Deck 29: The Child with a Genitourinary Condition

Question 1

The 6-year-old scheduled for an orchiopexy shyly asks the nurse, "What are they going to do to me 'down there'?" The nurse's best response would be:

A) "They are going to fix you up 'down there.'"
B) "They will move your testicle from your abdomen to your scrotum."
C) "What do you think your doctor is going to do?"
D) "You shouldn't worry. Your doctor knows exactly what to do."

Answer 1

"What do you think your doctor is going to do?"

Question 2

While a child is receiving prednisone to treat nephrotic syndrome, it is important for the nurse to assess the child for:

A) infection.
B) urinary retention.
C) easy bruising.
D) hypoglycemia.

Answer 2

infection.

Question 3

The nurse is explaining to a 17-year-old female the actions to prevent urinary tract infection. The nurse determines the adolescent understands the information when she says a good drink to keep urine acidic is:

A) milk.
B) grape juice.
C) apple juice.
D) orange juice.

Answer 3

apple juice.

Question 4

An appropriate intervention for the edematous child with reduced mobility related to nephrotic syndrome would be to:

A) teach the child to minimize body movements.
B) change the child's position frequently.
C) keep the head of the child's bed flat.
D) keep edematous areas moist and covered.

Question 5

The nurse discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. The statement made by the parent indicating a need for further teaching is:

A) "My daughter should wash and wipe the perineal area from front to back."
B) "I am only going to have my daughter wear cotton underwear."
C) "It is acceptable to take frequent bubble baths."
D) "She needs to drink lots of fluids and void frequently."

Question 6

Because of the hyperkalemia associated with acute glomerulonephritis, the nurse recommends that the child avoid foods such as:

A) dairy products.
B) whole-grain cereals.
C) organ meats.
D) bananas.

Question 7

When diuresis has not occurred after a month on corticosteroids, the nurse explains to the parents of a child with nephrotic syndrome that diuresis can be brought about by a protocol of:

A) ibuprofen, an antiinflammatory agent.
B) furosemide (Lasix), a diuretic.
C) ciprofloxacin (Cipro), an antibiotic.
D) cyclophosphamide (Cytoxan), an antisuppressant.

Question 8

Parents are speaking with the urologist about their son's undescended testicle. The nurse determines the child's father understands the information presented when he states:

A) "An undescended testicle can reduce fertility."
B) "The testicle usually descends spontaneously during the first month of life."
C) "Surgical correction reduces the risk for testicular tumors."
D) "The optimal time to surgically correct the condition is at diagnosis."

Question 9

A 6-year-old child with daytime enuresis complains of dysuria and urgency; the nurse recognizes these as signs and symptoms of:

A) urinary tract infection.
B) nephrotic syndrome.
C) acute glomerulonephritis.
D) vesicoureteral reflux.

Question 10

The physical assessment technique that the nurse would omit in caring for a 2-year-old who has a Wilms' tumor is:

A) performing range-of-motion exercises on lower extremities.
B) palpating the abdomen.
C) assessing for bowel sounds.
D) percussing ankle and knee reflexes.

Question 11

The initial sign of nephrosis that the nurse might note in the child would be:

A) raspberry-like rash.
B) periorbital edema.
C) temperature elevation.
D) abdominal pain.

Question 12

The nurse clarifies that the urinary diversion procedure that would be least damaging to the body image of the adolescent would be:

A) urostomy.
B) ileal conduit.
C) nephrostomy.
D) suprapubic placement.

Question 13

The statement made by a parent of a child with nephrotic syndrome indicating an understanding of discharge teaching is:

A) "I will make sure he gets his measles vaccine as soon as he gets home."
B) "He can stop taking his medication next week."
C) "I should check his urine for protein when he goes to the bathroom."
D) "He should eat a low-protein diet for the next few weeks."

Question 14

A parent tells the nurse that her child is scheduled for an x-ray of the bladder and urethra that is done while the child is urinating. The nurse recognizes this description as a(n):

A) cystometrogram.
B) cystoscopy.
C) voiding cystourethrogram.
D) intravenous pyelogram.

Question 15

During a physical assessment of a hospitalized 5-year-old, the nurse notes that the foreskin has been retracted and is very tight on the shaft of the penis; the nurse is unable to return it over the head of the penis. The nurse should:

A) forcibly push the foreskin down over the head of the penis.
B) place a warm compress on the penis.
C) notify the charge nurse.
D) wait a few hours and try again.

Question 16

The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. The nurse clarifies that while on prednisone, immunizations:

A) can interfere with the treatment for nephrosis.
B) require that the child have antibiotic coverage.
C) can be given in smaller, divided doses.
D) should be delayed.

Question 17

A 5-year-old boy is admitted to the hospital with acute glomerulonephritis. In taking the child's history, the nurse recognizes the probable cause is:

A) recovery from German measles 2 months ago.
B) dysuria since the previous night.
C) a history of allergy.
D) a sore throat 2 weeks ago.

Question 18

When asked about correcting the hypospadias of a newborn, the nurse explains that with this condition:

A) no intervention is necessary as the defect will correct itself over time.
B) surgical repair of the hypospadias is done before 18 months of age.
C) corrective surgery is usually delayed until the preschool age.
D) repairing the defect will increase the risk of testicular cancer.

Question 19

A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. An appropriate nursing intervention for this child would be:

A) providing activities for the child on restricted activity.
B) feeding the child a protein-restricted diet.
C) carefully handling edematous extremities.
D) observing the child for evidence of hypotension.

Question 20

The nurse cautions the parents of a child who has had a nephrectomy that he will have to practice a lifelong avoidance of:

A) contact sports.
B) horseback riding.
C) alcohol.
D) diuretic medications.

Question 21

The nurse explains that the test that measures the pressure and volume of the urine stream is called the _________________.

Question 22

What special considerations are related to long-term prednisone therapy in preschoolers? Select all that apply.

A) Delayed immunization
B) Hypertension
C) Enlargement of the sex organs
D) Alteration in nutrition
E) Increased risk for infection

Question 23

What will the nurse caring for a newborn with exstrophy of the bladder include in the care? Select all that apply.

A) Diaper infant tightly.
B) Protect skin around bladder.
C) Position infant on back.
D) Prepare for surgical closure.
E) Cover exposed bladder with shield.

Question 24

When a child's ureter becomes completely obstructed from scarring, the nurse explains that urinary diversion may be necessary to prevent the reflux back into the renal pelvis from causing ____________________.

Question 25

The nurse caring for a child with nephrotic syndrome is alert to which classic symptoms of this disorder? Select all that apply.

A) Proteinuria
B) Grossly bloody urine
C) Hyperalbuminemia
D) Fatigue
E) Generalized edema

Question 26

The inability to void even though the urge to do so is strong is known as _______________.

Question 27

The nurse is aware that genitourinary surgery is especially stressful for preschool children because of what factor(s)? Select all that apply.

A) They may perceive the treatment as punishment.
B) They are especially prone to separation anxiety.
C) They are sexually curious and developmentally fixated on their genitals.
D) They have a fear of castration.
E) They are embarrassed by having their genitals exposed.
F) None of the above

Question 28

The nurse uses a diagram to show how the _______________, the working unit of the kidney, filters and regulates fluids.

Question 29

The parents of a newborn are concerned that their son's scrotum is enlarged and swollen on one side. The nurse's best response would be:

A) "It is very common in the newborn that one gonad is larger than the other."
B) "Birth trauma caused bruising to the scrotum. It will reduce in size in a few days."
C) "It is a collection of fluid that will most likely correct itself in a year."
D) "The doctor will drain this collection of blood before your baby is discharged."