Deck 52: The Child With Alterations in Genitourinary Function

Question 1

Which instructions should be provided to the parents of a 4-year-old girl who has experienced chronic urinary tract infections (UTIs) in the last 2 years? Select all that apply.
1) Wear only nylon underwear for better air flow.
2) Teach the child to wipe from front to back.
3) Encourage the child to take long baths by allowing the child bubbles and toys in the tub.
4) Encourage the child to drink additional fluids throughout the day.
5) Plan potty breaks every 2 hours throughout the day.

Answer 1

2, 4, 5

Question 2

Which clinical manifestations should the nurse anticipate upon assessment for a preschool-age child with a urinary tract infection (UTI)?
1) Headache, hematuria, and vertigo
2) Foul-smelling urine, elevated blood pressure (BP), and hematuria
3) Urgency, dysuria, and fever
4) Severe flank pain, nausea, and headache

Answer 2

3

Question 3

Which clinical manifestations should the nurse anticipate when assessing a child who has been admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?
1) Massive proteinuria, hypoalbuminemia, and edema
2) Hematuria, bacteriuria, and weight gain
3) Urine specific gravity decreased and urinary output increased
4) Gross hematuria, albuminuria, and fever

Answer 3

1

Question 4

Which nutritional interventions should the nurse include in the plan of care for a pediatric client who is receiving peritoneal dialysis in the treatment of chronic renal failure? Select all that apply.
1) Provide small, frequent meals.
2) Avoid battles over nutritional intake.
3) Administer supplements by tube feedings, if needed.
4) Implement hand hygiene frequently.
5) Perform daily catheter site care.

Question 5

Which assessment finding, after the dialysate is drained during peritoneal dialysis for a child experiencing acute renal failure, would warrant further action by the nurse?
1) The dialysate is clear on return.
2) The volume of drained dialysate is less than the volume infused.
3) The child is restless, wanting to get up and play.
4) The child's vital signs are basically the same as were noted on infusion.

Question 6

Which actions should the nurse implement when assessing the physical growth for a child who is diagnosed with chronic renal failure? Select all that apply.
1) Asking the child to step on the scale
2) Measuring the child's height
3) Measuring the child's head circumference
4) Using the Denver II with the child
5) Monitoring the child's blood pressure

Question 7

Which is the priority nursing intervention when caring for a neonate who is born with bladder exstrophy?
1) Measuring intake and output
2) Inserting a Foley catheter
3) Covering the defect with sterile plastic wrap
4) Palpating the bladder mass to ensure urine is expelled

Question 8

Which parental statement indicates understanding of the process involved with a kidney transplant for a child with renal failure?
1) "We are happy our child will not have to take any more medicine after the transplant."
2) "We understand our child will not be at risk anymore for catching colds from other children at school."
3) "We will be glad we will not have to bring our child in to see the doctor again."
4) "We know it is important to see that our child takes prescribed medications after the transplant."

Question 9

Which is the appropriate nursing intervention when providing care to a child, diagnosed with nephrotic syndrome, who is edematous and on bed rest?
1) Monitor blood pressure every 30 minutes.
2) Reposition every 2 hours.
3) Limit visitors.
4) Encourage fluids.

Question 10

Which menu choices for a child who is diagnosed with renal failure and experiencing hyperkalemia indicate the need for further instruction by the nurse?
1) Carrots and green, leafy vegetables
2) Spaghetti and meat sauce with breadsticks
3) Hamburger on a bun and cherry gelatin
4) Chips, cold cuts, and canned foods

Question 11

Which risks of undescended testes should the nurse include in the teaching session for the parents of a newborn diagnosed with this condition? Select all that apply.
1) Sperm production will be affected after puberty.
2) Abdominal testes are subject to injury.
3) Abdominal testes have a higher risk of developing cancer.
4) Hormonal production will be affected.
5) The testes are at greater risk of torsion.

Question 12

Which urinalysis result should the nurse anticipate for a child who is admitted with acute glomerulonephritis?
1) Bacteriuria and increased specific gravity
2) Hematuria and proteinuria
3) Proteinuria and decreased specific gravity
4) Bacteriuria and hematuria

Question 13

Which laboratory tests should the nurse prepare to draw when admitting a pediatric client with possible obstructive uropathy? Select all that apply.
1) Platelet count
2) Blood urea nitrogen (BUN)
3) Partial thromboplastin time (PTT)
4) Blood culture
5) Creatinine

Question 14

The nurse is preparing medication instruction for a child who has undergone a kidney transplant and is prescribed cyclosporine. The parents ask the nurse about the reason for the cyclosporine. Which rationale for this medication should the nurse include in the response?
1) Suppress rejection
2) Decrease pain
3) Improve circulation
4) Boost immunity

Question 15

Which clean-catch urinalysis finding should the nurse be most concerned for a child who is admitted to an urgent care center to rule out a urinary tract infection?
1) 2+ white blood cells
2) 1+ red blood cells
3) Urine appearance: cloudy
4) Specific gravity: 1009

Question 16

Which complications should the nurse monitor for when providing care to a child who is having hemodialysis for the treatment of kidney failure? Select all that apply.
1) Migraines
2) Hypotension
3) Infections
4) Fluid overload
5) Shock

Question 17

Which assessment finding would necessitate action by the nurse for a 10-month-old child who is 4 hours postoperative for the placement of a urethral stent?
1) Bloody urine
2) One void since returning from surgery
3) Bladder spasms responding to pharmacologic intervention
4) Double diapering from the previous shift

Question 18

Which nursing actions are appropriate to assess growth and development for an adolescent client diagnosed with chronic renal failure? Select all that apply.
1) Using the Denver II during a health maintenance visit
2) Educating parents on normal milestones
3) Monitoring for delayed sexual maturation
4) Comparing blood pressure values from previous visit
5) Plotting height and weight measurements

Question 19

A preschool-age child is admitted to the hospital with acute postinfectious glomerulonephritis (APIGN) and is admitted to the hospital. Which is the priority nursing diagnosis for this child?
1) Risk for Injury related to hypertension.
2) Altered Growth and Development related to a chronic disease.
3) Risk for Infection related to hypertension.
4) Fluid Volume Excess related to decreased plasma filtration.

Question 20

Which assessment questions should the nurse include in the psychosocial assessment to determine the effects of chronic renal failure treatments on the growth and development of a school-age child? Select all that apply.
1) "How does it make you feel to have to follow a special diet?"
2) "Do you take your medications every day?"
3) "How does it make you feel to undergo dialysis treatments?"
4) "Do you attend school each day?"
5) "How does it make you feel when your parents come home late from work?"

Question 21

Which interventions should the nurse include in the plan of care for a pediatric client who is receiving peritoneal dialysis in the treatment of chronic renal failure to prevent infection? Select all that apply.
1) Provide small, frequent meals.
2) Avoid battles over nutritional intake.
3) Administer supplements by tube feedings, if needed.
4) Implement hand hygiene frequently.
5) Perform daily catheter site care.