PrepU Questions Final

The nurse is caring for an infant boy with grade IV vesicoureteral reflux. Which finding would lead the nurse to suspect that hydronephrosis is present?

Abdominal mass

A 3-year-old child is exhibiting irritability, fever, and decreased appetite. A recent history of which of the following would make the nurse suspicious of a urinary tract infection (UTI)?

Abdominal pain

A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a 1-week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out what possible explanation for the bedwetting?

The child has been sexually abused, maybe on the fishing trip.

The nurse is caring for a child diagnosed 3 months ago with juvenile idieopathic arthritis (JIA). The caregiver states that the child has recently reported little pain and is not currently taking aspirin or NSAIDs. The caregiver also tells the nurse that just to be on the safe side, she is continuing to keep the child from doing physical exercise. The mother states, "I think we have beaten this disease." In working with this child and the caregiver, which statement would be best for the nurse to make?

"Let's review some of the instructions. She does need to take an anti-inflammatory every day."

A nursing instructor has completed a class session on Guillain-Barré syndrome. Which statement by a student indicates a need for further education?

"Paralysis peaks at about 3 weeks before recovery, but most do not completely recover from the paralysis."

A symptom often seen in acute glomerulonephritis is edema. The most common site the edema is first noted is in which area of the body?

Eyes

The prevention of cerebral palsy is the most important aspect of care. Which of the following are focus areas for the prevention of cerebral palsy? Select all that apply.

Prenatal care to improve nutrition Postnatal prevention of infection Perinatal monitoring to decrease birth trauma

A child is getting a diagnostic work-up for nephrotic syndrome. Which lab results would the nurse expect to see?

Proteinuria, hypoalbuminemia, and hypercholesterolemia

A nurse is examining a boy with cerebral palsy. He has hypertonic muscles and abnormal clonus in his legs and walks on his toes. Which of the following is the type of cerebral palsy that this boy is demonstrating?

Spastic

The nurse is assessing the neonate shown. From the assessment, the nurse notes that there is paralysis of the lower extremities. For which condition does the nurse anticpate performing care?

Spina bifida with myelomeningocele

A female adolescent comes to the clinic for an evaluation. Assessment reveals a possible urinary tract infection. What would the nurse expect to be done to confirm this suspicion?

Urine culture

The nurse is caring for a child admitted with a urinary tract infection. In addition to foul-smelling urine, which clinical manifestation would the nurse assess for?

Vomiting

The nurse is working with a child with altered genitourinary status. Which intervention would be included in the plan of care for the client with excess fluid volume?

Weigh the child daily on the same scale.

The parents of a school-aged client diagnosed with acute glomerulonephritis are asking when their child can increase activity. Which instruction is most accurate?

When gross hematuria has subsided

A client has just been admitted to the unit with a history of recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would suspect which condition?

acute glomerulonephritis

A nurse is performing a newborn assessment and notices a small dimple on the sacral area. The infant has a normal neurological assessment and moves all extremities well. What does the nurse suspect that the dimple indicates?

spina bifida occulta

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause?

E coli

The nurse is doing client teaching with a child who has been placed in a brace to treat scoliosis. Which statement made by the child indicates an understanding of the treatment?

"At least when I take a shower I have a few minutes out of this brace."

Which statement about cerebral palsy would be accurate?

"Cerebral palsy is a condition that doesn't get worse."

The nurse is preparing to post a sign above the crib of an infant with a Wilms tumor. Which statement should the nurse post immediately?

"Do not palpate abdomen."

The nurse is caring for a school-age child diagnosed with juvenile arthritis (JA). Currently, the child's hips and knees are inflamed and painful. What statement by the parent would indicate a need for further education?

"I will keep my child home from school when there is a flare up to help reduce the amount of time my child is in pain."

The nurse is talking with the caregiver of a 13-year-old diagnosed with scoliosis. The child has come to the clinic to be fitted with a brace to begin her treatment. The child appears upset and angry and states, "I hate this brace; I hate it already." In an effort to support this child, which statement would be the most appropriate for the nurse to make to this child's caregiver?

"If you can afford it, let your daughter choose an article or two of clothing that she can wear with the brace that will help her feel that she looks good."

A nurse is teaching the parents of a child who has been diagnosed with spina bifida. Which statement by the nurse would be the most accurate description of spina bifida?

