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1.A 6-month-old patient is admitted to the emergency department for constipation, abdominal distention, and failure to thrive. The patient’s mother reports that he had episodes of watery diarrhea and vomiting at home.These signs and symptoms are characteristic of which disorder?

Hirschsprung’s disease 
Gastroesophageal reflux 
Acute appendicitis 
Crohn’s disease 

2.Most term infants pass meconium in the first:

4 hours of life. 
12 hours to 18 hours of life. 
24 hours to 48 hours of life. 
14 days of life. 

3.The definitive test for a diagnosis of Hirschsprung’s disease is:

full-thickness rectal biopsy demonstrating the absence of ganglion cells in the myenteric and submucosal plexuses. 
constipation and blood in stool. 
diarrhea and fever with elevated WBCs.  
full-thickness rectal biopsy demonstrating the presence of ganglion cells in the myenteric and submucosal plexuses. 

4.A 10-month-old patient is diagnosed with bowel obstruction secondary to Hirschsprung’s disease. He has received a nursing diagnosis of Risk for deficient fluid volume related to decreased intake and losses secondary to loss of appetite and vomiting. What is an appropriate nursing intervention for this patient? Select all that apply.

Administer IV fluids and electrolytes as prescribed 
Keep patient NPO until surgery 
Administer analgesics as prescribed 
None of the above 

5.A nurse is about to perform ostomy care for a pouched, 12-month-old patient. What supplies should the nurse plan to bring into the room?

Appropriate system 
Hypoallergenic skin barrier 
Skin care products 
All of the above 

6.A 10-month old patient has just received a colostomy for Hirschsprung’s disease. Which findings are signs and symptoms of skin breakdown or stomal complications in the patient?

Bleeding 
Ribbon-like stools 
Failure to pass stool 
All of the above

7.Upon assessment of a patient’s stoma, a moderate amount of bleeding in and around the stoma is discovered. An appropriate nursing intervention in this situation would be to:

notify the patient’s physician.
cover the stoma with gauze. 
irrigate the stoma. 
apply antibiotic ointment. 

8.What nonpharmacologic techniques could you use with a 9 month infant to address pain?

Non Nutritive sucking 
Relaxation 
Guided imagery 
None of the above 

9.A colostomy bag was full of stool and flatus upon assessment. How might you go about teaching caregivers to empty the colostomy bag?

Position bag to gravity, place pad under bag, open bag, empty bag with a downward motion into a container, close bag, clean patient and bag if needed, remove pad, empty container contents into toilet 
Place pad under bag, position bag to gravity, open bag, empty bag with a downward motion into a container, close bag, clean patient and bag if needed, remove pad, empty container contents into toilet
Open bag, empty bag with a downward motion into a container, close bag, clean patient and bag if needed, remove pad, empty container contents into toilet 
Open bag, place pad under bag, position bag to gravity, empty bag with a downward motion into a container, close bag, clean patient and bag if needed, remove pad, empty container contents into toilet 

10.How might you evaluate a caregiver’s knowledge of ostomy care?

Ask them to participate in the care while in your presence 
Ask them if they has any questions regarding ostomy care 
Ask them to verbally explain to you how they would go about caring for the ostomy site 
All of the above 
SCIENCE
HEALTH SCIENCE
NURSING
BIO 1123

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