Question 1

A child has been admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS). The clinical manifestations will include which of the following?

Accepted Answer

Minimal change nephrotic syndrome (MCNS) is characterized by massive proteinuria (excretion of >3.5 g of protein per 24 hours), hypoalbuminemia (serum albumin level of <2.5 g/dL), and edema (usually periorbital, leg or ankle). Hematuria, bacteriuria, weight gain, decreased urine-specific gravity and increased urinary output, gross hematuria, albuminuria, and fever are not typically associated with MCNS.

Question 2

Following a hypospadias repair, the 10-month-old child returns from the operating room with a urethral stent. It is now four hours since the child's surgery. Which assessment finding should be reported to the surgeon?

Accepted Answer

B

Question 3

A child is scheduled for a kidney transplant. The nurse has completed the preoperative teaching to prepare the child and parents for the surgery and postoperative considerations. Which statement indicates that the parents understand the process involved with a kidney transplant?

Accepted Answer

Option A is incorrect because the child will still have to take medications after the transplant to prevent rejection of the donor kidney. Option B is incorrect because the child will still be at risk for infections even after the transplant. Option C is incorrect because the child will have to follow up with the doctor after the transplant to ensure the success of the transplant. Option D is the correct option because it shows an understanding of the importance of taking medications after the transplant to avoid rejection.

Question 4

A four-year-old has acute glomerulonephritis (AGN) and is admitted to the hospital. The priority nursing diagnosis for this child would be:

Accepted Answer

The priority nursing diagnosis for a child with acute glomerulonephritis (AGN) is Risk for injury related to hypertension. Hypertension is a common complication of AGN, and it can lead to further kidney damage and other complications such as stroke or seizures. Monitoring and managing the child's blood pressure is crucial to prevent these potential risks. Altered growth and development, risk for infection, and fluid volume excess are also potential concerns for a child with AGN, but they are not the priority nursing diagnosis in this case.

Question 5

A child with acute renal failure is being treated with peritoneal dialysis. Following medical orders, the dialysate has been infused into the child's abdomen. When the dialysate is drained, the nurse notes the following findings. Which finding requires notification of the physician?

Accepted Answer

A lower volume of drained dialysate relative to the volume infused could indicate that the dialysis is not effectively removing waste products from the child's body, which could lead to further complications. The other findings are within normal limits or expected outcomes of the procedure. Restlessness can be managed with appropriate distractions, and clear dialysate and stable vital signs are desirable outcomes. However, the finding of a lower drained volume requires further investigation and possible intervention.

Question 6

A child with nephritic syndrome is severely edematous. The primary health care provider has placed the child on bed rest. An important nursing intervention for this child would be to:

Accepted Answer

Repositioning the child every two hours is important to prevent pressure ulcers and to promote circulation. Monitoring BP every 30 minutes may be necessary, but it is not the most important intervention. Limiting visitors and encouraging fluids may also be necessary, but they do not directly address the child's edema and bed rest requirements.

Question 7

Which sets of symptoms are characteristic of a preschool-age child with a urinary tract infection?

Accepted Answer

Preschool-age children with a urinary tract infection typically experience urgency (sudden urge to urinate), dysuria (painful urination), and fever. Hematuria (blood in urine) may also be present. Other symptoms such as headache, flank pain, and nausea are more commonly seen in older children and adults with urinary tract infections. Foul-smelling urine and elevated blood pressure are not commonly associated with urinary tract infections.

Question 8

A child has undergone a kidney transplant and is receiving cyclosporine. The parents ask the nurse about the reason for the cyclosporine. The nurse should explain that the drug is given to:

Accepted Answer

Cyclosporine is an immunosuppressant drug used to suppress the body's immune response to prevent organ rejection after a transplant.

Question 9

A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show which of the following?

Accepted Answer

Hematuria (presence of blood in urine) and proteinuria (presence of protein in urine) are common signs of acute glomerulonephritis.

Question 10

A nurse is preparing to admit a child with possible obstructive uropathy. What labs should the nurse expect to draw on this child?

Accepted Answer

Blood urea nitrogen (BUN) and creatinine are important labs to assess kidney function and can be used to diagnose obstructive uropathy. Platelet count and partial thromboplastin time (PTT) are not directly related to this diagnosis. A blood culture may be drawn if a systemic infection is suspected, but it is not specific to obstructive uropathy.

Question 11

A child is admitted to the hospital with a diagnosis of "rule out" urinary tract infection. A clean-catch urine specimen is submitted to the lab. When the results return, the nurse evaluates the findings. Which finding would the nurse question?

Accepted Answer

A specific gravity of 1009 is on the lower end of the normal range (1.005-1.030) and might not be directly indicative of a urinary tract infection (UTI). In contrast, findings such as white blood cells (indicative of infection), red blood cells (possible injury or infection), and cloudy urine (often seen in UTIs) are more directly associated with UTIs.

Question 12

A child is undergoing hemodialysis. The child should be monitored closely for:

Accepted Answer

The answer of A child is undergoing hemodialysis. The child...

Question 13

A child in renal failure has hyperkalemia. The nurse plans to instruct the child and her parents to avoid which foods?

Accepted Answer

Carrots and green, leafy vegetables are high in potassium, which should be avoided in hyperkalemia.

Question 14

A baby is born with bladder exstrophy. Immediate care for this infant will include which intervention?

Accepted Answer

Covering the defect with sterile plastic wrap is a critical immediate intervention for a baby born with bladder exstrophy to prevent infection and maintain a moist environment until surgical repair can be performed. This condition involves the bladder being exposed outside the body, and protecting the exposed area is essential.

Question 15

A four-year-old girl has been treated for three urinary tract infections (UTI) in the last two years. Which instructions can the nurse give to the mother to help reduce the child's risk of acquiring another UTI?

Accepted Answer

B) Teaching the child to wipe from front to back can reduce the risk of bacteria from the anal area spreading to the urethral area.
D) Encouraging the child to drink additional fluids throughout the day can help flush out bacteria from the urinary tract and reduce the risk of infection.
E) Planning potty breaks every two hours throughout the day can also help flush out bacteria and reduce the time that bacteria remain in the urinary tract. Wearing nylon underwear is not recommended as it can trap moisture and increase the risk of infection, and long baths with bubbles and toys can irritate the urethral area and also increase the risk of infection.

Question 16

The surgeon is discussing plans for orchiopexy with the parents of an infant born with cryptorchidism. The parents are overwhelmed and do not hear much of the discussion. The nurse will clarify the surgeon's explanation by discussing that the risk of undescended testes include:

Accepted Answer

The answer of The surgeon is discussing plans for orchiopexy...

Quiz 53: The Child With Alterations in Genitourinary Function

A child has been admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS) . The clinical manifestations will include which of the following?