Deck 29: The Child with a Genitourinary Condition

Question 1

Parents are speaking with the urologist about their son's undescended testicle.Which statement by the child's father causes the nurse to determine he understands the information presented?

A) "An undescended testicle can reduce fertility."
B) "The testicle usually descends spontaneously during the first month of life."
C) "Surgical correction reduces the risk for testicular tumors."
D) "The optimal time to surgically correct the condition is at diagnosis."

Answer 1

"An undescended testicle can reduce fertility."

Question 2

The nurse is explaining to a 17-year-old female the actions to prevent urinary tract infection.Which is the best beverage for the nurse to recommend to keep urine acidic?

A) Milk
B) Grape juice
C) Apple juice
D) Orange juice

Answer 2

Apple juice

Question 3

A parent tells the nurse that her child is scheduled for an x-ray of the bladder and urethra that is done while the child is urinating.What is this test known as?

A) Cystometrogram
B) Cystoscopy
C) Voiding cystourethrogram
D) Intravenous pyelogram

Answer 3

Voiding cystourethrogram

Question 4

Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?

A) "I will make sure he gets his measles vaccine as soon as he gets home."
B) "He can stop taking his medication next week."
C) "I should check his urine for protein when he goes to the bathroom."
D) "He should eat a low-protein diet for the next few weeks."

Question 5

During a physical assessment of a hospitalized 5-year-old,the nurse notes that the foreskin has been retracted and is very tight on the shaft of the penis; the nurse is unable to return it over the head of the penis.What action should the nurse implement?

A) Forcibly push the foreskin down over the head of the penis.
B) Place a warm compress on the penis.
C) Notify the charge nurse.
D) Wait a few hours and try again.

Question 6

The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten.What does the nurse clarify about receiving immunizations while on prednisone?

A) Can interfere with the treatment for nephrosis
B) Require that the child have antibiotic coverage
C) Can be given in smaller, divided doses
D) Should be delayed

Question 7

What is an initial sign of nephrosis that the nurse might note in a child?

A) Raspberry-like rash
B) Periorbital edema
C) Temperature elevation
D) Abdominal pain

Question 8

A 5-year-old boy is admitted to the hospital with acute glomerulonephritis.In taking the child's history,what does the nurse recognize as the probable cause?

A) Recovery from German measles 2 months ago
B) Dysuria since the previous night
C) A history of allergy
D) A sore throat 2 weeks ago

Question 9

A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed.What is the most appropriate nursing intervention for this child?

A) Providing activities for the child on restricted activity
B) Feeding the child a protein-restricted diet
C) Carefully handling edematous extremities
D) Observing the child for evidence of hypotension

Question 10

Diuresis has not occurred on a child with nephrotic syndrome after a month on corticosteroids.What protocol can the nurse encourage to bring about diuresis?

A) Ibuprofen, an anti-inflammatory agent
B) Furosemide (Lasix), a diuretic
C) Ciprofloxacin (Cipro), an antibiotic
D) Cyclophosphamide (Cytoxan), an antisuppressant

Question 11

What foods does the nurse recommend the child with acute glomerulonephritis avoid to prevent hyperkalemia?

A) Dairy products
B) Whole-grain cereals
C) Organ meats
D) Bananas

Question 12

When asked about correcting the hypospadias of a newborn,what does the nurse explain about this condition?

A) No intervention is necessary as the defect will correct itself over time.
B) Surgical repair of the hypospadias is done before 18 months of age.
C) Corrective surgery is usually delayed until the preschool age.
D) Repairing the defect will increase the risk of testicular cancer.

Question 13

Which urinary diversion procedure is the least damaging to the body image of the adolescent?

A) Urostomy
B) Ileal conduit
C) Nephrostomy
D) Suprapubic placement

Question 14

A 6-year-old child with daytime enuresis complains of dysuria and urgency.What does the nurse recognize these signs and symptoms indicate?

A) Urinary tract infection
B) Nephrotic syndrome
C) Acute glomerulonephritis
D) Vesicoureteral reflux

Question 15

The 6-year-old scheduled for an orchiopexy shyly asks the nurse,"What are they going to do to me 'down there'?" What is the nurse's best response?

