Deck 43: Nursing Care of the Child With an Alteration in Urinary Elimination/Genitourinary Disorder

Question 1

The nurse is caring for a child who is experiencing an acute renal transplant rejection and is to receive muromonab-CD3. Which of the following would the nurse most likely expect to assess after the first dose is administered?

A) Fever with chills, chest tightness
B) Cough, hyperkalemia
C) Photosensitivity, gastrointestinal (GI) upset
D) Urinary retention, decreased appetite

Answer 1

Fever with chills, chest tightness

Question 2

The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color?

A) Cloudy yellow
B) Cola colored
C) Pale to almost clear urine
D) Light orange to moderately yellow colored

Answer 2

Cola colored

Question 3

The nurse is caring for a 4-year-old with a suspected urinary tract infection. Which of the following would be most appropriate when obtaining a urine specimen from the child?

A) "I will need a urine sample."
B) "Let your mom help you tinkle in this cup."
C) "Please tinkle in this cup right now."
D) "Please void in this cup instead of the toilet."

Answer 3

"Let your mom help you tinkle in this cup."

Question 4

The nurse is providing postsurgical care for an infant who has undergone a hypospadias repair. Which action by the nurse would be most important to help keep the area clean while maintaining proper position of the drainage tubing?

A) Keeping the drainage tube taped in an upright position
B) Administering antibiotics as ordered
C) Administering analgesics as prescribed
D) Using a double-diapering technique

Question 5

The nurse is caring for an infant with bladder exstrophy. As part of the infant's preoperative plan of care, the nurse monitors for abdominal skin excoriation. Which action would be most appropriate for promoting healing and preventing further skin breakdown?

A) Cleaning the area well with a scented diaper wipe
B) Applying a barrier/healing cream or paste on skin
C) Keeping the bladder moist and covered with a sterile bag
D) Covering the area with sterile gauze pads after tub baths

Question 6

The nurse is caring for a 4-year-old girl with vulvovaginitis. After explaining to the girl's mother how to help prevent subsequent episodes, which statement by the mother indicates a need for additional teaching?

A) "She needs to wipe from front to back."
B) "I will make sure she changes her underwear every day."
C) "She should probably avoid bubble baths."
D) "I will help supervise her wiping after bowel movements."

Question 7

A nurse is caring for a 7-year-old girl scheduled for an intravenous pyelogram (IVP). Which of the following would be the priority before the test?

A) Checking with the parents for any allergies
B) Ensuring adequate hydration
C) Giving the girl an enema
D) Screening her for pregnancy

Question 8

A 6-year-old child has undergone a renal transplant and is receiving cyclosporine. The nurse instructs the parents to be especially alert for which of the following?

A) Weight loss
B) Hypotension
C) Signs of infection
D) Hair loss

Question 9

The nurse is taking a health history of a child with suspected acute poststreptococcal glomerulonephritis. Which of the following responses would alert the nurse to a confirmed risk factor for this condition?

A) "She has been very healthy up to now."
B) "He just got over a head cold with laryngitis."
C) "My child is just 18 months old."
D) "My child has not been sick at all."

Question 10

The nurse is caring for a 12-year-old girl with nephrotic syndrome. The girl confides that she feels like a "freak" compared to her peers because of her weight, edema, and moon face. Which response by the nurse would be most appropriate?

A) "Let's put you in touch with some other girls who are also having the same body changes."
B) "Luckily, this is just a temporary, unfortunate part of your condition; you need to accept it."
C) "Your real friends do not care about your appearance and just want you to get well."
D) "You are beautiful in your own way; what matters is what is on the inside."

Question 11

An 8-year-old girl is scheduled for a renal ultrasound. Which of the following would the nurse include in the plan of care when preparing the child for this test?

A) Withholding food and fluids after midnight
B) Checking the child for allergies to shellfish
C) Ensuring the child has a full bladder
D) Informing the child she should feel no discomfort

Question 12

The nurse is preparing a teaching plan for the parents of a child with a urinary tract infection (UTI). Which of the following would the nurse encourage the parents to avoid?

A) Liberal fluid intake
B) Caffeine
C) Cranberry juice
D) Cotton underwear

Question 13

The mother of a child with end-stage renal disease asks the nurse why her son is getting an injection of erythropoietin. When responding to the mother, the nurse incorporates understanding of which of the following as the rationale?

A) To treat low calcium levels
B) To stimulate growth in stature
C) To stimulate red blood cell growth
D) To correct acidosis

Question 14

A child is diagnosed with hemolytic-uremic syndrome (HUS). Review of the child's laboratory test results would reveal which of the following?

