Gastro

Question 1

A 14-year-old patient involved in an ATV collision was admitted 4 days ago with multiple fractures and a subcapsular splenic hematoma. The child is now pale and complains of new onset left shoulder pain, anxiety, and dizziness. These findings suggest
A. intraabdominal hemorrhage
B. fat emboli syndrome
C. pulmonary embolism
D. delayed bowel rupture

Answer 1

A. intraabdominal hemorrhage

Question 2

An adolescent is admitted with a stab wound to the abdomen. The organ most likely to be injured is the 
A. colon
B. small bowel
C. liver 
D. spleen

Answer 2

B. small bowel

Question 3

A patient with gastrointestinal bleeding is receiving a somatostatin infusion. Somatostatin
A. is administered into the gastric artery.
B. decreases portal blood flow
C. may cause cardiac or bowel ischemia
D. binds to the proton pump

Answer 3

B. decreases portal blood flow

Question 4

A 9-year-old patient is admitted to the PICU with severe acute abdominal pain, anorexia, nausea, and right lower quadrant tenderness. Symptoms have gradually increased over the past 2 days. Which of the following laboratory tests is most likely to suggest the cause of these findings? 
A. Serum lipase level
B. Hepatitis panel
C. Complete blood count
D. Serum amylase level

Answer 4

C. Complete blood count

Question 5

A 13-month-old child is admitted with a history of periodic, sudden onset acute absominal pain that resolves in 15-20 minutes. These episodes have occurred several times over the past 2 days with increasing frequency and duration. A sausage-shaped mass is palpable in the right upper quandrant. A stool sample is positive for occult blood. What type of enema is likely to be ordered?
A. Barium enema
B. Air contrast enema
C. Water enema
D. Gastrogradin enema

Answer 5

B. Air contrast enema

Question 6

A 2-week-old infant is admitted for bronchiolitis. The patient develops abdominal distention and vomiting, and passes a bloody stool. The nurse suspects necrotizing enterocolitis and anticipates the child will next need an 
A. urgent air enema
B. exploratory laparotomy
C. upper GI endoscopy
D. abdominal radiograph

Answer 6

D. abdominal radiograph

Question 7

A 4-week-old infant is admitted for dehydration and failure to thrive. This full-term child had no prenatal or birth complications, was doing well for the first two weeks of life, then experienced progressively worsening vomiting. The infant appears hungry and eats eagerly, but vomits most of every feeding. These findings suggest
A. colic
B. gastroesophageal reflux
C. pyloric stenosis
D. Hirschsprung's disease

Answer 7

C. pyloric stenosis

Question 8

An infant has a large gastroschisis suspended in a silastic silo. The nurse understands this infant is at risk for a significant loss of 
A. body heat
B. whole blood
C. plasma
D. gastrointestinal fluids

Answer 8

A. body heat

Question 9

Three hours after ischemic bowel repair, which of the following findings suggests a child needs to return to surgery for further bowel resection?
A. Systemic vascular resistance is 975 dynes*sec/cm5
B. The white blood cell count is 17,000/ mm3
C. The child requires aggressive fluid resuscitation
D. The patient’s SvO2 has remained 70% since surgery

Answer 9

C. The child requires aggressive fluid resuscitation

Question 10

A child is admitted for acture liver failure following ingestion of toxic mushrooms. The patient exhibits each of the following findings. Which one would suggest that liver failure is worsening?
A. Low mean arterial pressure
B. Hyperhylcemia followed by hypoglycemia
C. An ammonia level of 65 mcg/dL
D. A prothrombin time of 11.5 seconds

Answer 10

B. Hyperhylcemia followed by hypoglycemia

Question 11

A child with biliary atresia has a Kasai procedure performed at 3 days of age. Eleven years later the child is admitted to the PICU with cirrhosis, hematemesis, and dark stools. The nurse explains to the family that the definitive intervention this child will most likely need next is a
A. transjugular intrahepatic portosystemic shunt
B. partial hepatectomy
C. esophageal sclerotherapy procedure
D. liver transplantation

Answer 11

D. liver transplantation

Question 12

A 9 kg 3-year-old child recently placed in foster care is admitted for malnutrition. Laboratory studies reveal low serum phosphorus, magnesium, and potassium levels. The nurse anticipates
A. slowly feeding and replacing electrolytes
B. continuing feeds with close monitoring
C. switching to total parental nutrition
D. aggressively feeding to replace deficits

Answer 12

A. slowly feeding and replacing electrolytes