A) "They are going to fix you up 'down there'."
B) "They will move your testicle from your abdomen to your scrotum."
C) "What do you think your doctor is going to do?"
D) "You shouldn't worry. Your doctor knows exactly what to do."

Question 16

Which physical assessment technique will the nurse omit when caring for a 2-year-old diagnosed with Wilms' tumor?

A) Performing range-of-motion exercises on lower extremities
B) Palpating the abdomen
C) Assessing for bowel sounds
D) Percussing ankle and knee reflexes

Question 17

What is an appropriate intervention for the edematous child with reduced mobility related to nephrotic syndrome?

A) Reach the child to minimize body movements.
B) Change the child's position frequently.
C) Keep the head of the child's bed flat.
D) Keep edematous areas moist and covered.

Question 18

What will the nurse caution the parents of a child who has had a nephrectomy that he will have to avoid?

A) Contact sports
B) Horseback riding
C) Alcohol
D) Diuretic medications

Question 19

What is it important to assess in a child receiving prednisone to treat nephrotic syndrome?

A) Infection
B) Urinary retention
C) Easy bruising
D) Hypoglycemia

Question 20

The nurse discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child.Which statement made by the parent indicates a need for further teaching?

A) "My daughter should wash and wipe the perineal area from front to back."
B) "I am only going to have my daughter wear cotton underwear."
C) "It is acceptable to take frequent bubble baths."
D) "She needs to drink lots of fluids and void frequently."

Question 21

The strong urge to void,often despite the inability to do so,is known as _______________.

Question 22

A 7-year-old child has a BUN of 25 mg/dL.What is the nurse aware this lab value might indicate?

A) Dehydration
B) Renal disease
C) Need for steroid therapy
D) Diabetes
E) Pituitary malfunction

Question 23

What special considerations are related to long-term prednisone therapy in preschoolers?

A) Delayed immunization
B) Hypertension
C) Enlargement of the sex organs
D) Alteration in nutrition
E) Increased risk for infection

Question 24

The nurse caring for a child with nephrotic syndrome is alert to which classic symptoms of this disorder?

A) Proteinuria
B) Grossly bloody urine
C) Hyperalbuminemia
D) Fatigue
E) Generalized edema

Question 25

The parents of a newborn are concerned that their son's scrotum is enlarged and swollen on one side.What is the nurse's best response?

A) "It is very common in the newborn that one gonad is larger than the other."
B) "Birth trauma caused bruising to the scrotum. It will reduce in size in a few days."
C) "It is a collection of fluid that will most likely correct itself in a year."
D) "The doctor will drain this collection of blood before your baby is discharged."

Question 26

What will the nurse caring for a newborn with exstrophy of the bladder include in the care?

A) Diaper infant tightly.
B) Protect skin around bladder.
C) Position infant on back.
D) Prepare for surgical closure.
E) Cover exposed bladder with shield.

Question 27

________________ is a narrowing of the preputial opening of the foreskin,which prevents the foreskin from being retracted over the penis.

Question 28

The nurse is providing information to parents of a child born with bilateral cryptorchidism.What information is accurate to include?

A) This is the most common form.
B) Fertility will be unaffected.
C) Surgical intervention is not recommended.
D) An inguinal hernia may be present.

Question 29

When a child's ureter becomes completely obstructed from scarring,the nurse explains that urinary diversion may be necessary to prevent the reflux back into the renal pelvis from causing ____________________.

Question 30

The nurse uses a diagram to show how the _______________,the working unit of the kidney,filters and regulates fluids.

Question 31

The nurse explains that the device that measures the pressure and volume of the urine stream is called the _________________.

Question 32

An adolescent male is admitted to the ED with severe acute scrotal pain.When documenting medical history the nurse notes cryptorchidism at birth.What diagnosis does the nurse expect?

A) Urinary tract infection
B) Nephrosis
C) Torsion
D) Phimosis

Question 33

The nurse is aware that genitourinary surgery is especially stressful for preschool children.What factor(s)lend to this stress?

A) They may perceive the treatment as punishment.
B) They are especially prone to separation anxiety.
C) They are sexually curious and developmentally fixated on their genitals.
D) They have a fear of castration.
E) They fear death.

Question 34

The nurse is measuring ouput on an infant on the pediatric unit.When weighing the diaper and subtracting the weight of the dry diaper,the nurse records 30 grams and documents this as _________ mL.