Deck 31: Caring for the Child With a Genitourinary Condition

Question 1

A practicing nurse explains to a nursing student that which is the most common cause of acute renal failure in children?

A) Congenital renal problems
B) Glomerulonephritis
C) Hemolytic uremic syndrome
D) Tylenol (acetaminophen) overdose

Answer 1

Hemolytic uremic syndrome

Question 2

A school-age female child has a urinary tract infection (UTI).The culture has come back positive for Escherichia coli.Which teaching measure is most important for the nurse to include in the teaching plan?

A) Avoid bubble baths and nylon panties.
B) Offer the child fluids frequently.
C) Place the child on a voiding schedule.
D) Teach the child to wipe from front to back.

Answer 2

Teach the child to wipe from front to back.

Question 3

A nurse is obtaining a bagged urine collection on an infant.Which action by the nurse is most important?

A) Clean and powder the skin prior to bagging.
B) Remove the bag as soon as it contains urine.
C) Send the sample to the laboratory as soon as possible.
D) Use universal precautions, including gloves.

Answer 3

Use universal precautions, including gloves.

Question 4

The pediatric clinic nurse calls a parent to report urinalysis findings for her child including microscopic hematuria.Which question by the nurse is most appropriate?

A) "Has your child recently had strep throat?"
B) "Has your child been in a bike or car crash?"
C) "Has your child started menstruating yet?"
D) "Has your child taken lots of bubble baths?"

Question 5

An acutely ill child is admitted for a suspected severe urinary tract infection (UTI).Which is the priority action by the nurse?

A) Administer broad-spectrum antibiotics as ordered.
B) Obtain a urine sample for culture and sensitivity.
C) Start an IV line for aggressive fluid resuscitation.
D) Teach the parents how to prevent future UTIs.

Question 6

A child is in the emergency department following a car crash.Which finding noted by the nurse warrants immediate intervention?

A) Complains "I hurt all over."
B) Grey-Turner's sign
C) Increased WBCs
D) Tachycardia

Question 7

A school-age child has renal disease and the parent wants to know how this could cause the child's hypertension.Which response by the nurse is the most appropriate?

A) "The high blood pressure caused the kidney disease."
B) "The kidneys regulate renin, which controls blood pressure."
C) "The medication your child takes often raises blood pressure."
D) "The renal diet includes a lot of sodium, which raises blood pressure."

Question 8

A child is prescribed gentamycin (Garamycin)and develops acute kidney injury.Which etiology is the most likely cause of the child's acute kidney injury?

A) Intrarenal
B) Postrenal
C) Prerenal
D) Streptococcal

Question 9

A 6-year-old child is scheduled for a voiding cystourethrogram.Which action by the nurse is the most appropriate?

A) Ask the parents about shellfish or iodine allergies.
B) Give the child a preprocedure cleansing enema.
C) Instruct the parents to give the child clear liquids afterward.
D) Provide developmentally appropriate teaching.

Question 10

A child is being treated for nephrotic syndrome.Which assessment finding indicates that an important goal for this child is being met?

A) Decreased abdominal girth
B) Diminished urine output
C) Improved rash
D) Increased weight over a week

Question 11

An infant is born with exstrophy of the bladder but otherwise appears healthy.Which nursing diagnosis is the priority for this infant?

A) Altered family processes
B) Fluid volume deficit
C) Hypothermia
D) Risk for infection

Question 12

An adolescent on the cross-country track team had a urinalysis during a school physical that showed proteinuria.Which action by the nurse is the most appropriate?

A) Advise the teen not to run for 48 hours and repeat the test.
B) Collaborate with the provider to order kidney imaging tests.
C) Explain the finding is insignificant and does not need follow-up.
D) Take the teen's blood pressure on three separate occasions.

Question 13

An infant appears dehydrated.Laboratory results indicate a serum sodium of 143 mEq/L.Which fluid would the nurse use for IV replacement?

A) 0.45% normal saline
B) 0.9% normal saline
C) 3% normal saline
D) D5W with 20 mEq KCL

Question 14

A child has glomerulonephritis and hypertension.Which dietary modification is most appropriate for the nurse to suggest?

A) High fiber
B) High potassium
C) Low saturated fat
D) Low sodium

Question 15

A child presents to the pediatric clinic,where the parent reports that the child has had bloody diarrhea and joint pain.Which diagnostic test does the nurse prepare the child and parent for first?

