Chapter 45

The nurse is conducting an assessment on a school-age child with urosepsis. Which assessment finding should the nurse expect? a. Fever with a positive blood culture b. Proteinuria and edema c. Oliguria and hypertension d. Anemia and thrombocytopenia

A

One of the clinical manifestations of chronic renal failure is uremic frost. Which best describes this term? a. Deposits of urea crystals in urine b. Deposits of urea crystals on skin c. Overexcretion of blood urea nitrogen d. Inability of body to tolerate cold temperatures

B

The diet of a child with nephrosis usually includes requirement? a. High protein b. Salt restriction c. Low fat d. High carbohydrate

B

The narrowing of preputial opening of foreskin is referred to as what? a. Chordee b. Phimosis c. Epispadias d. Hypospadias

B

Which factor predisposes a child to urinary tract infections? a. Increased fluid intake b. Short urethra in young girls c. Prostatic secretions in males d. Frequent emptying of the bladder

B

A child with secondary enuresis who reports of dysuria or urgency should be evaluated for what condition? (Select all that apply.) a. Hypocalciuria b. Nephrotic syndrome c. Glomerulonephritis d. Urinary tract infection (UTI) e. Diabetes mellitus

D, E

What should the nurse recommend to prevent urinary tract infections in young girls? a. Wearing cotton underpants b. Limiting bathing as much as possible c. Increasing fluids; decreasing salt intake d. Cleansing the perineum with water after voiding

A

When a child diagnosed with chronic renal failure, the progressive deterioration produces a variety of clinical and biochemical disturbances that eventually are manifested in the clinical syndrome known as what? a. Uremia b. Oliguria c. Proteinuria d. Pyelonephritis

A

Which diagnostic test allows visualization of the renal parenchyma and renal pelvis without exposure to external beam radiation or radioactive isotopes? a. Renal ultrasound b. Computed tomography c. Intravenous pyelography d. Voiding cystourethrography

A

What are the primary clinical manifestations of acute glomerulonephritis? (Select all that apply.) a. Oliguria b. Hematuria c. Proteinuria d. Hypertension e. Bacteriuria

A, B, C, D

A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show: a. bacteriuria and hematuria. b. hematuria and proteinuria. c. bacteriuria and increased specific gravity. d. proteinuria and decreased specific gravity.

B

A school-age child with chronic renal failure is admitted to the hospital with a serum potassium level of 5.2 mEq/L. Which prescribed medication should the nurse plan to administer? a. Spironolactone b. Sodium polystyrene sulfonate c. Lactulose d. Calcium carbonate

B

An objective of care for the child with nephrosis is what desired outcome? a. Reduced blood pressure b. Reduced excretion of urinary protein c. Increased excretion of urinary protein d. Increased ability of tissues to retain fluid

B

Calcium carbonate is given with meals to a child with chronic renal disease. The purpose of this is to achieve which desired result? a. Prevent vomiting b. Bind phosphorus c. Stimulate appetite d. Increase absorption of fat-soluble vitamins

B

Which statement is descriptive of renal transplantation in children? a. It is an acceptable means of treatment after age 10 years. b. It is preferred means of renal replacement therapy in children. c. Children can receive kidneys only from other children. d. The decision for transplantation is difficult since a relatively normal lifestyle is not possible.

B

A school-age child has been admitted to the hospital diagnosed with minimal-change nephrotic syndrome. Which clinical manifestations should the nurse expect to assess? (Select all that apply.) a. Weight loss b. Generalized edema c. Proteinuria > 2+ d. Fatigue e. Irritability

B, C, D, E

The nurse is conducting teaching for an adolescent being discharged to home after a renal transplantation. The adolescent needs further teaching if which statement is made? a. "I will report any fever to my primary health care provider." b. "I am glad I only have to take the immunosuppressant medication for 2 weeks." c. "I will observe my incision for any redness or swelling." d. "I won't miss doing kidney dialysis every week."

B

The nurse closely monitors the temperature of a child diagnosed with nephrosis. The purpose of this is to detect an early sign of what undesirable outcome? a. Infection b. Hypertension c. Encephalopathy d. Edema

A

What intervention is a component of the therapeutic management of nephrosis? a. Corticosteroids b. Antihypertensive agents c. Long-term diuretics d. Increased fluids to promote diuresis

A

What should the nurse include in a teaching plan for the parents of a child with vesicoureteral reflux? a. The importance of taking prophylactic antibiotics b. Suggestions for how to maintain fluid restrictions c. The use of bubble baths as an incentive to increase bath time d. The need for the child to hold urine for 6 to 8 hours

A

The nurse is teaching the parent about the diet of a child experiencing severe edema associated with acute glomerulonephritis. Which information should the nurse include in the teaching? a. You will need to decrease the number of calories in your child's diet." b. "Your child's diet will need an increased amount of protein." c. "You will need to avoid adding salt to your child's food." d. "Your child's diet will consist of low-fat, low-carbohydrate foods."

