Deck 16: Renal Disorder

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.

A)The patient is not on a restricted diet or fluid intake at this time.
B)All urine is to be strained and sediment kept for analysis.
C)The thiazide diuretic may be discontinued on discharge.
D)The patient and parents need to understand any medication regimen.
E)A metabolic workup is no longer necessary.

Answer 1

All urine is to be strained and sediment kept for analysis.
The patient and parents need to understand any medication regimen.

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.

A)Administration of prophylactic antibiotic medication
B)Reason for checking feet and lower legs for edema
C)Method to use when strictly monitoring daily weight
D)Suggestions about maintaining a low activity level
E)Provision of written material about diet and fluid restriction

Answer 2

Reason for checking feet and lower legs for edema
Method to use when strictly monitoring daily weight
Provision of written material about diet and fluid restriction

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.

A)Routine immunizations given to healthy children are administered.
B)Annual pneumococcal conjugate vaccinations are encouraged.
C)Live viral vaccinations such as varicella and MMR are appropriate.
D)Intranasal influenza vaccine are preferred for children with CKD.
E)Annual attenuated influenza vaccinations are recommended.

Answer 3

Routine immunizations given to healthy children are administered.
Annual pneumococcal conjugate vaccinations are encouraged.
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?

A)Elevated serum creatinine
B)Positive for proteinuria
C)Stool positive for occult blood
D)Renal biopsy shows 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?

A)14 mg
B)18 mg
C)22 mg
D)30 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?

A)Increase IV fluids to 125 mL/hour.
B)Cover blood glucose on a sliding scale.
C)Establish NPO status and prepare patient for surgery.
D)Administer IV morphine 5 mg every 2 hours for pain.

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?

A)Hemodialysis
B)Nifedipine orally
C)Increase fluids
D)Antibiotic therapy

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?

A)Applying clean catch techniques
B)Attaching an external urine bag
C)Catching urine in a sterile diaper
D)Performing urinary catheterization

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?

A)White blood cells: 15,000 cells/ $\mu$ L
B)Positive for glucose and protein
C)Potassium: 3.5-5.0 mEq/L
D)Hematocrit: 37%

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)?

A)The toddler is 3 years of age.
B)The toddler attends a preschool.
C)The toddler is a circumcised male.
D)The symptoms are comparable to an adult 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?

A)Preparation necessary for surgery
B)Information about medication therapy
C)Importance of genetic counseling
D)Necessity of establishing 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?

A)Serum sodium of 138 mEq/L
B)Serum potassium of 4.5 mEq/L
C)A high level of protein in the urine
D)Low serum levels of HDL and LDLs

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)?

A)Bruising in the flank area
B)Tenderness in the lower back
C)Hesitation and pain with urination
D)Suprapubic swelling and pain

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?

A)The neonate should be circumcised immediately.
B)The diagnosis is usually an isolated anomaly.
C)A ventral curvature of the penis is likely.
D)A pediatric surgeon will perform the surgery.

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?

A)"What behavior did you see to indicate joint pain?"
B)"When and where did you first notice swelling?"
C)"Is the child urinating, and what color is the urine?"
D)"How were you managing the symptoms at home?"

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?

A)Serum creatinine level of 0.6
B)Hematocrit level of 38%
C)Serum BUN of 20 mg/dL
D)Serum potassium of 5.7 mEq/L

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?

A)Hospitalization for removal of tonsils at 10 years of age
B)Prolonged use of acetaminophen for frequent headaches
C)A family history that is positive for renal calculi formation
D)Acknowledgment of being sexually active since 14 years of age

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?

A)Hypospadias
B)Henoch-Schönlein purpura
C)Acute kidney injury
D)Urinary tract infection

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?

A)"The diet will be low calorie, low carbohydrate, no added salt, and low potassium."
B)"Nonsteroidal medications are used only if acetaminophen is not effective."
C)"Careful skin inspection and care is given because of swelling and poor circulation."
D)"We can initially treat diarrhea with over-the-counter antidiarrheal medications."