Question 1

Which instructions should be provided to the parents of a 4-year-old girl who has experienced chronic urinary tract infections (UTIs) in the last 2 years? Select all that apply.

Accepted Answer

Wiping from front to back helps prevent bacteria from the anus entering the urethra. Drinking additional fluids and taking frequent potty breaks can help flush out bacteria. Wearing nylon underwear may actually contribute to UTIs by trapping moisture and bacteria, and taking long baths with bubbles and toys can also increase the risk of UTIs.

Question 2

Which clinical manifestations should the nurse anticipate upon assessment for a preschool-age child with a urinary tract infection (UTI)?

Accepted Answer

Preschool-age children with UTIs commonly present with urgency, dysuria, and fever. Other possible symptoms include abdominal or back pain, foul-smelling urine, and frequency. Headache, hematuria, and vertigo are less common in UTIs. Elevated BP is not typically a symptom of UTIs. Severe flank pain, nausea, and headache may indicate a more serious complication such as pyelonephritis.

Question 3

Which clinical manifestations should the nurse anticipate when assessing a child who has been admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?

Accepted Answer

The clinical manifestations associated with MCNS include massive proteinuria (greater than 40 mg/m2/hour), hypoalbuminemia, and edema. Hematuria and bacteriuria are typically not present, and urine specific gravity is typically elevated with decreased urinary output. Gross hematuria and fever are also not typically seen with MCNS.

Question 4

Which nutritional interventions should the nurse include in the plan of care for a pediatric client who is receiving peritoneal dialysis in the treatment of chronic renal failure? Select all that apply.

Accepted Answer

Small, frequent meals can help manage nutritional intake and prevent overwhelming the child. Avoiding battles over nutritional intake helps reduce stress and encourages a positive relationship with food. Administering supplements by tube feedings ensures adequate nutrition if oral intake is insufficient.

Question 5

Which assessment finding, after the dialysate is drained during peritoneal dialysis for a child experiencing acute renal failure, would warrant further action by the nurse?

Accepted Answer

A lesser volume of drained dialysate than infused can indicate inadequate clearance of waste products and excess fluid in the body, which would require further intervention by the nurse. Options A, C, and D are considered normal findings during peritoneal dialysis.

Question 6

Which actions should the nurse implement when assessing the physical growth for a child who is diagnosed with chronic renal failure? Select all that apply.

Accepted Answer

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Question 7

Which is the priority nursing intervention when caring for a neonate who is born with bladder exstrophy?

Accepted Answer

Covering the defect with sterile plastic wrap is the priority nursing intervention for a neonate born with bladder exstrophy to prevent infection and maintain moisture at the site. This condition involves the bladder being exposed outside the body, necessitating immediate protective measures.

Question 8

Which parental statement indicates understanding of the process involved with a kidney transplant for a child with renal failure?

Accepted Answer

This statement indicates understanding of the importance of medication compliance after a kidney transplant, which is crucial for the success of the transplant. The other statements do not address key aspects of the transplant process.

Question 9

Which is the appropriate nursing intervention when providing care to a child, diagnosed with nephrotic syndrome, who is edematous and on bed rest?

Accepted Answer

Reposition every 2 hours is the appropriate nursing intervention for a child diagnosed with nephrotic syndrome who is edematous and on bed rest. This will help prevent skin breakdown and promote circulation. Monitoring blood pressure every 30 minutes is not necessary unless ordered by the healthcare provider. Limiting visitors and encouraging fluids are important interventions, but repositioning takes priority in this situation.

Question 10

Which menu choices for a child who is diagnosed with renal failure and experiencing hyperkalemia indicate the need for further instruction by the nurse?

Accepted Answer

Carrots and green, leafy vegetables are high in potassium and should be avoided by a child with renal failure and hyperkalemia.

Question 11

Which risks of undescended testes should the nurse include in the teaching session for the parents of a newborn diagnosed with this condition? Select all that apply.

Accepted Answer

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Question 12

Which urinalysis result should the nurse anticipate for a child who is admitted with acute glomerulonephritis?

Accepted Answer

Hematuria and proteinuria are common findings in a child with acute glomerulonephritis. Bacteriuria is not typically present and specific gravity may be normal or decreased due to decreased renal function.

Question 13

Which laboratory tests should the nurse prepare to draw when admitting a pediatric client with possible obstructive uropathy? Select all that apply.

Accepted Answer

When admitting a pediatric client with possible obstructive uropathy, the nurse should prepare to draw blood for BUN (to assess kidney function) and creatinine (to assess kidney function and help diagnose obstructive uropathy). Platelet count and PTT are not specifically indicated for obstructive uropathy. Blood culture may be indicated if the child has signs or symptoms of infection, but it is not specific to obstructive uropathy.

Question 14

The nurse is preparing medication instruction for a child who has undergone a kidney transplant and is prescribed cyclosporine. The parents ask the nurse about the reason for the cyclosporine. Which rationale for this medication should the nurse include in the response?

Accepted Answer

Cyclosporine is an immunosuppressant medication that is commonly used to prevent rejection after a kidney transplant. It works by suppressing the immune system, which helps prevent the body from attacking and rejecting the transplanted kidney.

Question 15

Which clean-catch urinalysis finding should the nurse be most concerned for a child who is admitted to an urgent care center to rule out a urinary tract infection?

Accepted Answer

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Question 16

Which complications should the nurse monitor for when providing care to a child who is having hemodialysis for the treatment of kidney failure? Select all that apply.

Accepted Answer

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Question 17

Which assessment finding would necessitate action by the nurse for a 10-month-old child who is 4 hours postoperative for the placement of a urethral stent?

Accepted Answer

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Question 18

Which nursing actions are appropriate to assess growth and development for an adolescent client diagnosed with chronic renal failure? Select all that apply.

Accepted Answer

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Question 19

A preschool-age child is admitted to the hospital with acute postinfectious glomerulonephritis (APIGN) and is admitted to the hospital. Which is the priority nursing diagnosis for this child?

Accepted Answer

Hypertension is a common complication of APIGN and can lead to the development of other serious conditions such as heart failure, stroke, or seizures. Thus, the priority nursing diagnosis for this child should be related to the risk for injury caused by hypertension.

Question 20

Which assessment questions should the nurse include in the psychosocial assessment to determine the effects of chronic renal failure treatments on the growth and development of a school-age child? Select all that apply.

Accepted Answer

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Quiz 52: The Child With Alterations in Genitourinary Function