Chapter 24: The Child with Gastrointestinal Dysfunction

MULTIPLE CHOICE

1. Which condition in a child should alert a nurse for increased fluid requirements?

a. Fever

b. Mechanical ventilation

c. Congestive heart failure

d. Increased intracranial pressure (ICP)

ANS: A

Fever leads to great insensible fluid loss in young children because of increased body surface

area relative to fluid volume. Respiratory rate influences insensible fluid loss and should be

monitored in the mechanically ventilated child. Congestive heart failure is a case of fluid

overload in children. Increased ICP does not lead to increased fluid requirements in children.

PTS: 1 DIF: Cognitive Level: Understand REF: 763

TOP: Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

2. A nurse is conducting an in-service on gastrointestinal disorders. The nurse includes

that melena, the passage of black, tarry stools, suggests bleeding from which area?

a. Perianal or rectal area

b. Hemorrhoids or anal fissures

c. Upper gastrointestinal (GI) tract

d. Lower GI tract

ANS: C

Melena is denatured blood from the upper GI tract or bleeding from the right colon. Blood

from the perianal or rectal area, hemorrhoids, or lower GI tract would be bright red.

PTS: 1 DIF: Cognitive Level: Apply REF: 792

TOP: Integrated Process: Teaching/Learning

MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

3. Which type of dehydration is defined as “dehydration that occurs in conditions in

which electrolyte and water deficits are present in approximately balanced proportion”?

a. Isotonic dehydration

b. Hypotonic dehydration

c. Hypertonic dehydration

d. All types of dehydration in infants and small children

ANS: A

Isotonic dehydration is the correct term for this definition and is the most frequent form of

dehydration in children. Hypotonic dehydration occurs when the electrolyte deficit exceeds

the water deficit, leaving the serum hypotonic. Hypertonic dehydration results from water loss

in excess of electrolyte loss and is usually caused by a proportionately larger loss of water or a

larger intake of electrolytes. This definition is specific to isotonic dehydration.

PTS: 1 DIF: Cognitive Level: Understand REF: 767

TOP: Integrated Process: Nursing Process: Assessment

 1 / 3

MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

4. A nurse is admitting an infant with dehydration caused from water loss in excess of

electrolyte loss. Which type of dehydration is this infant experiencing?

a. Isotonic

b. Isosmotic

c. Hypotonic

d. Hypertonic

ANS: D

Hypertonic dehydration results from water loss in excess of electrolyte loss. This is the most

dangerous type of dehydration. It is caused by feeding children fluids with high amounts of

solute. Isotonic dehydration occurs in conditions in which electrolyte and water deficits are

present in balanced proportion and is another term for isotonic dehydration. Hypotonic

dehydration occurs when the electrolyte deficit exceeds the water deficit, leaving the serum

hypotonic.

PTS: 1 DIF: Cognitive Level: Understand REF: 767

TOP: Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

5. An infant is brought to the emergency department with dehydration. Which physical

assessment finding does the nurse expect?

a. Weight gain

b. Bradycardia

c. Poor skin turgor

d. Brisk capillary refill

ANS: C

Clinical manifestations of dehydration include poor skin turgor, weight loss, lethargy, and

tachycardia. The infant would have prolonged capillary refill, not brisk.

PTS: 1 DIF: Cognitive Level: Understand REF: 767

TOP: Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

6. Parents call the clinic and report that their toddler has had acute diarrhea for 24 hours.

The nurse should further ask the parents if the toddler has which associated factor that is

causing the acute diarrhea?

a. Celiac disease

b. Antibiotic therapy

c. Immunodeficiency

d. Protein malnutrition

ANS: B

Acute diarrhea is a sudden increase in frequency and change in consistency of stools and may

be associated with antibiotic therapy. Celiac disease is a problem with gluten intolerance and

may cause chronic diarrhea if not identified and managed appropriately. Immunodeficiency

would occur with chronic diarrhea. Protein malnutrition or kwashiorkor causes chronic

diarrhea from lowered resistance to infection.

PTS: 1 DIF: Cognitive Level: Apply REF: 772

 2 / 3

TOP: Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

7. Which pathogen is the viral pathogen that frequently causes acute diarrhea in young

children?

a. Giardia organisms

b. Shigella organisms

c. Rotavirus

d. Salmonella organisms

ANS: C

Rotavirus is the most frequent viral pathogen that causes diarrhea in young children. Giardia

(parasite) and Salmonella are bacterial pathogens that cause diarrhea. Shigella is a bacterial

pathogen that is uncommon in the United States.

PTS: 1 DIF: Cognitive Level: Understand REF: 772

TOP: Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

8. Which is a parasite that causes acute diarrhea?

a. Shigella organisms

b. Salmonella organisms

c. Giardia lamblia

d. Escherichia coli

ANS: C

G. lamblia is a parasite that represents 10% of non-dysenteric illness in the United States.

Shigella, Salmonella, and E. coli are bacterial pathogens.

PTS: 1 DIF: Cognitive Level: Understand REF: 775

TOP: Integrated Process: Nursing Process: Assessment

MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation

9. A child is admitted with bacterial gastroenteritis. Which lab results of a stool specimen

confirm this diagnosis?

a. Eosinophils

b. Occult blood

c. pH less than 6

d. Neutrophils and red blood cells

ANS: D

Neutrophils and red blood cells in stool indicate bacterial gastroenteritis. Protein intolerance

and parasitic infections are suspected in the presence of eosinophils. Occult blood may

indicate pathogens such as Shigella, Campylobacter, or hemorrhagic Escherichia coli strains.

A pH of less than 6 may indicate carbohydrate malabsorption or secondary lactase

insufficiency.

PTS: 1 DIF: Cognitive Level: Understand REF: 775

TOP: Integrated Process: Nursing Process: Evaluation

MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential

Powered by qwivy(www.qwivy.org)

 3 / 3