A) Echocardiogram
B) Skin assessment
C) Serum renal studies
D) Urinalysis

Question 16

A child is brought to the pediatric clinic,where the parent reports that the child has tea-colored urine and puffy eyes.Which diagnostic test does the nurse prepare the parent and child for based on the assessment findings?

A) BUN and creatinine
B) Intravenous pyelogram
C) Suprapubic aspiration
D) Voiding cystourethrogram

Question 17

A child is admitted to the hospital with suspected hemolytic uremic syndrome (HUS).Laboratory results indicate elevated BUN,creatinine,and potassium.Which action by the nurse takes priority?

A) Administer antibiotics.
B) Apply cardiac monitoring.
C) Insert a urinary catheter.
D) Obtain a stool sample.

Question 18

An infant has poor feeding,fever,and malodorous urine.The parents do not want the nurse to catheterize the child.Which response by the nurse is the most appropriate?

A) Apply a urine collection bag on the baby.
B) Explain how this procedure obtains the best results.
C) Give the baby acetaminophen (Tylenol) for fever.
D) Inform the health-care provider of the refusal.

Question 19

A child has acute kidney injury following a serious motor vehicle crash.Which intervention takes priority?

A) Administer IV fluids and blood products.
B) Insert an indwelling urinary catheter.
C) Monitor hourly urine output measurements.
D) Place the child on a low-sodium diet.

Question 20

The parents of a child diagnosed with vesicoureteral reflux (VUR)want to know why their child's kidneys appear large on an abdominal x-ray.Which response by the nurse is the most appropriate?

A) Enlarged due to urine backup
B) Genetic defect causing VUR
C) Multiple tumors
D) Unrelated finding

Question 21

An adolescent male patient had an orchiopexy for cryptorchidism as an infant.Which health promotion activity does the nurse educate this patient about?

A) Annual digital prostate exam
B) Fertility testing
C) Genetic screening
D) Testicular self-exam monthly

Question 22

A student nurse wants to know why a bruit is heard and a thrill palpated at the site of an AV fistula used for dialysis.Which response by the nephrology nurse is the most appropriate?

A) Abnormal findings signaling complications
B) Flapping of the AV valve during circulation
C) Small blood clots blocking some blood flow
D) Turbulent blood flow through the fistula

Question 23

The student learns that which hormones are regulated by the kidneys?

A) Calcitriol
B) Creatinine
C) Estradiol
D) Erythropoietin
E) Renin

Question 24

A child is receiving hemodialysis.The parents ask why hypotension is a possible complication.Which response by the nurse is the most appropriate?

A) "It could be from the anticoagulant we use."
B) "Kidney disease can often cause hypotension."
C) "The treatment is removing fluid from his body."
D) "Your child is critically ill and is unstable."

Question 25

The nurse is assisting a 12-year-old kidney transplant recipient to select items from the hospital menu.Which meal indicates an appropriate understanding of dietary restrictions?

A) Chicken alfredo, breadstick
B) Cheese pizza, fruit cocktail
C) Lasagna, salad, breadstick
D) Pasta with tomato sauce, salad

Question 26

An adolescent patient with acute kidney injury (AKI)asks why she is taking Tums (calcium carbonate).Which response by the nurse is the most appropriate?

A) Gets rid of phosphorus
B) Prevents Curling ulcers
C) Prevents gastric reflux
D) Provides calcium

Question 27

A nurse is caring for a child with acute kidney injury (AKI)at home.The child's laboratory work is as follows: serum albumen 2.8 g/dL and serum protein 4 g/dL.Which action by the nurse is the most appropriate?

A) Assess the child for edema.
B) Document findings in the chart.
C) Facilitate a dietitian referral.
D) Weigh and measure the child.

Question 28

A child is hospitalized with acute kidney injury (AKI)and has a critical hyperkalemia.Which order would the nurse question as inappropriate for this child?

A) Calcium gluconate
B) Dextrose and insulin
C) Emergent dialysis
D) Kayexalate (sodium polystyrene) enema

Question 29

A school-age boy is in the emergency department with testicular torsion.Which action by the nurse takes priority for this patient?

A) Administer prophylactic antibiotics.
B) Assess and treat the child's pain.
C) Ensure surgical consent is on the chart.
D) Ice and elevate the scrotum.

Question 30

A child is receiving home peritoneal dialysis.When the visiting nurse assesses the patient,he finds the outflow from the dialysis to be cloudy.Which action by the nurse is the most appropriate?

