Intussusception Study Guide

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Sample questions from Intussusception Study Guide

This material has 12 questions with answers and rationales. Here are the first 5.

1. 1.A nurse explains intussusception to the caregiver of a 9-month-old infant. Which explanation best describes the condition and its usual cause in this age group?

   • A.A segment of bowel slides into an adjacent segment, causing obstruction and potentially reduced blood flow; often no definite structural cause is identified.
   • B.The bowel rotates around its mesentery, causing obstruction; a congenital polyp is usually responsible in infants.
   • C.Inflammation stops intestinal movement without mechanical obstruction; this usually results from opioid use in infants.
   • D.A congenital narrowing blocks the stomach outlet, causing vomiting and reduced blood flow to the colon.

   Rationale: Intussusception is telescoping of one bowel segment into another, which can obstruct the lumen and compress mesenteric vessels. Many infant cases have no identified structural lead point; older children and adults are more likely to have one. Rotation describes volvulus, not intussusception. Loss of movement without mechanical blockage describes ileus. Gastric outlet narrowing describes pyloric stenosis.

2. 2.An 18-month-old child has sudden episodes of crying and drawing the knees toward the abdomen, followed by quiet periods. The child has vomited and has fewer wet diapers. Which assessment finding requires the most urgent escalation?

   • A.A caregiver reports that the child seemed comfortable between earlier episodes.
   • B.No blood or mucus is visible in the child's stool.
   • C.The abdomen is now rigid, and the child is lethargic with cool extremities and delayed capillary refill.
   • D.A sausage-shaped abdominal mass is palpable, but the child remains alert with warm extremities.

   Rationale: Rigidity suggests peritoneal irritation, while lethargy, cool extremities, and delayed capillary refill suggest impaired perfusion or shock. These findings require immediate escalation. Comfortable intervals are typical early in intussusception and do not exclude disease. Bloody mucus stool can be a late finding, so its absence is not reassuring. A sausage-shaped mass supports the diagnosis but is less urgent than signs of peritonitis and shock.

3. 3.A stable toddler is being evaluated for suspected intussusception. Which statement about diagnostic testing is accurate?

   • A.A normal abdominal radiograph reliably excludes intussusception.
   • B.Abdominal ultrasound is generally the preferred initial study, while laboratory tests help evaluate dehydration and physiologic effects.
   • C.An elevated white blood cell count confirms intussusception without imaging.
   • D.Contrast-enhanced abdominal CT is routinely required before attempting reduction in every child.

   Rationale: Ultrasound is generally the preferred initial imaging test in children and may show a target appearance without radiation exposure. Laboratory studies can assess electrolyte abnormalities and other effects but do not establish the diagnosis. A normal radiograph does not exclude intussusception; radiographs may help assess obstruction or free air. Leukocytosis is nonspecific. CT is not routinely required in typical pediatric cases.

4. 4.A child with suspected intussusception is tachycardic, has delayed capillary refill, and has repeated vomiting. The abdomen is rigid, and imaging shows free intraperitoneal air. Which plan should the nurse anticipate?

   • A.Offer oral rehydration solution and reassess perfusion before obtaining IV access.
   • B.Prepare for immediate air enema reduction because perforation increases the urgency of nonsurgical treatment.
   • C.Give an antiemetic and wait for vomiting to resolve before beginning fluids or surgical consultation.
   • D.Keep the child NPO, obtain IV access, administer prescribed isotonic fluids and analgesia, monitor closely, and prepare for antibiotics and urgent surgery.

   Answer and rationale are in the full material.

5. 5.A toddler has undergone successful enema reduction of intussusception. Which nursing plan best supports recovery and safe discharge?

   • A.Continue assessment of pain, vital signs, abdominal findings, and hydration; resume feeding as ordered after recovery assessment, and teach caregivers to return promptly for recurrent symptoms.
   • B.Discharge immediately after reduction because successful treatment eliminates the possibility of recurrence.
   • C.Keep the child NPO for several days regardless of assessment findings, and explain that recurrent cramping is expected.
   • D.Advance directly to a full meal and advise caregivers to seek care only if bloody stool develops.

   Answer and rationale are in the full material.