Question 1

Identify one or more choices that best complete the statement or answer the question.
-An adolescent who is 16 years of age is being discharged home after treatment for kidney stones. The nurse provides the patient and parents with written instructions for reference at home. Which information will the nurse include? Select all that apply.

Accepted Answer

B,D

Question 2

Identify one or more choices that best complete the statement or answer the question.
-The nurse is providing care for a 3-year-old toddler admitted with a diagnosis of nephrotic syndrome related to a recent upper respiratory infection. In preparation for discharge, which teaching does the nurse provide for the parents? Select all that apply.

Accepted Answer

Nephrotic syndrome involves the kidneys and can lead to edema, hence the importance of checking for swelling in the feet and lower legs (B). Strict monitoring of daily weight is crucial to detect fluid retention or loss (C). Diet and fluid restrictions are often part of managing nephrotic syndrome to control edema and other symptoms, making it important to provide written materials for reference (E). Prophylactic antibiotics (A) are not typically used in nephrotic syndrome management unless there's a specific reason, and maintaining a low activity level (D) is not generally required unless the child's condition warrants it.

Question 3

Identify one or more choices that best complete the statement or answer the question.
-The nurse is providing teaching to the parents of a preschool-age toddler diagnosed with chronic kidney disease (CKD). Which information does the nurse cover regarding vaccinations for the toddler? Select all that apply.

Accepted Answer

Routine immunizations are given to children with CKD, annual pneumococcal conjugate vaccinations are encouraged, and annual attenuated influenza vaccinations are recommended.

Question 4

The nurse is providing care to a school-age child admitted because of the presence of colicky abdominal pain, palpable purpura on the lower extremities, edema of the face and lips, and anorexia. The suspected diagnosis is Henoch-Schönlein purpura. Which diagnostic test result does the nurse expect to validate the diagnosis?

Accepted Answer

Henoch-Schönlein purpura (HSP) is characterized by IgA deposition in small vessels, which can be confirmed by a renal biopsy showing IgA deposition.

Question 5

The nurse is providing care for a 9-year-old patient diagnosed with postinfectious glomerulonephritis. The nurse is aware of hypertension and a prescribed dose of nifedipine 0.5 mg/kg/dose every 4 hours. The patient weighs 63 pounds. Which dose does the nurse give every 4 hours?

Accepted Answer

First, convert the patient's weight from pounds to kilograms by dividing by 2.2 (63 lbs / 2.2 = 28.64 kg). Then, calculate the dose using the prescribed amount of 0.5 mg/kg (28.64 kg * 0.5 mg/kg = 14.32 mg). The closest dose to this calculation is 14 mg.

Question 6

The nurse is providing care for an adolescent patient admitted with a diagnosis of nephrolithiasis. The patient's symptoms include flank pain, hematuria, and vomiting. The nurse notices an hourly output of 20 mL/hour. Patient's medical history includes UTIs, type 1 diabetes mellitus, and one kidney at birth. Which medical prescription does the nurse expect immediately from the physician?

Accepted Answer

The answer of The nurse is providing care for an...

Question 7

The nurse is providing care for a 7-year-old child whose admitting diagnosis is poststreptococcal glomerulonephritis. The nurse expects which care to be prescribed for the child?

Accepted Answer

Poststreptococcal glomerulonephritis is an immune-mediated condition that occurs following an infection with certain strains of streptococcus bacteria. Antibiotic therapy is typically prescribed to treat any remaining streptococcal infection and prevent further complications. Hemodialysis is not a standard treatment for this condition unless severe kidney failure occurs. Nifedipine, a calcium channel blocker, is not a direct treatment for poststreptococcal glomerulonephritis. Increasing fluids is not specifically indicated and can be contraindicated in cases where there is significant kidney impairment leading to fluid overload.

Question 8

The pediatric nurse receives a medical prescription to obtain a urine sample for culture from an infant 6 months of age diagnosed with a UTI. By which method will the nurse collect the sample?

Accepted Answer

Urinary catheterization is the most reliable method to obtain a sterile urine sample for culture in infants, ensuring that the sample is not contaminated.

Question 9

A 9-year-old male patient arrives at the emergency department with suprapubic tenderness, nausea, vomiting, and painful urination. Which laboratory result does the nurse expect from a urinalysis?

Accepted Answer

The presence of white blood cells (WBCs) in the urine (pyuria) is indicative of a urinary tract infection (UTI), which aligns with the patient's symptoms of suprapubic tenderness, nausea, vomiting, and painful urination.

