practice questions peds

a 13 month old is discharged following repair of his epispadias. which statement made by the parents indicates they understand the discharge teaching? a. if a mucous plug forms in the urinary drainage tube, we will irrigate it gently to prevent a blockage b. if a mucous plug forms in the urinary drainage tube, we will allow it to pass on its own because this is a sign of healing c. we will make sure the dressing is looseley applied to increase the toddlers comfort d. if we notice any yellow drainage, we will know that everything is healing well

a

a child had a UTI 3 months ago and was treated with an oral antibiotic. a follow up urinalysis revealed normal results. the child has had no other problems until this visit when the child was diagnosed with anther UTI. which is the most appropriate plan? a. obtain urinalysis and culture b. evaluate for renal failure c. admit to peds unit d. send home on antibiotic e. schedule VCUG

a

the manifestations of hemolytic uremic syndrome are due primarily to which event? a. the swollen lining of the small blood vessels damages the red blood cells, which are then removed by the spleen, leading to anemia b. there is a disturbance of the glomerular basement membrane, allowing large proteins to pass through c. the red blood cell changes shape, causing it to obstruct microcirculation d. there is a depression in the production of all formed elements of the blood

a

which statement by a parent is most consistent with minimal change nephrotic syndrome (MCNS)? a. my child missed 2 days of school last week because of a really bad cold b. after camping last week, my childs legs were covered in bug bites c. my child came home from school a week ago because of vomiting and stomach cramps d. we have a pet turtle but no one washes their hands after playing with the turtle

a

which child is at risk for developing glomerulonephritis? a. a 3 year old who had impetigo 1 week ago b. a 5 year old with history of 5 utis in previous year c. a 6 year old with new onset type 1 DM d. a 10 year old recovering from viral pneumonia

a (impetigo is associated with streptococcal organism commonly associated with glomerulonephritis)

the parents of a child with glonerulonephritis ask how they will know their child is improving after they go home. which are the nurses best responses? SATA a. your childs urine output will increase, and the urine will become less tea colored b. your child will have more energy as lab test become more normal c. your childs appetite will decrease as urine output increases d. your childs lab values will become more normal e. your childs weight will increase as the urine becomes less tea colored

a, e

the clinical manifestations of minimal change nephrotic syndrome (MCNS) are due to which of the following? a. chemical changes in the composition of albumin b. increased permeability of the glomeruli c. obstruction of the capillaries of the glomeruli d. loss of the kidneys ability to excrete waste and concentrate urine

b

the parent of a child with glomerulonephritis asks the nurse why the urine is such a funny color. which is the nurses best response? a. it is not uncommon for the urine to be discolored when children are receiving steroids and blood pressure meds b. there is blood in your childs urine that causes it to be tea colored c. your childs urine is very concentrated, so it appears to be discolored d. a ketogenic diet often causes the urine to be tea colored

b

which would the nurse most likely find in the history of a child with hemolytic uremic syndrome (HUS)? SATA a. frequent UTIs and possible vesicourectal reflux b. vomiting and diarrhea before admission c. bee sting and localized edema of the site for 3 days d. previously healthy with no signs of illness e. anorexia and bruising

b,e

a child with minimal change nephrotic syndrome has generalized edema. the skin appears stretched, and areas of breakdown are noted over the boney prominences. the child has been receiving furosemide twice daily for several days. which does the nurse expect to be included in the treatment plan to reduce edema? a. an increase in the amount and frequency of furosemide b. addition of a second diuretic, such as mannitol c. admin of IV albumin d. elimination of all fluids and sodium from the childs diet

c

an infant is scheduled for a hypospadias and chordee repair. the parent asks the nurse, "i understand why the hypospadias repair is necessary, but do they have to fix the chordee as well?" which is the nurses best response? a. I understand your concern. parents do not want their children to undergo extra surgery b. the chordee repair is done strictly for cosmetic reasons that may affect your son as he ages c. the repair is done to optimize sexual functioning when he is older d. this is the best time to repair the chordee because he will be having surgery anyway

c

the nurse is caring for a 4 year old who weighs 15 kg. at the end of a 10 hours period, the nurse notes the urine output to be 150 mL. what action does nurse take? a. notified the health care provider because this urine ouput is too low b. encourages the child to increase oral intake c. records the childs urine output in the chart d. admin isotonic fluid intravenously to help with rehydration

c

the nurse is caring for a newborn with hypospadias. his parents ask if circumcision is an option. which is the nurses best response? a. circumcision is a fading practice and is now contraindicated in most children b. circumcision in children with hypospadias is recommended because it helps prevent infection c. circumcision is an option, but it cannot be done at this time d. circumcision can never be performed on a child with hypospadias

c

the parents of a child hospitalized with minimal change nephrotic syndrome ask why the last blood test revealed elevated lipids. which is the nurses best response? a. if your child had just eaten a fatty meal, the lipids may have been falsely elevated b. its not unusual to see elevated lipids in children because of the dietary habits of today c. because your child is losing so much protein, the liver is stimulated and makes more lipids d. your childs blood is very concentrated because of the edema, so the lipids are falsely elevated

c

which child does not need a urinalysis to evaluate for a uti? a. a 4 month old female presenting with a 2 day history of fussiness and poor appetite; current vital signs include axillary T 100.8F, HR 120 BPM b. a 4 year old female who states "it hurts when I pee"; she has been urinating every 30 minutes; VS are WNL c. an 8 year old male presenting with a finger laceration; mother states he had surgical re implantation of his ureters 2 years ago d. a 12 year old female complaining of pain to her lower right back; she denies any burning or frequency at this time; oral temp of 101.5F

c

which combination of signs is commonly associated with glomerulonephritis? a. massive proteinuria, hematuria, decreased urinary output, and lethargy b. mild proteinuria, increased urinary output, and lethargy c. mild proteinuria, hematuria, decreased urinary output, and lethargy d. massive proteinuria, decreased urinary output, and hypotension

c

which finding requires immediate attention in a child with glomerulonephritis? a. sleeping most of the day and being very cranky when awake; blood pressure 170/90 b. urine output is 190 mL in an 8 hr period and is color of coke c. complaining of severe headache and photophobia d. refusing breakfast and lunch saying he just is not hungry

c

a parent asks the nurse how to prevent the child from having minimal change nephrotic syndrome again. Which is the nurses best response? a. it is very rare for a child to have a relapse after having fully recovered b. unfortunately, many children have cycles of relapse, and there is very little that can be done to prevent it c. your child is much less likely to get sick again if sodium is decreased in the diet d. try to keep your child away from sick children because relapses have been associated with infectious illnesses

d

which is the best way to obtain a urine sample in an 8 month olf being evaluated for a uti? a. carefully cleanse the perineum from front to back and apply a self adhesive urine collection bag to the perineum b. insert an indwelling foley catheter, obtain the sample, and wait for results c. place a sterile cotton ball in the diaper and immediately obtain the sample with a syringe after first void d. using a straight cath, obtain sample and immediately remove cath without waiting for results of urine sample

d

which should the nurse teach a group of girls and parents about the importance of preventing utis? a. avoiding constipation has no effect on the occurrence of utis b. after urinating, always wipe from back to front c. hygiene is an important preventive measure and can be accomplished with frequent tub baths d. increased fluids will help prevent and treat utis

d

the bladder capacity of a 3 year old is approximately how much? a. 1.5 fl oz b. 3 fl oz c. 4 fl oz d. 5 fl oz

d (capacity of bladder in fluid ounces can be estimated by adding 2 to childs age)