Question 1

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

Accepted Answer

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

Question 2

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

Accepted Answer

Bananas are very high in potassium and should be avoided.

Question 3

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

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 4

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

Accepted Answer

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

Question 5

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:

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 6

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:

Accepted Answer

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

Question 7

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:

Accepted Answer

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

Question 8

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:

Accepted Answer

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

Question 9

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:

Accepted Answer

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

Question 10

An appropriate intervention for the child with minimal change nephrotic syndrome who is edematous would be to:

Accepted Answer

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

Question 11

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

Accepted Answer

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

Question 12

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

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 13

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

Accepted Answer

The infant is kept on his back or side with special attention to the skin around the exposed bladder, which is constantly bathed with urine. These infants are diapered loosely, if at all. Surgical closure is done as quickly as possible.

Question 14

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

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 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:

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 16

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

Accepted Answer

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

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 of this condition as:

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 18

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:

Accepted Answer

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

Question 19

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:

Accepted Answer

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

Question 20

A parent tells the nurse 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):

Accepted Answer

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

Quiz 28: The Child With a Genitourinary Condition