A) Decreased blood urea nitrogen (BUN) and creatinine
B) Decreased platelets and leukocytosis
C) Hypernatremia and hypokalemia
D) Respiratory acidosis and proteinuria

Question 15

After teaching the parents of a child with a hydrocele about this condition, which statement indicates that the teaching was successful?

A) "If this gets worse and we don't treat it, our son could become infertile."
B) "This condition should gradually go away on its own."
C) "The surgeon is going to operate on him immediately."
D) "It's going to be difficult putting ice packs on his scrotum."

Question 16

A nurse is conducting a physical examination of an infant and observes the urethral opening on the dorsal side of the penis. The nurse documents this finding as which of the following?

A) Hypospadias
B) Epispadias
C) Varicocele
D) Hydrocele

Question 17

A 15-year-old boy comes to the emergency department accompanied by his parents. The boy reports an abrupt onset of sudden pain on the right side of his scrotum. When asked to rate his pain on a scale of 1 to 10, with 10 being the most severe, the boy states, "It's a 12." Further assessment reveals a blue-black swelling on the affected side. The nurse suspects testicular torsion and immediately notifies the physician based on the understanding of which of the following?

A) The condition is a surgical emergency.
B) The boy is at risk for sepsis
C) Intravenous antibiotics need to be initiated.
D) Renal failure is imminent.

Question 18

The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. Which of the following would the nurse least likely expect to find?

A) Hyperlipidemia
B) Hypoalbuminemia
C) Decreased blood urea nitrogen (BUN)
D) Hypoproteinemia

Question 19

The nurse is applying a urine bag to a 15-month-old boy to collect a urine specimen. Which of the following would the nurse do first?

A) Apply benzoin to the scrotal area
B) Tuck the bag downward inside the diaper
C) Pat the perineal area dry after cleaning
D) Apply the narrow portion of the bag on the perineal space

Question 20

A group of students are reviewing information about renal failure in children. The students demonstrate a need for additional teaching when they identify which agent as a potential contributor to renal failure?

A) Vancomycin
B) Gentamicin
C) Co-trimoxazole
D) Amoxicillin

Question 21

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which of the following would the nurse incorporate into the presentation as the most common cause?

A) Klebsiella
B) Escherichia coli
C) Staphylococcus aureus
D) Pseudomonas

Question 22

A nurse is interviewing the parents of a child diagnosed with obstructive uropathy. Which statement by the parents would the nurse identify as significant?

A) "She's been constipated quite a few times."
B) "We've noticed that her bed is wet in the morning."
C) "She had surgery to repair a problem with her anus."
D) "She had a bacterial skin infection about a week ago."

Question 23

The nurse is assessing a child with acute poststreptococcal glomerulonephritis. Which of the following would the nurse expect to assess? Select all answers that apply.

A) Irritability
B) Abdominal pain
C) Hypertension
D) Crackles
E) Polyphagia

Question 24

A nurse identifies a nursing diagnosis of impaired urinary elimination related to urinary tract infection. When developing the plan of care, which of the following would be most important for the nurse to do first?

A) Develop a schedule for bladder emptying
B) Encourage fluid intake
C) Assess usual voiding patterns
D) Monitor intake and output

Question 25

While presenting a panel discussion to a group of parents about urinary tract infections in children, one of the parents asks the nurse, "Why would my daughter be more at risk than my son?" Which response by the nurse would be most accurate?

A) "Girls have a smaller bladder size than boys do."
B) "A girl's urethra is closer to the rectal opening."
C) "A girl's urethra is longer than a boy's urethra."
D) "Her kidneys are less well protected."

Question 26

A child returns from surgery in which a stoma was created in the abdominal wall to the bladder. The nurse identifies this as which of the following?

A) Vesicostomy
B) Ureteral stent
C) Continent urinary diversion
D) Bladder augmentation

Question 27

The nurse is preparing an 8-year-old girl for a cystoscopy. Which instruction would be most appropriate to give to the child?

A) "You need to make sure that you don't go to the bathroom before the test."
B) "You mightfeel some burning when you go to the bathroom afterward."
C) "I'm going to have to put a tube into your bladder to empty it."
D) "I have to put a thick tight rubber band around your arm to get a blood specimen."

Question 28

The nurse is assessing a 5-year-old child's genitourinary system. Which of the following would the nurse document as a normal finding? Select all answers that apply.

A) Labial fusion
B) Round abdomen
C) Positive bowel sounds
D) Dullness over the spleen
E) Undescended testicles