Title: Quiz: Care of the Child with Gastrointestinal, Urinary, and Skin Disorders/Diseases
Course: PRN 0096 Practical Nursing III > Section: Nursing Care of Pediatric Client

Q: The finding in a newborn assessment suggestive of tracheoesophageal fistula is:
- Failure to pass meconium in 24 hours
- Choking on the first feeding
- Palpable mass in the sternal area
- Visible peristalsis across abdomen
A: Choking on the first feeding
If right: After birth, a newborn with tracheoesophageal fistula will vomit and choke when the first feeding is introduced.
If wrong: After birth, a newborn with tracheoesophageal fistula will vomit and choke when the first feeding is introduced.

Q: An appropriate intervention for a 3-month-old infant who has gastroesophageal reflux is to:
- Position the infant in the crib on its abdomen, with the head elevated.
- Administer medication as ordered to stimulate the pyloric sphincter.
- Give thin rice cereal with formula before feeding solid foods.
- Place the infant in an infant seat after feedings.
A: Position the infant in the crib on its abdomen, with the head elevated.
If right: After feedings, the infant is placed in a prone position to avoid increased intraabdominal pressure.
If wrong: After feedings, the infant is placed in a prone position to avoid increased intraabdominal pressure.

Q: The nurse, planning a parent education program about lead poisoning prevention, would include the information that the sources of lead in the community are most likely:
- Increased lead content of air
- Use of aluminum cookware
- Deteriorating paint in older buildings
- Inhaling smog
A: Deteriorating paint in older buildings
If right: The primary source of lead is paint from old, deteriorating buildings.
If wrong: The primary source of lead is paint from old, deteriorating buildings.

Q: A child has been diagnosed with ascariasis (roundworm). The statement made by her mother that may suggest a cause for her condition is:
- “I’ve been airing out the house on these nice breezy days.”
- “My child often goes out to the garden and pulls up a carrot to eat.”
- “She runs barefoot so much I have to wash her feet at least twice a day.”
- “We just remodeled our bathroom at home.”
A: “My child often goes out to the garden and pulls up a carrot to eat.”
If right: The child can ingest roundworm eggs from contaminated soil.
If wrong: The child can ingest roundworm eggs from contaminated soil.

Q: The nurse would expect the stools of a child with celiac disease to have which appearance?
- Ribbonlike
- Hard, constipated
- Bulky, frothy
- Loose, foul-smelling
A: Bulky, frothy
If right: Celiac disease causes malabsorption. Stools that are large, bulky, and frothy may indicate malabsorption.
If wrong: Celiac disease causes malabsorption. Stools that are large, bulky, and frothy may indicate malabsorption.

Q: After reviewing dietary restrictions for celiac disease, the nurse determines that a parent understands the information when she states that a grain that can be eaten by a child with celiac disease is:
- Wheat
- Oats
- Barley
- Rice
A: Rice
If right: Rice is a gluten-free grain that can be eaten by children afflicted with celiac disease.
If wrong: Rice is a gluten-free grain that can be eaten by children afflicted with celiac disease.

Q: Nursing interventions for the mother of a 10-month-old infant with nonorganic failure to thrive would include:
- Pointing out errors that the nurse observes when the mother is caring for the infant
- Discussing negative characteristics of the infant with the mother
- Having the nurse provide as much of the infant’s care as possible
- Teaching the mother about the developmental milestones to expect in the next few months
A: Teaching the mother about the developmental milestones to expect in the next few months
If right: The nurse can increase parent’s knowledge of growth and development by providing anticipatory guidance about normal developmental milestones.
If wrong: The nurse can increase parent’s knowledge of growth and development by providing anticipatory guidance about normal developmental milestones.

Q: The nurse instructing a mother how to administer oral nystatin suspension, prescribed to treat thrush, would teach to:
- Pour the prescribed amount into a nipple and have the infant suck the medication.
- Squirt the prescribed dose into the back of the mouth and have the infant swallow.
- Give the medication mixed with a small amount of juice in a bottle.
- Use a sterile applicator to swab the medication on the oral mucosa.
A: Use a sterile applicator to swab the medication on the oral mucosa.
If right: 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.
If wrong: 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.