C

What is the most appropriate nursing diagnosis for the child with acute glomerulonephritis? a. Risk for Injury related to malignant process and treatment. b. Deficient Fluid Volume related to excessive losses. c. Excess Fluid Volume related to decreased plasma filtration. d. Excess Fluid Volume related to fluid accumulation in tissues and third spaces.

C

What is the term used to identify when the meatal opening is located on the dorsal surface of the penis? a. Chordee b. Phimosis c. Epispadias d. Hypospadias

C

What major complication is noted in a child with chronic renal failure? a. Hypokalemia b. Metabolic alkalosis c. Water and sodium retention d. Excessive excretion of blood urea nitrogen

C

The nurse is caring for an infant with a suspected urinary tract infection. Which clinical manifestations would be observed? (Select all that apply.) a. Vomiting b. Jaundice c. Failure to gain weight d. Swelling of the face e. Back pain f. Persistent diaper rash

A, C, F

A school-age child is admitted to the hospital with acute glomerulonephritis and oliguria. Which dietary menu items should be allowed for this child? (Select all that apply.) a. Apples b. Bananas c. Cheese d. Carrot sticks e. Strawberries

A, D, E

The nurse is teaching parents of a child with chronic renal failure (CRF) about the use of recombinant human erythropoietin (rHuEPO) subcutaneous injections. Which statement indicates the parents have understood the teaching? a. "These injections will help with the hypertension." b. "We're glad the injections only need to be given once a month." c. "The red blood cell count should begin to improve with these injections." d. "Urine output should begin to improve with these injections."

C

The diet of a child with chronic renal failure is usually characterized as: a. high in protein. b. low in vitamin D. c. low in phosphorus. d. supplemented with vitamins A, E, and K.

C

The nurse is admitting a school-age child in acute renal failure with reduced glomerular filtration rate. Which urine test is the most useful clinical indication of glomerular filtration rate? a. pH b. Osmolality c. Creatinine clearance d. Protein level

C

Which diagnostic finding is present when a child has primary nephrotic syndrome? a. Hyperalbuminemia b. Positive ASO titer c. Leukocytosis d. Proteinuria

D

Which intervention is appropriate when examining a male infant for cryptorchidism? a. Cooling the examiner's hands b. Taking a rectal temperature c. Eliciting the cremasteric reflex d. Warming the room

D

A mother asks the nurse what would be the first indication that acute glomerulonephritis is improving. The nurse's best response should be to identify which occurrence? a. Blood pressure will stabilize. b. Child will have more energy. c. Urine will be free of protein. d. Urinary output will increase.

D

A preschool child is being admitted to the hospital with dehydration and a urinary tract infection (UTI). Which urinalysis result should the nurse expect with these conditions? a. WBC <1; specific gravity 1.008 b. WBC <2; specific gravity 1.025 c. WBC >2; specific gravity 1.016 d. WBC >2; specific gravity 1.030

D

The nurse is caring for an adolescent who has just started dialysis. The child seems always angry, hostile, or depressed. What should the nurse contribute this behavior to? a. Neurologic manifestations that occur with dialysis b. Physiologic manifestations of renal disease c. Adolescents having few coping mechanisms d. Adolescents often resenting the control and enforced dependence imposed by dialysis

D

The nurse understands that hypospadias refers to what urinary anomaly? a. Absence of a urethral opening. b. Penis shorter than usual for age. c. Urethral opening along dorsal surface of penis. d. Urethral opening along ventral surface of penis.

D

The nurse, caring for a child with acute renal failure, should recognize event as a sign of hyperkalemia? a. Dyspnea b. Seizure c. Oliguria d. Cardiac arrhythmia

D

What is a common side effect of corticosteroid therapy? a. Fever b. Hypertension c. Weight loss d. Increased appetite

D

What is an advantage of peritoneal dialysis? a. Treatments are done in hospitals. b. Protein loss is less extensive. c. Dietary limitations are not necessary. d. Parents and older children can perform treatments.

D

What is the most common cause of acute renal failure in children? a. Pyelonephritis b. Tubular destruction c. Urinary tract obstruction d. Severe dehydration

D

Which clinical manifestation would be seen in a child with chronic renal failure? a. Hypotension b. Massive hematuria c. Hypokalemia d. Unpleasant "uremic" breath odor

D