how should a nurse manage a child with a newly inserted gastrostomy tube

HESI LPN

Nutrition Final Exam

1. How should a healthcare professional manage a child with a newly inserted gastrostomy tube?

A. Monitor for signs of infection
B. Increase the child's fluid intake
C. Restrict all oral intake
D. Use only sterile equipment for feedings

Correct answer: A

Rationale: Monitoring for signs of infection at the gastrostomy site is crucial for ensuring proper care and preventing complications. This involves observing for redness, swelling, warmth, or drainage around the insertion site. Increasing the child's fluid intake (Choice B) may be beneficial for hydration but is not specifically related to managing a newly inserted gastrostomy tube. Restricting all oral intake (Choice C) is not necessary as long as the healthcare professional follows the recommended guidelines for feeding. While using sterile equipment for feedings (Choice D) is important, monitoring for signs of infection takes precedence in the immediate post-insertion period.

2. What is a causative factor of Hirschsprung disease?

A. Frequent evacuation of solids, liquids, and gases
B. Excessive peristaltic movement
C. Absence of parasympathetic ganglion cells in a portion of the colon
D. One portion of the bowel telescoping into another

Correct answer: C

Rationale: The correct answer is C: Absence of parasympathetic ganglion cells in a portion of the colon. Hirschsprung disease is a congenital condition characterized by the absence of nerve cells (ganglia) in parts of the colon. This absence leads to a lack of peristalsis in the affected segment, resulting in severe constipation and bowel obstruction. Choices A, B, and D are incorrect. Choice A describes symptoms of diarrhea rather than a causative factor of Hirschsprung disease. Excessive peristaltic movement (choice B) is not a causative factor but rather the opposite, as Hirschsprung disease is associated with reduced peristalsis. Choice D, which refers to intussusception, is a different condition unrelated to Hirschsprung disease.

3. What should be monitored in a child with congenital adrenal hyperplasia (CAH)?

A. Blood glucose levels
B. Electrolyte balance
C. Urine output
D. Hemoglobin levels

Correct answer: B

Rationale: In a child with congenital adrenal hyperplasia (CAH), monitoring electrolyte balance is crucial. CAH can lead to adrenal insufficiency, causing imbalances in electrolytes such as sodium and potassium. Monitoring electrolyte levels helps in preventing complications like dehydration, electrolyte disturbances, and adrenal crisis. While blood glucose levels may need monitoring in other conditions like diabetes, it is not the primary concern in CAH. Urine output is important in assessing kidney function but is not a direct monitoring parameter for CAH. Hemoglobin levels are more relevant in conditions such as anemia, not specifically in CAH.

4. What is the primary goal in managing a child with chronic asthma?

A. Achieve and maintain symptom control
B. Avoid all physical activity
C. Increase dietary sodium
D. Restrict medication use

Correct answer: A

Rationale: The primary goal in managing a child with chronic asthma is to achieve and maintain symptom control. This helps improve the child's quality of life by reducing asthma symptoms and exacerbations. Choice B is incorrect because avoiding all physical activity is not recommended for children with asthma; in fact, regular physical activity can be beneficial. Choice C is incorrect as increasing dietary sodium is not a primary goal in managing asthma. Choice D is incorrect because restricting medication use can lead to uncontrolled asthma symptoms and complications.

5. Which measure best describes the amounts of nutrients that should be consumed by the population?

A. The Dietary Reference Intakes, as they provide a set of nutrient intake values for healthy people in the United States and Canada
B. The Tolerable Upper Intake levels, as they indicate the maximum daily amount of a nutrient considered safe for most healthy people
C. The Estimated Average Requirements, as they reflect the average daily amount of a nutrient needed to maintain a specific function in half of the healthy individuals of a population
D. The Recommended Dietary Allowances, as they represent the average daily amount of a nutrient considered adequate to meet the known nutrient needs of practically all healthy individuals

Correct answer: D

Rationale: The Recommended Dietary Allowances (RDAs) are the best measure to describe the amounts of nutrients that should be consumed by the population. RDAs represent the average daily intake level that meets the nutrient requirements of nearly all (97-98%) healthy individuals in a particular life stage and gender group. Choice A, the Dietary Reference Intakes, provide a set of nutrient intake values but do not specifically address the average daily amount of a nutrient considered adequate for practically all individuals. Choice B, the Tolerable Upper Intake levels, focus on the maximum daily amount of a nutrient deemed safe for most healthy people, not the average daily amount needed. Choice C, the Estimated Average Requirements, reflect the average daily amount of a nutrient needed by half of the healthy individuals, which is not as comprehensive as the RDAs that cater to nearly all healthy people.