Q: An infant is admitted to the hospital with severe dehydration. Laboratory results show pH 7.32, PaCO_2 40, HCO_3 21. The nurse interprets these values as:
- Metabolic acidosis
- Metabolic alkalosis
- Respiratory acidosis
- Respiratory alkalosis
A: Metabolic acidosis
If right: A pH lower than 7.35 indicates acidosis. If the child’s pH falls in the same line as the HCO_3-, the problem is metabolic (see Table 27-4).
If wrong: A pH lower than 7.35 indicates acidosis. If the child’s pH falls in the same line as the HCO_3-, the problem is metabolic (see Table 27-4).

Q: The nurse discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. The statement made by the parent indicating a need for further teaching is:
- “My daughter should wash and wipe the perineal area from front to back.”
- “I am only going to have my daughter wear cotton underwear.”
- “It is acceptable to take frequent bubble baths.”
- “She needs to drink lots of fluids and void frequently.”
A: “It is acceptable to take frequent bubble baths.”
If right: Oils in bubble bath and similar products are known to irritate the urethra.
If wrong: Oils in bubble bath and similar products are known to irritate the urethra.

Q: When asked about correcting the hypospadias of their newborn, the nurse explains that with this condition:
- No intervention is necessary as the defect will correct itself over time.
- Surgical repair of the hypospadias is done before 18 months of age.
- Corrective surgery is usually delayed until the preschool period.
- Repairing the defect will increase the risk of testicular cancer.
A: Surgical repair of the hypospadias is done before 18 months of age.
If right: Treatment of hypospadias consists of surgical repair and is usually performed before 18 months of age.
If wrong: Treatment of hypospadias consists of surgical repair and is usually performed before 18 months of age.

Q: The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. The nurse clarifies that while on prednisone, immunizations:
- Can interfere with the treatment for nephrosis
- Require that the child have antibiotic coverage
- Can be given in smaller, divided doses
- Should be delayed
A: Should be delayed
If right: No vaccinations or immunizations should be administered while the disease is active and during immunosuppressive therapy.
If wrong: No vaccinations or immunizations should be administered while the disease is active and during immunosuppressive therapy.

Q: When diuresis has not occurred after a month on corticosteroids, the nurse explains to the parents of a child with nephrotic syndrome that diuresis can be brought about by a protocol of:
- Ibuprofen, an antiinflammatory agent
- Lasix, a diuretic
- Cipro, an antibiotic
- Cytoxan, an antisuppressant
A: Cytoxan, an antisuppressant
If right: A potent antisuppressant such as Cytoxan can bring about diuresis when corticosteroids have proven ineffective.
If wrong: A potent antisuppressant such as Cytoxan can bring about diuresis when corticosteroids have proven ineffective.

Q: Because of the hyperkalemia associated with acute glomerulonephritis, the nurse recommends that the child avoid such foods as:
- Dairy products
- Whole-grain cereals
- Organ meats
- Bananas
A: Bananas
If right: Bananas are very high in potassium and should be avoided.
If wrong: Bananas are very high in potassium and should be avoided.

Q: A 6-year-old child with daytime enuresis complains of dysuria and urgency; the nurse recognizes these as signs and symptoms of:
- Urinary tract infection
- Nephrotic syndrome
- Acute glomerulonephritis
- Vesicoureteral reflux
A: Urinary tract infection
If right: Urinary frequency and pain during micturition are symptoms of acute urinary tract infection.
If wrong: Urinary frequency and pain during micturition are symptoms of acute urinary tract infection.

Q: A 5-year-old boy is admitted to the hospital with acute glomerulonephritis. In taking the child’s history, the nurse recognizes the probable cause of this condition as:
- Recovered from German measles 2 months ago
- Dysuria since the previous night
- A history of allergy
- A sore throat 2 weeks ago
A: A sore throat 2 weeks ago
If right: Acute glomerulonephritis develops from 1 to 3 weeks after a streptococcal infection, which causes an allergic-type response that alters the effectiveness of the glomeruli.
If wrong: Acute glomerulonephritis develops from 1 to 3 weeks after a streptococcal infection, which causes an allergic-type response that alters the effectiveness of the glomeruli.

