Deck 44: The Child with a Genitourinary Alteration

Question 1

Which clinical finding warrants further intervention for the child with acute post streptococcal glomerulonephritis?

A) Weight loss to within 1 lb of the preillness weight
B) Urine output of 1 mL/kg/hr
C) A positive antistreptolysin O (ASO) titer
D) Inspiratory crackles

Answer 1

Inspiratory crackles

Question 2

The nurse assessing a child with acute poststreptococcal glomerulonephritis should be alert for which finding?

A) Increased urine output
B) Hypotension
C) Tea-colored urine
D) Weight gain

Answer 2

Tea-colored urine

Question 3

Which dietary modification is appropriate for a child with chronic renal failure?

A) Decreased protein
B) Decreased fat
C) Increased potassium
D) Increased phosphorus

Answer 3

Decreased protein

Question 4

Parents ask the nurse,"When should our child's hypospadias be corrected?" The nurse responds that correction of hypospadias should be accomplished by the time the child is

A) 1 month of age.
B) 6 to 12 months of age.
C) school age.
D) sexually mature.

Question 5

What should the nurse include in a teaching plan for the parents of a child with vesicoureteral reflux?

A) The importance of taking prophylactic antibiotics if prescribed
B) Suggestions for how to maintain fluid restrictions
C) The use of bubble baths as an incentive to increase bath time
D) The need for the child to hold urine for 6 to 8 hours

Question 6

Which finding indicates that a child receiving prednisone for primary nephrotic syndrome is in remission?

A) Urine is negative for casts for 5 days.
B) Urine has <1+ protein for 3 to 7 consecutive days.
C) Urine is positive for glucose for 1 week.
D) Urine is up to a trace for blood for 1 week.

Question 7

Which statement by a school-age girl indicates the need for further teaching about the prevention of urinary tract infections (UTIs)?

A) "I always wear cotton underwear."
B) "I really enjoy taking a bubble bath."
C) "I go to the bathroom every 3 to 4 hours."
D) "I drink four to six glasses of fluid every day."

Question 8

The mother of a child who was recently diagnosed with acute glomerulonephritis asks the nurse why the physician keeps talking about "casts" in the urine.The nurse explains that casts in the urine indicate

A) glomerular injury.
B) glomerular healing.
C) recent streptococcal infection.
D) excessive amounts of protein in the urine.

Question 9

What is an appropriate intervention for a child with nephrotic syndrome who is edematous?

A) Teach the child to minimize body movements.
B) Change the child's position every 2 hours.
C) Avoid the use of skin lotions.
D) Bathe every other day.

Question 10

Which intervention is appropriate when examining a male infant for cryptorchidism?

A) Cooling the examiner's hands
B) Taking a rectal temperature
C) Eliciting the cremasteric reflex
D) Warming the room

Question 11

Which factor predisposes the urinary tract to infection?

A) Increased fluid intake
B) Short urethra in young girls
C) Prostatic secretions in males
D) Frequent emptying of the bladder

Question 12

The narrowing of preputial opening of foreskin is called

A) chordee.
B) phimosis.
C) epispadias.
D) hypospadias.

Question 13

A child with secondary enuresis who complains of dysuria or urgency should be evaluated for which condition?

A) Hypocalciuria
B) Nephrotic syndrome
C) Glomerulonephritis
D) UTI

Question 14

Which of the following is a true statement describing the differences in the pediatric genitourinary system compared with the adult genitourinary system?

A) The young infant's kidneys can more effectively concentrate urine than an adult's kidneys.
B) After 6 years of age, kidney function is nearly like that of an adult.
C) Unlike adults, most children do not regain normal kidney function after acute renal failure.
D) Young children have shorter urethras, which can predispose them to UTIs.

Question 15

You are the nurse caring for a 4-year-old child who has developed acute renal failure as a result of hemolytic-uremic syndrome (HUS).Which bacterial infection was most likely the cause of HUS?

A) Pseudomonas aeruginosa
B) Escherichia coli
C) Streptococcus pneumoniae
D) Staphylococcus aureus

Question 16

Which diagnostic finding is present when a child has primary nephrotic syndrome?

A) Hyperalbuminemia
B) Positive ASO titer
C) Leukocytosis
D) Proteinuria

Question 17

Which statement by a parent of a child with nephrotic syndrome indicates an understanding of a no-added-salt diet?

