Question

A nurse is caring for an infant who has inadequate motility of part of the intestine resulting in a mechanical obstruction. The nurse should identify this finding as a manifestation of which of the following disorders?

Answer 1

Correct Answers:

Hirschsprung's disease

Rationale :

🔷 Hirschsprung’s disease occurs when ganglion cells are absent in a segment of the bowel, causing loss of peristalsis in that area.

🔷 Without normal enteric nerve stimulation, the affected segment stays tonically contracted, creating a functional mechanical obstruction.

🔷 Stool and gas cannot pass easily, so the bowel above the defect becomes distended from backup.

🔷 This condition is classically linked to delayed passage of meconium, abdominal distention, and chronic constipation in infants.

🔷 The key concept is intestinal “inadequate motility” in one segment leading to obstruction—this directly matches Hirschsprung’s.

Encopresis

🔷This is involuntary stool soiling (often from chronic constipation) and is not caused by an aganglionic bowel segment.

🔷 It reflects overflow leakage, not a primary intestinal motility defect creating obstruction.

Enterocolitis

🔷This is inflammation/infection of the intestines, not “inadequate motility of part of the intestine” causing obstruction.

🔷 While Hirschsprung-associated enterocolitis can occur, enterocolitis itself is not the motility-based mechanical obstruction described.

Pyloric stenosis

🔷This is hypertrophy of the pylorus causing gastric outlet obstruction, not an intestinal segment motility problem.

🔷 It presents with projectile nonbilious vomiting rather than a lower intestinal obstruction from absent peristalsis.

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Answer 2

Correct Answers:

"Using an authoritative style means communicating with our child often about our expectations and reasons for disciplinary actions."

Rationale :

🔷 Authoritative parenting combines high expectations (limit-setting) with high responsiveness (warmth and communication).

🔷 Explaining expectations and reasons supports a child’s internalized discipline and improves cooperation over time.

🔷 This style promotes independence while still maintaining clear boundaries, which supports healthy development.

🔷 Frequent communication helps children understand cause-and-effect, making discipline more effective and less punitive.

🔷 The statement accurately describes structured guidance + respectful dialogue, which is the hallmark of authoritative parenting.

“Permissive style leads to frequent discipline…”

🔷Permissive parenting is typically low discipline/low limits, not frequent discipline.

🔷 Children often set many rules, but the parent usually provides minimal enforcement, which is the opposite of “frequent discipline.”

“Authoritative allows children to have input…”

🔷Children may have input, but authoritative parenting still includes firm, consistent limits set by the parent.

🔷 This option is incomplete because it can sound like children “decide” the rules, which fits better with permissive patterns.

“Uninvolved ensures needs are met…”

🔷Uninvolved/neglectful parenting is low warmth and low control, often failing to meet needs consistently.

🔷 It is linked to poorer outcomes because children lack structure and emotional support.

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Answer 3

Correct Answers:

"The exact causes of autism spectrum disorder are not fully understood, but it is believed to be related to a combination of genetic and environmental factors."

Rationale :

🔷 Current evidence supports that ASD is multifactorial, involving genetic influences and environmental contributors rather than one single cause.

🔷 Many genes affect brain development and synaptic functioning, increasing susceptibility to ASD traits.

🔷 Environmental factors are best understood as risk modifiers (not sole causes) that may interact with genetic vulnerability.

🔷 Stating the cause is “not fully understood” is accurate because ASD represents a spectrum with diverse biological pathways.

🔷 This response is appropriate education because it is evidence-based, reduces stigma, and avoids misinformation.

“MMR vaccine… leading cause”

🔷Large-scale research has found no causal link between vaccines and ASD.

🔷 This statement promotes misinformation and can reduce vaccine uptake, increasing risk of preventable disease outbreaks.

“Poor parenting… lack of nurturing”

🔷ASD is a neurodevelopmental condition, not caused by parenting style.

🔷 This claim is harmful because it increases blame and stigma and is not supported by evidence.

“Gluten and casein… cause ASD”

🔷Diet does not cause ASD; some children may have GI sensitivities, but that is different from causation.

