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NR602-Final Questions and Answers 100% Solved
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NR602-Final Questions and Answers 100% Solved
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NR602-Final Questions and Answers100% Solved
Chapter 40 - GI Disorders
Following a difficult vaginal birth of a singleton pregnancy, the client starts bleeding heavily.
Clots are expressed, and a foley catheter is inserted to empty the bladder, because the uterine
fundus is soft, and displaced laterally from midline.
Vital signs are 99.8 F, pulse 90 beats/min, respirations 20 breaths/min, and BP 130/90 mm Hg.
Which pharmacologic intervention is indicated? Correct Ans-Administration of prostaglandin
analogue to reduce r/o hemorrhaging
Following a vaginal birth, a client has lost a significant amount of blood and is
starting to experience signs of hypovolemic shock.
Which clinical signs would be consistent with this clinical diagnosis? Correct Ans-
Compensatory response of tachycardia and decreased pulse pressure.
The nurse recognizes that infection may be present in her postpartum client when the client
exhibits: Correct Ans-A temperature of 100.4 on the second postpartum day and 100.8 on
the fourth.
To determine an adverse response to carboprost tromethamine (Hemabate) {used to treat
postpartum uterine hemorrhage}, the nurse should frequently assess: Correct Ans-Breath
sounds.
,What data in the client's history should the nurse recognize as being pertinent to a possible
diagnosis of postpartum depression? Correct Ans-Teenage depression episode.
The nurse notes that the fundus of a postpartum patient is boggy, shifted to the left of the
midline, and 2cm above the umbilicus.
What is the nurse's priority action? Correct Ans-Massage the fundus of the uterus.
The parent of a colicky infant asks about using a probiotic medication.
What will you tell them? Correct Ans-There is no conclusive evidence about using probiotics
to treat colic.
A toddler who was born prematurely refuses most solid foods and has poor weight gain. A
barium swallow study reveals a normal esophagus.
What will the primary care pediatric nurse practitioner consider next to manage this child's
nutritional needs? Correct Ans-Video fluoroscopy swallowing study
A toddler is seen in the clinic after a 2 day history of intermittent vomiting and diarrhea. An
assessment reveals an irritable child with dry mucous membranes, 3 second capillary refill, 2
second recoil of skin, mild tachycardia and tachypnea, and cool hands and feet. The child has
had two wet diapers in the past 24 hours.
What will the primary care pediatric nurse practitioner recommend? Correct Ans-Oral
rehydration solution with follow-up in 24 hours.
,A 9-year-old girl has a history of frequent vomiting, and her mother has frequent migraine
headaches. The child has recently begun having more frequent and prolonged episodes
accompanied by headaches. An exam reveals abnormal eye movements and mild ataxia.
What is the correct action? Correct Ans-Refer to a pediatric gastroenterologist for further
workup.
The parent of a 3-month-old reports that the infant arches and gags while feeding and spits up
undigested formula frequently. The infant's weight gain has dropped to the 5th percentile from
the 12 th percentile.
What is the best course of treatment for this infant? Correct Ans-Begin a trial of extensively
hydrolyzed protein formula for 2-4 weeks.
A school age child has a 3-month history of dull, aching epigastric pain that worsens with eating
and awakens the child from sleep. A complete blood count shows a hemoglobin of 8 mg/dL.
What is the next step in management? Correct Ans-Refer for EGD.
A 2-month-old infant cries up to 4 hours each day and, according to the parents, is inconsolable
during crying episodes with fists and legs noted to be tense and stiff. The infant is breastfeeding
frequently but is often fussy during feedings. The physical exam is normal, and the infant is
gaining weight normally.
What will the primary care pediatric nurse practitioner recommend? Correct Ans-Eliminating
certain foods from the mother's diet.
A child is in the clinic after swallowing a metal bead. A radiograph of the GI tract shows a 6 mm
cylindrical object in the child's stomach. The child is able to swallow without difficulty and is not
experiencing pain.
, What is the correct course of treatment? Correct Ans-Have the parents watch for the object
in the child's stool.
A 10-year-old child has had abdominal pain for 2 days, which began in the
periumbilical area and then localized to the right lower quadrant. The child vomited once today
and then experienced relief from pain followed by an increased fever.
What is the likely diagnosis? Correct Ans-Appendicitis with perforation
An 18-month-old child has a 1 day history of intermittent, cramping abdominal pain with
nonbilious vomiting. The child is observed to scream and draw up his legs during pain episodes
and becomes lethargic in between. The primary care pediatric nurse practitioner notes a small
amount of bloody, mucous stool in the diaper.
What is the most likely diagnosis? Correct Ans-Intussusception
A school age child has had abdominal pain for 3 months that occurs once or twice weekly and is
associated with a headache and occasional difficulty sleeping, often causing the child to stay
home from school. The child does not have vomiting or diarrhea and is gaining weight normally.
The physical exam is normal.
According to Bishop, what is included in the initial diagnostic workup for this child? Correct
Ans-CBC
ESR
Amylase
Lipase
UA
Abdominal ultrasound
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