Question 1

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.

Accepted Answer

Acute glomerulonephritis develops from 1 to 3 weeks after a streptococcal infection,which causes an allergic-type response that alters the effectiveness of the glomeruli.

Question 2

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. "

Accepted Answer

Oils in bubble bath and similar products are known to irritate the urethra.

Question 3

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.

Accepted Answer

Although children may feel well,activity is limited until hematuria resolves.

Question 4

During a physical assessment of a hospitalized 5-year-old,the nurse notes that the foreskin has been retracted and is very tight on the shaft of the penis;the nurse is unable to return it over the head of the penis.The nurse should: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

Accepted Answer

Notify the charge nurse of this occurrence of paraphimosis.The tight foreskin can impede blood flow to the penis;this should be remedied immediately.

Question 5

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.

Accepted Answer

Prednisone depresses the immune response and increases susceptibility to infection.Because steroids mask signs of infection,the child must be assessed for more subtle symptoms of illness.

Question 6

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. "

Accepted Answer

The parents should be instructed to keep a daily record of the child's urinary proteins.

Question 7

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.

Accepted Answer

The edema of nephrotic syndrome is generalized and not readily noticed,even by the parents,but an early sign that can be assessed is periorbital edema.

Question 8

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.

Accepted Answer

A potent antisuppressant such as Cytoxan can bring about diuresis when corticosteroids have proven ineffective.

Question 9

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.

Accepted Answer

Bananas are very high in potassium and should be avoided.

Question 10

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.

Accepted Answer

The ileal conduit diverts urine to the colon,and the urine is excreted with the feces.There is no external appliance,as is needed with the other diversion methods.

Question 11

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.

Accepted Answer

Juices such as apple or cranberry help maintain acidity of urine.

Question 12

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.

Accepted Answer

No vaccinations or immunizations should be administered while the disease is active and during immunosuppressive therapy.

Question 13

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. "

Accepted Answer

Although orchiopexy improves the condition,the fertility rate among patients may be reduced even when only one testis is undescended.

Question 14

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.

Accepted Answer

Children who have only one kidney should avoid contact sports to prevent injury to that remaining organ.

Question 15

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.

Accepted Answer

The child should be turned frequently to prevent respiratory tract infection and to prevent pressure on delicate skin.

Question 16

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. "

Accepted Answer

Encourage the patient to talk about what he knows and what feelings he has about the surgery.School-age children have a fear of bodily harm.

Question 17

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.

Accepted Answer

Palpation of the abdomen could disturb the tumor and cause the malignancy to spread.

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.

Accepted Answer

Treatment of hypospadias consists of surgical repair and is usually performed before 18 months of age.

Question 19

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.

Accepted Answer

Urinary frequency and pain during micturition are symptoms of acute urinary tract infection.

Question 20

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.

Accepted Answer

An x-ray examination of the bladder and urethra before and during micturition is called a voiding cystourethrogram.

Quiz 29: The Child with a Genitourinary Condition

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:

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 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:

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:

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

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

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

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:

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

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

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:

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:

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:

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

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

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:

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

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

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

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) :