🔷 Restrictive diets without medical indication can risk nutrient deficiencies and do not treat the core neurodevelopmental condition.

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Answer 4

Correct Answers:

"As a nurse, I am required by law to report suspected child abuse."

Rationale :

🔷 Nurses are mandated reporters, meaning they are legally required to report suspected abuse—not proven abuse.

🔷 The nurse’s role is to report reasonable suspicion to protect the child and initiate proper investigation.

🔷 This response is clear, professional, and reinforces the nurse’s legal and ethical duty to prioritize child safety.

🔷 It avoids sharing details that could compromise an investigation while still providing an honest explanation.

🔷 It also helps de-escalate by framing the action as law-based policy, not a personal accusation.

“Unable to discuss… contact supervisor”

🔷This may appear evasive and does not correctly educate the parent about mandatory reporting law.

🔷 While involving a supervisor can help, the nurse should still provide the appropriate legal rationale for reporting.

“Reported to supervisor who decided…”

🔷This incorrectly implies the nurse is not directly responsible, but mandated reporting requires the nurse to act.

🔷Shifting responsibility can create confusion and does not reinforce the nurse’s legal obligation.

“Provider will explain”

🔷A provider may discuss care, but reporting suspected abuse is a nursing/legal duty, not something to defer.

🔷Delaying or deflecting may undermine timely protection and accountability.

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Answer 5

Correct Answers:

32

Rationale :

🔷 Convert weight: 35 lb ÷ 2.2 = 15.9 kg (rounded to one decimal for dosing math).

🔷 Ordered dose: 2 mg/kg/day × 15.9 kg = 31.8 mg/day.

🔷 Round to nearest whole number: 31.8 → 32 mg/day.

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Answer 6

Correct Answers:

Tachycardia

Rationale :

🔷 A glucose of 55 mg/dL indicates hypoglycemia, which triggers a strong sympathetic (adrenergic) response.

🔷 Adrenergic symptoms include tachycardia, shakiness, sweating, and anxiety, matching the adolescent’s presentation.

🔷 The body releases epinephrine to raise glucose via glycogenolysis, which also increases heart rate.

🔷 Neuro symptoms such as difficulty speaking and concentrating reflect neuroglycopenia (brain not getting enough glucose).

🔷 Together, these findings align best with tachycardia as an expected hypoglycemia sign.

Polyuria

🔷 Polyuria is typical of hyperglycemia due to osmotic diuresis, not low blood sugar.

🔷 With hypoglycemia, the issue is insufficient circulating glucose, not glucose spilling into urine.

Deep, rapid respirations

🔷 Kussmaul respirations occur with metabolic acidosis, classically DKA (hyperglycemia).

🔷 Hypoglycemia does not cause the same acidotic compensatory breathing pattern.

Dry, flushed skin

🔷 Dry, flushed skin is more consistent with hyperglycemia/dehydration.

🔷 Hypoglycemia more often causes diaphoresis and pallor from adrenergic activation.

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Answer 7

Correct Answers:

Notify practitioner

Rationale :

🔷 Passing a normal brown stool may indicate a change in obstruction status, including possible partial reduction or altered bowel function.

🔷 Intussusception can be intermittent, and symptom changes require immediate provider notification before proceeding with reduction.

🔷 An air enema is both diagnostic and therapeutic, but the plan should be reassessed when clinical findings change to avoid unnecessary risk (e.g., perforation).

🔷 Notifying the practitioner supports timely re-evaluation (repeat assessment, imaging decisions, procedure confirmation).

🔷 This is the safest action because it prioritizes clinical decision-making based on updated patient status.

Measure abdominal girth

🔷This can trend distention, but it does not address the immediate need to update the provider about a significant clinical change.

🔷 A normal stool does not rule out intussusception, so relying on girth alone could delay needed action.

Plan to move forward with procedure

🔷Proceeding without reassessment ignores a potentially meaningful status change that could alter the risk/benefit of the procedure.

🔷 Clinical changes should prompt provider review before continuing an invasive reduction method.

Auscultate for bowel sounds

🔷Bowel sounds are nonspecific and can be present even with obstruction or intermittent reduction.