Question 10

The nurse in a pediatric clinic is collecting information for the reason a parent has brought a toddler to the clinic. The parent states the toddler cries with urination and is sometimes incontinent. The nurse obtains an axillary temperature of 101.2°F (38.4°C). For which additional reason does the nurse suspect a urinary tract infection (UTI)?

Accepted Answer

The toddler is 3 years of age is a risk factor for UTI.

Question 11

The nurse is admitting a 6-month-old infant for testing because of a second UTI and suprapubic pain with palpation. Diagnostic tests reveal a grade II vesicoureteral reflux (VUR). Which information does the nurse provide to the family?

Accepted Answer

Grade II vesicoureteral reflux (VUR) is often managed with medication therapy to prevent infections and potentially allow the condition to resolve as the child grows, rather than immediate surgery, genetic counseling, or dialysis.

Question 12

A 6-year-old patient is brought to the pediatrician's office with symptoms of feeling ill, periorbital edema, weight gain, and anorexia. The nurse suspects nephrotic syndrome. Which laboratory value confirms the nurse's suspicion?

Accepted Answer

Nephrotic syndrome is characterized by a high level of protein in the urine (proteinuria), which is a result of damage to the glomeruli in the kidneys. This condition leads to a decrease in the level of protein in the blood, causing symptoms such as edema.

Question 13

An adolescent who is 15 years of age is brought to the pediatric clinic because of bloody urine. Which additional finding during assessment will cause the nurse to consider acute kidney injury (AKI)?

Accepted Answer

Bruising in the flank area can indicate trauma to the kidneys, which can lead to acute kidney injury (AKI). This is because trauma or injury to the kidneys can disrupt their normal function, leading to issues such as bloody urine.

Question 14

Shortly after the birth of a male neonate, the parents are informed about the diagnosis of hypospadias. The physician explains that the neonate's urethral opening is located midpenile, and surgery will occur between the ages of 6 and 12 months. Which additional explanation does the nurse provide to the parents?

Accepted Answer

The diagnosis of hypospadias is usually an isolated anomaly.

Question 15

The nurse in a pediatric clinic is gathering information from the parent of a toddler who has anorexia, generalized edema, and joint pain following a bout with strep throat. Which question(s) will most likely give the nurse information for a specific condition?

Accepted Answer

The symptoms described are indicative of post-streptococcal glomerulonephritis, a condition that can follow strep throat and affect the kidneys, leading to issues like anorexia, edema, and urine discoloration. Asking about urination and urine color can provide specific insights into kidney function, which is relevant to diagnosing this condition.

Question 16

A high school male adolescent arrives at the emergency department following a fall sustained while rock climbing. The physician prescribes diagnostic tests to rule out acute kidney injury (AKI). Which diagnostic finding does the nurse report immediately to the health-care provider?

Accepted Answer

The serum potassium level of 5.7 mEq/L is significantly elevated and indicates hyperkalemia, which can be life-threatening and is associated with cardiac arrhythmias. This finding should be reported immediately to the healthcare provider, especially in the context of potential acute kidney injury (AKI) where potassium levels can rise due to decreased kidney function.

Question 17

The nurse is admitting an adolescent who is 19 years of age with a diagnosis of acute renal infection. While obtaining medical and health history information, which finding does the nurse identify as supporting the diagnosis?

Accepted Answer

Sexual activity, especially in females, can increase the risk of urinary tract infections (UTIs), which can ascend to the kidneys and cause acute renal infections. Choices A, B, and C are less directly related to the risk of developing an acute renal infection.

Question 18

A parent brings a 12-month-old toddler to the pediatrician because the toddler cries a lot and then stops on her own. The parent has noticed a little blood in the diaper every time it is wet. Assessment reveals a temperature of 101.3°F (38.5°C). Which condition does the nurse anticipate after a urinalysis?

Accepted Answer

The symptoms described, including crying (which may indicate pain or discomfort), blood in the diaper, and fever, are indicative of a urinary tract infection (UTI). Urinalysis is a common diagnostic tool for UTIs, which can confirm the presence of bacteria, white blood cells, or blood in the urine.

Question 19

The nurse is providing teaching for the parents of a child diagnosed with hemolytic uremic syndrome (HUS) 10 months ago. Which statement by a parent indicates the teaching is understood?

Accepted Answer

Careful skin inspection and care is important in HUS due to potential swelling and poor circulation, which can lead to skin breakdown.

Quiz 16: Renal Disorder