CPEN Gastrointestinal Emergencies 2

Question 1

A 3-year-old presents with sudden onset of inconsolable crying, drawing up the legs, and currant jelly stools. Which intervention is the priority?

Accepted Answer

Prepare for air or hydrostatic enema reduction

Answer

Currant jelly stools with colicky abdominal pain are hallmark signs of intussusception, and non-surgical reduction via air or hydrostatic enema is the first-line treatment.

Question 2

An infant presents with bilious vomiting and abdominal distension within the first 24 hours of life. Which condition is most concerning?

Accepted Answer

Malrotation with midgut volvulus

Answer

Bilious vomiting in a neonate is a surgical emergency until proven otherwise, with malrotation and midgut volvulus being the most immediately life-threatening cause.

Question 3

When performing a nasogastric lavage on a pediatric patient with suspected upper GI bleed, which finding would indicate active bleeding requiring urgent intervention?

Accepted Answer

Persistent bright red blood despite lavage

Answer

Persistent bright red blood despite gastric lavage indicates active, ongoing hemorrhage requiring urgent endoscopy or surgical intervention.

Question 4

A 7-year-old with known short bowel syndrome presents with high-volume watery diarrhea, fever, and abdominal cramping after starting a new enteral formula. What is the most appropriate first action?

Accepted Answer

Hold the enteral feed and assess for formula intolerance or infection

Answer

High-volume diarrhea with fever in a child with short bowel syndrome warrants stopping enteral feeds and evaluating for infection (including C. difficile) or formula intolerance before resuming.

Question 5

Which electrolyte abnormality is most commonly associated with prolonged, forceful vomiting in an infant with pyloric stenosis?

Accepted Answer

Hypokalemic hypochloremic metabolic alkalosis

Answer

Repeated loss of hydrochloric acid and potassium through vomiting in pyloric stenosis causes hypokalemic hypochloremic metabolic alkalosis.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Gastrointestinal Emergencies 2