Q: The 6-year-old scheduled for an orchiopexy shyly asks the nurse, “What are they going to do to me ‘down there’?” The nurse’s best response would be:
- “They are going to fix you up ‘down there’”
- “They will move your testicle from your abdomen to your scrotum.”
- “What do you think your doctor is going to do?”
- “You shouldn’t worry. Your doctor knows exactly what to do.”
A: “What do you think your doctor is going to do?”
If right: Encourage the patient to talk about what he knows and what feelings he has about the surgery. School-age children have a fear of bodily harm.
If wrong: Encourage the patient to talk about what he knows and what feelings he has about the surgery. School-age children have a fear of bodily harm.

Q: When the 2-day-old infant is noted to have small pustules on her skin, the nurse should:
- Report it immediately because it may be a staphylococcus infection.
- Keep the affected area dry and clean.
- Teach the parents how to care for seborrheic dermatitis.
- Chart the finding as it may be the beginning of a strawberry nevus.
A: Report it immediately because it may be a staphylococcus infection.
If right: A staphylococcal infection can spread readily from one infant to another. Small pustules on the newborn must be reported immediately.
If wrong: A staphylococcal infection can spread readily from one infant to another. Small pustules on the newborn must be reported immediately.

Q: The home health nurse discovers a family infected with pediculosis and helps the mother understand ways to start eradication of the lice, such as:
- Covering the hair with Vaseline
- Applying a soda-vinegar solution to the hair
- Combing through the hair with a vinegar-water solution
- Shampooing the hair with dish detergent
A: Combing through the hair with a vinegar-water solution
If right: Combing a vinegar/water solution through the hair with a fine-tooth comb and then shampooing is an initial step toward eradication.
If wrong: Combing a vinegar/water solution through the hair with a fine-tooth comb and then shampooing is an initial step toward eradication.

Q: The nurse assesses a major burn as:
- Partial-thickness burn involving 25% of the body surface
- Partial-thickness burn involving 12% of the body surface
- Full-thickness burn involving 20% of the body surface
- Full-thickness burn involving 5% of the body surface
A: Full-thickness burn involving 20% of the body surface
If right: A full-thickness burn involving 10% or more of the body surface is considered a major burn.
If wrong: A full-thickness burn involving 10% or more of the body surface is considered a major burn.

Q: A child had a burn evidenced by pink skin and blistering. The child complains of pain and is crying. The nurse documents the burn as:
- First-degree
- Second-degree superficial
- Second-degree deep dermal
- Third-degree
A: Second-degree superficial
If right: A second-degree superficial burn appears blistered, moist, and pink or red. The pain associated with this burn indicates tissue viability.
If wrong: A second-degree superficial burn appears blistered, moist, and pink or red. The pain associated with this burn indicates tissue viability.

Q: An allergy to which of the following would contraindicate the use of Silvadene as a topical agent for burns?
- Penicillin
- Iodine
- Tetanus immunizations
- Sulfa
A: Sulfa
If right: The use of Silvadene cream on burns is contraindicated if the patient has a sulfa allergy.
If wrong: The use of Silvadene cream on burns is contraindicated if the patient has a sulfa allergy.

Q: Which of the following would help the child with a serious burn meet nutritional needs during the subacute phase of recovery?
- Decrease calories because the child will be on bed rest and will not need as many.
- Increase calories and protein to compensate for the healing process.
- Increase fat to replace the layer of fat next to the burned skin.
- Decrease carbohydrates and starches because the pancreas is strained by the healing process.
A: Increase calories and protein to compensate for the healing process.
If right: Frequent meals and snacks high in calories, protein, and iron are needed to meet the increased metabolic needs of the child with burns.
If wrong: Frequent meals and snacks high in calories, protein, and iron are needed to meet the increased metabolic needs of the child with burns.

Q: On the first day postburn the body’s fluid reserves have left the circulating volume and entered the interstitial space, causing massive edema. The nurse monitors the burn victim very closely for:
- Increasing intracranial pressure
- Reduced urine output
- Eschar formation
- Fluid overload
A: Reduced urine output
If right: With the fluid shift associated with severe burns, the nurse must be observant for the reduction of urine, an indication of altered renal function.
If wrong: With the fluid shift associated with severe burns, the nurse must be observant for the reduction of urine, an indication of altered renal function.

Q: A child is brought to the emergency department with burns on the face and chest. The nurse’s first priority is:
- Assessing respiratory status
- Administering pain medication
- Removing clothing
- Inserting a Foley catheter
A: Assessing respiratory status
If right: Airway assessment and establishing an airway are the initial priorities.
If wrong: Airway assessment and establishing an airway are the initial priorities.