🔷 This assessment does not replace the need to communicate updated findings promptly to the practitioner.

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Answer 8

Correct Answers:

Auscultating the rate and characteristics of the child's heart sounds

Rationale :

🔷 Acute rheumatic fever can cause carditis, which may lead to new murmurs, tachycardia, and heart failure risk.

🔷 Cardiac involvement is the most dangerous complication, so assessing heart sounds and rate supports early detection of instability.

🔷 Auscultation helps identify valvular inflammation (often mitral) and guides urgency of further interventions.

🔷 Prioritizing cardiovascular assessment aligns with ABCs, since compromised cardiac function can rapidly threaten perfusion.

🔷 Early recognition of cardiac changes improves outcomes through prompt treatment and monitoring.

Pain-rating tool for joint pain

🔷Migratory polyarthritis is common, but pain is not the most immediate threat compared with carditis.

🔷 Pain assessment matters, but cardiac assessment must come first for safety.

Degree of parental anxiety

🔷Family support is important, but it is not priority over the child’s potential cardiac instability.

🔷 Addressing anxiety is better after the nurse establishes physiologic stability.

Assessing erythematous rash

🔷Erythema marginatum can occur, but it is not life-threatening compared with cardiac involvement.

🔷 Rash assessment does not provide immediate information about hemodynamic risk.

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Answer 9

Correct Answers:

Encourage the client to complete school work.

Rationale :

🔷 A 10-year-old is in Erikson’s Industry vs. Inferiority stage, focused on competence, productivity, and achievement.

🔷 Completing school work supports a sense of mastery, normalcy, and continued skill development despite hospitalization.

🔷 It reduces risk of inferiority by helping the child stay connected to peer-level expectations and progress.

🔷 It also supports identity and self-esteem by preserving routines tied to “being capable” and “doing well.”

🔷 This plan meets psychosocial needs by reinforcing accomplishment and preventing isolation from typical developmental tasks.

Daily session with a play therapist

🔷 Play therapy is valuable, but for school-age children the priority developmental task is industry/achievement.

🔷 School engagement more directly targets the child’s stage-related need for competence.

Discourage visits from friends

🔷 Peer relationships support industry and self-esteem, and discouraging visits increases isolation.

🔷 Lack of peer contact can worsen feelings of being “different” and contribute to inferiority.

Vary the child's schedule each day

🔷 Children benefit from predictable routines, especially during long hospitalizations.

🔷 Frequent schedule changes reduce control and stability, increasing stress and reducing participation in meaningful tasks.

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Answer 10

Correct Answers:

"The quality of food I provide him is more important than the quantity."

Rationale :

🔷 Toddlers often have variable appetites, so focusing on nutrient-dense quality is more appropriate than forcing quantity.

🔷 Growth rate slows after infancy, so caloric needs are much lower than infants, and intake naturally fluctuates day-to-day.

🔷 Offering balanced choices supports healthy habits and reduces power struggles around eating.

🔷 Parents should use the “division of responsibility”: caregiver offers healthy options, toddler decides how much to eat.

🔷 This statement reflects correct understanding that consistent healthy offerings matter more than exact volume consumed.

“About 3,000 calories.”

🔷Toddlers typically require far less (often around 1,000–1,400 kcal/day, depending on size and activity).

🔷 3,000 calories risks overfeeding and poor nutrition patterns.

“I will give him one of my vitamins each day.”

🔷Adult vitamins can contain unsafe doses (e.g., iron) and should not be given to toddlers unless prescribed.

🔷 If supplementation is needed, it should be a pediatric-appropriate formulation guided by the provider.

“I should expect increased appetite.”

🔷Appetite often decreases in toddlerhood because growth slows compared with infancy.

🔷 Expecting increased appetite can lead to unnecessary worry and pressure feeding.

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QLexNursing

1 :
A nurse is caring for an infant who has inadequate motility of part of the intestine resulting in a mechanical obstruction. The nurse should identify this finding as a manifestation of which of the following disorders?

2 :
A pediatric nurse is teaching a caregiver about different parenting styles and the effects they could have on children. Which of the following responses by the caregiver indicates an understanding of the teaching?

