Deck 28: The Child With a Genitourinary Condition

Question 1

The statement made by a parent of a child with nephrotic syndrome indicating an understanding of discharge teaching is:

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."

Answer 1

"I should check his urine for protein when he goes to the bathroom."

Question 2

Because of the hyperkalemia associated with acute glomerulonephritis, the nurse recommends that the child avoid such foods as:

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

Answer 2

Bananas

Question 3

While a child is receiving prednisone to treat nephrotic syndrome, it is important for the nurse to assess the child for:

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

Answer 3

Infection

Question 4

When asked about correcting the hypospadias of their newborn, the nurse explains that with 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 period.
D) Repairing the defect will increase the risk of testicular cancer.

Question 5

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

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 6

A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. An appropriate nursing intervention for this child would be:

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 7

The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. The nurse clarifies that while on prednisone, immunizations:

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 8

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

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 9

When diuresis has not occurred after a month on corticosteroids, the nurse explains to the parents of a child with nephrotic syndrome that diuresis can be brought about by a protocol of:

A) Ibuprofen, an antiinflammatory agent
B) Lasix, a diuretic
C) Cipro, an antibiotic
D) Cytoxan, an antisuppressant

Question 10

An appropriate intervention for the child with minimal change nephrotic syndrome who is edematous would be to:

A) Teach 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 11

A 6-year-old child with daytime enuresis complains of dysuria and urgency; the nurse recognizes these as signs and symptoms of:

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

Question 12

The nurse clarifies that the urinary diversion procedure that would be least damaging to the body image of the adolescent would be:

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

Question 13

The nurse caring for a newborn with exstrophy of the bladder will include in the care: Select all that apply.

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 14

The initial sign of nephrosis that the nurse might note in the child would be:

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

Question 15

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. The nurse should:

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 16

The physical assessment that the nurse would omit in caring for a 2-year-old who has a Wilms' tumor is:

A) Performing ROM on lower extremities
B) Palpating the abdomen
C) Assessing for bowel sounds
D) Percussing ankle and knee reflexes

Question 17

A 5-year-old boy is admitted to the hospital with acute glomerulonephritis. In taking the child's history, the nurse recognizes the probable cause of this condition as:

A) Recovered 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 18

Parents are speaking with the urologist about their son's undescended testicle. The nurse determines the child's father understands the information presented when he states:

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."

Question 19

The nurse is explaining to a 17-year-old female the actions to prevent urinary tract infection. The nurse determines the adolescent understands the information when she says a good drink to keep urine acidic is:

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

Question 20

A parent tells the nurse her child is scheduled for an x-ray of the bladder and urethra that is done while the child is urinating. The nurse recognizes this description as a(n):

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

Question 21

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 22

The nurse explains that the test that measures the pressure and volume of the urine stream is called the ____________________.

Question 23

The nurse caring for a child with nephrotic syndrome is alert to the classic symptoms of this disorder, which are: Select all that apply.

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

Question 24

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