A) "I can give my child sweet pickles."
B) "My child can put ketchup on his hotdog."
C) "I can let my child have potato chips."
D) "I do not put any salt in foods when I am cooking."

Question 18

A nurse is teaching a class on acute kidney injury.The nurse relates that acute kidney injury as a result of hemolytic-uremic syndrome (HUS)is classified as

A) Intrinsic renal.
B) Prerenal.
C) Postrenal.
D) Chronic.

Question 19

Hypospadias refers to

A) absence of a urethral opening.
B) penis shorter than usual for age.
C) urethral opening along dorsal surface of penis.
D) urethral opening along ventral surface of penis.

Question 20

Which condition is characterized by a history of bloody diarrhea,fever,abdominal pain,and low hemoglobin and platelet counts?

A) Acute viral gastroenteritis
B) Acute glomerulonephritis
C) Hemolytic-uremic syndrome
D) Acute nephrotic syndrome

Question 21

The most common cause of acute kidney injury in children is

A) pyelonephritis.
B) tubular destruction.
C) urinary tract obstruction.
D) severe dehydration.

Question 22

The primary clinical manifestations of acute kidney injury are which of the following?

A) Oliguria and hypertension
B) Hematuria and pallor
C) Proteinuria and muscle cramps
D) Bacteriuria and facial edema

Question 23

Which statement is descriptive of renal transplantation in children?

A) It is an acceptable means of treatment after age 10 years.
B) It is preferred means of renal replacement therapy in children.
C) Children can receive kidneys only from other children.
D) The decision is difficult, since a normal lifestyle is not possible.

Question 24

A nurse is planning care for a child admitted with nephrotic syndrome.Which interventions should be included in the plan of care? (Select all that apply.)

A) Administration of antihypertensive medications
B) Daily weights
C) Salt-restricted diet
D) Frequent position changes
E) Teaching parents to expect tea-colored urine

Question 25

A nurse is assessing lab results on four patients in the general pediatric unit.What child should the nurse go see first?

A) Urine specific gravity: 1.025
B) Urine ketones: positive in large amounts
C) Serum BUN 21 mg/dL
D) Serum creatinine 0.7 mg/dL

Question 26

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

A) Bacteriuria and hematuria
B) Hematuria and proteinuria
C) Bacteriuria and increased specific gravity
D) Proteinuria and decreased specific gravity

Question 27

The nurse closely monitors the temperature of a child with nephrotic syndrome.The purpose of this is to detect an early sign of which possible complication?

A) Infection
B) Hypertension
C) Encephalopathy
D) Edema

Question 28

The diet of a child with chronic renal failure is usually characterized as

A) high in protein.
B) low in vitamin D.
C) low in phosphorus.
D) supplemented with vitamins A, E, and K.

Question 29

The most appropriate nursing diagnosis for the child with acute glomerulonephritis is

A) Risk for Injury related to malignant process and treatment.
B) Deficient Fluid Volume related to excessive losses.
C) Risk for Imbalanced Fluid Volume related to a decrease in plasma filtration.
D) Excess Fluid Volume related to fluid accumulation in tissues and third spaces.

Question 30

A major complication in a child with chronic renal failure is

A) hypokalemia.
B) metabolic alkalosis.
C) water and sodium retention.
D) excessive excretion of blood urea nitrogen.

Question 31

A child with secondary enuresis who complains of dysuria or urgency should be evaluated for what conditions? (Select all that apply.)

A) Hypocalciuria
B) Nephrotic syndrome
C) Glomerulonephritis
D) UTI
E) Diabetes mellitus

Question 32

A nurse is assessing an infant for urinary tract infection (UTI).Which assessment findings should the nurse expect? (Select all that apply.)

A) Change in urine odor or color
B) Enuresis
C) Fever or hypothermia
D) Voiding urgency
E) Poor weight gain

Question 33

An infant is born with bladder exstrophy.What action by the nurse is the priority?

A) Obtain surgical consent for the corrective operation.
B) Cover the exposed bladder with non-adherent plastic wrap.
C) Insert an indwelling catheter to collect all the urine.
D) Obtain consent for genetic testing on parents and infant.