3 :
A nurse is educating a group of parents about potential causes of autism spectrum disorder (ASD). Which of the following responses should the nurse make?

4 :
A nurse reports an incident of suspected child abuse. One of the parents of the child becomes upset and demands to know the reason for the nurse's action. Which of the following responses by the nurse is appropriate?

5 :
A child with asthma will be receiving an oral dose of prednisone. The order reads prednisone 2 mg/kg per day. The child weighs 35 lbs. The child will receive ____milligrams daily. Round the answer to the nearest whole number.

7 :
The nurse is caring for a boy with probable intussusception. While waiting for a radiologist-guided air enema to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate?

8 :
A nurse is caring for an 8-year-old child who has acute rheumatic fever. Which of the following assessments is the nurse's priority immediately after admission?

9 :
A nurse is planning care for a 10-year-old child who will be hospitalized for an extended period of time. Which of the following actions should the nurse include in the plan of care to meet the client's psychosocial needs according to Erikson?

10 :
A nurse is reinforcing teaching about nutritional considerations with the parents of a toddler. Which of the following statements by the parents indicates an understanding of the teaching?

QLexNursing

1 : A nurse is caring for an infant who has inadequate motility of part of the intestine resulting in a mechanical obstruction. The nurse should identify this finding as a manifestation of which of the following disorders?

2 : A pediatric nurse is teaching a caregiver about different parenting styles and the effects they could have on children. Which of the following responses by the caregiver indicates an understanding of the teaching?

3 : A nurse is educating a group of parents about potential causes of autism spectrum disorder (ASD). Which of the following responses should the nurse make?

4 : A nurse reports an incident of suspected child abuse. One of the parents of the child becomes upset and demands to know the reason for the nurse's action. Which of the following responses by the nurse is appropriate?

5 : A child with asthma will be receiving an oral dose of prednisone. The order reads prednisone 2 mg/kg per day. The child weighs 35 lbs. The child will receive ____milligrams daily. Round the answer to the nearest whole number.

7 : The nurse is caring for a boy with probable intussusception. While waiting for a radiologist-guided air enema to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate?

8 : A nurse is caring for an 8-year-old child who has acute rheumatic fever. Which of the following assessments is the nurse's priority immediately after admission?

9 : A nurse is planning care for a 10-year-old child who will be hospitalized for an extended period of time. Which of the following actions should the nurse include in the plan of care to meet the client's psychosocial needs according to Erikson?

10 : A nurse is reinforcing teaching about nutritional considerations with the parents of a toddler. Which of the following statements by the parents indicates an understanding of the teaching?

1 :
A nurse is caring for an infant who has inadequate motility of part of the intestine resulting in a mechanical obstruction. The nurse should identify this finding as a manifestation of which of the following disorders?

2 :
A pediatric nurse is teaching a caregiver about different parenting styles and the effects they could have on children. Which of the following responses by the caregiver indicates an understanding of the teaching?

3 :
A nurse is educating a group of parents about potential causes of autism spectrum disorder (ASD). Which of the following responses should the nurse make?

4 :
A nurse reports an incident of suspected child abuse. One of the parents of the child becomes upset and demands to know the reason for the nurse's action. Which of the following responses by the nurse is appropriate?

5 :
A child with asthma will be receiving an oral dose of prednisone. The order reads prednisone 2 mg/kg per day. The child weighs 35 lbs. The child will receive ____milligrams daily. Round the answer to the nearest whole number.

7 :
The nurse is caring for a boy with probable intussusception. While waiting for a radiologist-guided air enema to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate?

8 :
A nurse is caring for an 8-year-old child who has acute rheumatic fever. Which of the following assessments is the nurse's priority immediately after admission?

9 :
A nurse is planning care for a 10-year-old child who will be hospitalized for an extended period of time. Which of the following actions should the nurse include in the plan of care to meet the client's psychosocial needs according to Erikson?

10 :
A nurse is reinforcing teaching about nutritional considerations with the parents of a toddler. Which of the following statements by the parents indicates an understanding of the teaching?