Quiz 42: Alterations of Digestive Function in Children
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1. Incomplete fusion of the nasomedial and intermaxillary process during the fourth week of embryonic development causes which condition in an infant?
a. Cleft palate c. Cleft lip
b. Sinus dysfunction d. Esophageal malformation
2. Increased gastrin secretion by the mother in the last trimester of pregnancy may cause which condition in the infant?
a. Pyloric stenosis c. Esophageal atresia
b. Meconium ileus d. Galactosemia
3. At 2 or 3 weeks of age, an infant who has been well fed and has gained weight begins to vomit for no apparent reason. The vomiting gradually becomes more forceful. These symptoms may be indicative of which disorder?
a. Esophageal atresia c. Pyloric stenosis
b. Congenital aganglionic megacolon d. Galactosemia
4. Which term is used to identify a condition in which the developing colon remains in the upper right quadrant instead of moving to its normal location?
a. Intestinal malrotation c. Duodenal obstruction
b. Ileocecal displacement d. Pyloric stenosis
5. Which term is used to identify an intestinal obstruction caused by meconium formed in utero that is abnormally sticky and adheres firmly to the mucosa of the small intestine?
a. Meconium cecum c. Meconium obstruction
b. Meconium ileus d. Meconium vivax
6. With which medical diagnosis is meconium ileus often associated?
a. Muscular dystrophy c. Cystic fibrosis
b. Cerebral palsy d. Congenital aganglionic megacolon
7. Congenital aganglionic megacolon (Hirschsprung disease) involves inadequate motility of the colon caused by neural malformation of which nervous system?
a. Central c. Sympathetic
b. Parasympathetic d. Somatic
8. Which term is used to describe an intestinal obstruction caused by the invagination of the ileum into the cecum and part of the ascending colon by collapsing through the ileocecal valve?
a. Congenital aganglionic megacolon c. Intussusception
b. Malrotation d. Volvulus
9. An infant suddenly develops abdominal pain, becomes irritable (colicky), and draws up the knees. Vomiting occurs soon afterward. The mother reports that the infant passed a normal stool, followed by one that looked like currant jelly. Based on these data, which disorder does the nurse suspect?
a. Congenital aganglionic megacolon c. Malrotation
b. Intussusception d. Volvulus
10. Cystic fibrosis is characterized by which symptom?
a. Excessive mucus production c. Low sodium content in perspiration
b. Elevated blood glucose levels d. Abnormally thin exocrine secretions
11. Which medication compensates for the deficiency that occurs as a result of cystic fibrosis?
a. Salt tablets c. Antihypertensives
b. Pancreatic enzymes d. Antibiotics
12. What causes a person with cystic fibrosis to experience an exocrine pancreatic insufficiency?
a. Pancreatic ducts are obstructed with mucus.
b. Impaired blood supply to the pancreas causes ischemia.
c. A genetically impaired pancreas is unable to produce digestive enzymes.
d. The pancreas has a volvulus at the ampulla of Vater.
13. What is the cause of faulty digestion of fats in those diagnosed with cystic fibrosis?
a. Bile ducts obstructed with mucus, prohibiting the release of bile
b. Failure to metabolize fat-soluble vitamins
c. Deficiency of pancreatic enzymes
d. Fat malabsorption that now occurs in the jejunum
14. Which disorder is characterized by damage to the mucosa of the duodenum and jejunum and impaired secretion of secretin, cholecystokinin, and pancreatic enzymes?
a. Wilson disease c. Gluten-sensitive enteropathy
b. Cystic fibrosis d. Galactosemia
15. What factor associated with gluten-sensitive enteropathy (celiac sprue) causes an infant to bruise and bleed easily?
a. Vitamin K deficiency from fat malabsorption
b. Bone marrow function depression
c. Iron, folate, and B12 deficiency anemias
d. Prescribed daily warfarin (Coumadin)
16. What distinguishes kwashiorkor from marasmus?
a. All nutrients, proteins, fats, and carbohydrates are reduced in kwashiorkor.
b. Physical growth of children is stunted in kwashiorkor but not in marasmus.
c. Muscle wasting, diarrhea, low hemoglobin, and infection characterize kwashiorkor.
d. Subcutaneous fat, hepatomegaly, and fatty liver are present in kwashiorkor.
17. Why is prolonged diarrhea more severe in children than it is in adults?
a. Less water is absorbed from the colon in children.
b. Fluid reserves are smaller in children.
c. Children have a higher fluid volume intake.
d. Children have diarrhea more often than adults.
18. In an infant who is 5 weeks old, an increase in bilirubin production and persistent jaundice support which diagnosis?
a. Pathologic hyperbilirubinemia c. Hepatitis A
b. Physiologic jaundice d. Infantile cirrhosis
19. Which type of diarrhea results from lactose intolerance?
a. Secretory c. Osmotic
b. Motility d. Small volume
20. Physiologic jaundice in a newborn is caused by:
a. Reabsorption of bilirubin in the small intestine
b. Impaired hepatic uptake and excretion of bilirubin
c. Increased bilirubin production
d. Mild conjugated (indirect-reacting) hyperbilirubinemia
21. In children, the risk factors for hepatitis B virus (HBV) are primarily associated with:
a. Living in urban communities
b. Mothers who are hepatitis C carriers
c. Transfusion therapy for hemophilia
d. Those of Hispanic ethnic background
22. Cirrhosis causes intrahepatic portal hypertension in children as a result of which mechanism?
a. Fibrosis that increases the resistance to blood flow within the portal system
b. Increased pressure from the twisting of the common bile ducts
c. Development of collateral circulation within the portal system
d. Shunting of fluid to the spleen or abdomen
23. What is the most common clinical sign of portal hypertension in children?
a. Right heart failure c. Splenomegaly
b. Pulmonary edema d. Diarrhea
24. What factors can contribute to the development of a cleft lip and a cleft palate? (Select all that apply.)
a. Maternal deficiency of B vitamins
b. Exposure to heavy metals during the second trimester of pregnancy
c. Maternal use of tobacco
d. Maternal diabetes mellitus
e. Genetic mutation of the transforming growth factor
25. Which situations have been associated with possible causes of the failure to thrive (FTT) in infants? (Select all that apply.)
a. Gastroesophageal reflux
b. Pyloric stenosis
c. Intestinal parasites
d. Adoption at birth
e. Psychosocial isolation
26. Which statements regarding Wilson disease in children are true? (Select all that apply.)
a. Wilson disease is a rare autosomal recessive defect.
b. Wilson disease affects copper metabolism.
c. A lack of necessary copper is a result of Wilson disease.
d. The liver is often affected in Wilson disease.
e. Corneal damage can be a result of Wilson disease.
27. What are the classic symptoms associated with hepatitis A in children? (Select all that apply.)
e. Muscle pain
28. Cystic fibrosis is directly responsible for complications to which structures? (Select all that apply.)
c. Lymph nodes
29. Which foods should be eliminated from the diet for children who have gluten-sensitive enteropathy (celiac sprue)? (Select all that apply.)
a. Citrus fruits
b. Starchy vegetables
c. Cereal grains
d. Red meat
Match the terms with the corresponding characteristics.
______ A. Gluten sensitivity
______ B. Periduodenal band
______ C. Congenital aganglionic megacolon
______ D. Protein energy malnutrition
______ E. Lack of digestive enzymes during fetal life
31. Hirschsprung disease
32. Marasmus and kwashiorkor
33. Celiac sprue
34. Meconium ileus