectively with stress to minimize symptoms.

47. An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include:

a. preparing family for impending death.

b. teaching family signs of central venous catheter infection.

c. teaching family how to calculate caloric needs.

d. securing TPN and gastrostomy tubing under diaper to lessen risk of dislodgment.

48. A nurse is receiving report on a newborn admitted yesterday after a gastroschisis repair. In the report, the nurse is told the newborn has a physician’s prescription for an NG tube to low intermittent suction. The reporting nurse confirms that the NG tube is to low intermittent suction and draining light green stomach contents. Upon initial assessment, the nurse notes that the newborn has pulled the NG tube out. Which is the priority action the nurse should take?

a. Replace the NG tube and continue the low intermittent suction.

b. Leave the NG tube out and notify the physician at the end of the shift.

c. Leave the NG tube out and monitor for bowel sounds.

d. Replace the NG tube, but leave to gravity drainage instead of low wall suction.

49. Parents of a child undergoing an endoscopy to rule out peptic ulcer disease (PUD) from H. pylori ask the nurse, “If H. pylori is found will my child need another endoscopy to know that it is gone?” Which is the nurse’s best response?

a. “Yes, the only way to know the H. pylori has been eradicated is with another endoscopy.”

b. “We can collect a stool sample and confirm that the H. pylori has been eradicated.”

c. “A blood test can be done to determine that the H. pylori is no longer present.”

d. “Your child will always test positive for H. pylori because after treatment it goes into remission, but can’t be completely eradicated.”

50. A child has recurrent abdominal pain (RAP) and a dairy-free diet has been prescribed for 2 weeks. Which explanation is the reason for prescribing a dairy-free diet?

a. To rule out lactose intolerance

b. To rule out celiac disease

c. To rule out sensitivity to high sugar content

d. To rule out peptic ulcer disease