A) Call 911 and send the child to the hospital.
B) Call the nephrology clinic to make an appointment.
C) Review teaching with the child on the process.
D) Take a full set of vitals and notify the provider.

Question 31

A nurse is assigned to care for four children who have acute kidney injury (AKI).Which child should the nurse see first after obtaining the handoff report?

A) Anuric
B) Oliguric
C) Has deep, rapid respirations
D) Having in-room dialysis

Question 32

A new mother asks the nurse why babies are more prone to dehydration than adults.Which rationales from the nurse best answer this mother's question?

A) A greater body surface area than adults
B) Higher percentage of total body water
C) Improved ability of kidneys to concentrate urine
D) Kidneys too efficient in excreting waste
E) More fluids losses through GI tract and skin

Question 33

A nurse is preparing to administer gentamicin (Garamycin),IV,to a hospitalized child.Before administering the medication,the nurse checks the drug trough level,which is 13 µg/mL.Which action by the nurse is the priority for this child?

A) Administer the medication.
B) Document the findings.
C) Have the laboratory re-run the specimen.
D) Notify the health-care provider.

Question 34

The parents of a child with chronic kidney disease ask the nurse why the child is prescribed epoetin alfa (Epogen).Which response by the nurse is the most accurate?

A) "It binds with and removes phosphorus."
B) "It will help his body to make more red blood cells."
C) "It will help to boost his white blood cell count."
D) "It will help his body to make more platelets so he doesn't bleed."

Question 35

The student studying the renal system learns that the kidneys have several functions.Which options are functions of the kidneys?

A) Filtering the blood
B) Maintaining electrolyte balance
C) Regulating acid-base balance
D) Removing waste products
E) Suppressing hormone release

Question 36

A child has acute kidney injury (AKI).Which primary acid-base balance does the nurse assess the child for?

A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis

Question 37

A child has just returned to the pediatric intensive care unit after having a kidney transplant.Which assessment takes priority for this child?

A) Level of consciousness
B) Hourly urine output
C) Pain
D) Vital signs

Question 38

A 5-year-old child has enuresis.Which medication regime does the nurse educate the parents on related to this diagnosis?

A) Imipramine (Tofranil), 10 mg before bed
B) Imipramine (Tofranil), 25 mg before bed
C) Oxybutynin chloride (Ditropan), 5 mg once daily
D) Oxybutynin chloride (Ditropan), 50 mg once daily

Question 39

The nurse is explaining the RIFLE classification of kidney injury to a student.Which options are included in this system?

A) End-stage kidney disease
B) Failure to concentrate urine
C) Injury to the kidney
D) Loss of protein in the urine
E) Risk of renal dysfunction

Question 40

A nurse is caring for a child who is scheduled for a kidney biopsy.The prebiopsy laboratory results indicate a platelet count of 88,000,pH of 7.28,and potassium of 5.8 mEq/L.Based on these laboratory results,which action by the nurse is the most appropriate?

A) Ensure signed consent is on the chart.
B) Document the findings in the chart.
C) Notify the provider immediately.
D) Prepare to administer Kayexalate (sodium polystyrene).

Question 41

The nurse is planning discharge teaching for a child who just had a kidney transplant.Which information does the nurse provide regarding signs of rejection?

A) Decreased urine output
B) Edema
C) Fever
D) Pain over the kidney
E) Weight loss

Question 42

A faculty member is explaining complications of hemodialysis to a group of students.Which complications does the faculty member include in the discussion with the students?

A) Bleeding
B) Febrile reactions
C) Hypotension
D) Infection
E) Pulmonary embolism

Question 43

A nurse is explaining to a group of students that there are certain criteria that are met before a child starts renal replacement therapy.Which of the following criteria does the nurse include in the discussion with the students?

A) Acidosis with pH < 7.2 or rising rapidly
B) BUN > 150 mg/dL, or lower if rising rapidly
C) Mental status changes from uremia
D) Potassium > 6.5 mEq/L despite treatment
E) Presence of dialyzable toxins or poisons

Question 44

A child weighs 32 kg (74.4 lb).This child's 24-hour fluid requirements would be calculated as ____________________.

Question 45

A nurse is providing teaching on toilet training to a parent education group.Which signs of training readiness does the nurse explain to the parents?

A) Can stay dry for at least 2 hours
B) Gets up by self at night for toileting
C) Showing interest in toileting
D) Tells parent of need to use toilet
E) Wants to hold urine and not void