"Its presence indicates that many areas of the central nervous system (CNS) may not develop or function adequately."

The caregiver of a 2-year-old who has a polyurethane resin cast on her arm calls the clinic to report that her child is crying and says that the cast has sand in it. The caregiver states that she has had casts herself and knows how badly they can itch. She says she always used a hanger to scratch but is worried that it will be too sharp for the child. Which statement would be appropriate for the nurse to make to this caregiver?

"Nothing should be put into the cast. You can blow cool air into it with a hair dryer."

A mother is angry about her son's diagnosis of osteosarcoma. She is telling him that if he had not played football last year and broken his leg, this would not have happened. What is the nurse's best response to the mother's statement?

"Playing sports does not cause osteosarcoma. It may draw attention to the weakened bone from the tumor, though."

A nurse is caring for a child with spina bifida. The child's mother asks the nurse what she did to cause the birth defect. Which statement would be the nurse's best response?

"The cause is unknown and there are many environmental factors that may contribute to it."

The nurse is speaking with a parent of a child diagnosed with scoliosis. The parent states, "I hate to think about my child having to wear a huge brace to treat this disorder. My best friend growing up had to wear one and she hated it." What is the best response by the nurse?

"The newer type of braces fit under the arms and are made to fit under clothing. They aren't nearly as big as they used to be."

The nurse has been teaching the parents of a child diagnosed with osteogenesis imperfecta about the use of bisphosphonates for this condition. What statement by a parent indicates a need for further education?

"This medication will cure my child of this disorder."

The nurse is caring for a newborn client newly diagnosed with developmental dysplasia of the hip. Which response by the nurse educates the parents on the correct plan of treatment for this diagnosis?

"Treatment will begin immediately."

A 13-year-old adolescent is being treated for scoliosis with a brace. During the first follow-up appointment after the brace was initiated, which statement by the adolescent indicates the need for further instruction?

"When I get home from school, I look forward to taking off my brace for a few hours before I go to bed."

The nurse is caring for a 7-month-old female infant diagnosed with a urinary tract infection (UTI). The parents are upset as this is the infant's second UTI with a fever. Which instruction is most helpful? Select all that apply.

A fever is commonly noted with a UTI. Change diapers promptly, especially after bowel movements. Female urethras are shorter and straighter than males.

The nurse is reviewing the medical record of the antepartum client with an abnormal alpha-fetoprotein test. The mother is distraught and states, "How bad can it be?" The nurse is correct to describe which?

A type of spina bifida

Which client would be the most likely person to be diagnosed with idiopathic scoliosis that requires treatment?

A young adolescent female

A 10-year-old girl is experiencing acute renal failure due to dehydration. The nurse is preparing to administer IV fluid. Which of the following interventions should the nurse take in caring for this child?

Administer the IV fluid slowly

The mother of a child who has sustained a fractured leg is worried how long her child will be unable to walk without crutches. The nurse would explain to the mother that the child should be walking independently soon due to what reason?

Children's bones heal faster than adults.

The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). What information would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply.

Color Sensation Pulse Capillary refill

The LPN is working with the RN to develop a plan of care for a child with nephrotic syndrome. Which of the following would be appropriate goals of treatment for this child? Select all that apply.

Conserving energy Preventing infection Promoting coping

A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate?

Creatinine clearance rate

A 7-year-old boy has experienced repeated urinary tract infections (UTIs). His older sister also experienced repeated UTIs and was diagnosed with vesicoureteral reflux, a condition that tends to appear in families. Therefore, the nurse suspects this same condition in this client. Which diagnostic tests would confirm this suspicion?

Cytoscopy

The nurse is observing a 3-year-old boy who is sitting and playing in the waiting area of his pediatrician's office. The nurse calls the boy and his mother back for the boy's appointment. The boy rolls onto his stomach and pushes himself to his knees. Then he presses his hands against his ankles, knees, and thighs, walking up the front of his body, to stand. Which condition should the nurse suspect in this client?

Duchenne muscular dystrophy

A baby is born with spina bifida with meningocele. The parents are visibly upset. The father states, "What did we do wrong? How will I ever love this child?" What is the priority action by the nurse?

Encourage the parents to express their feelings and emotions openly.

The pediatric nurse examines the radiographs of a client that show that there are lesions on the bone. This finding is indicative of:

Ewing sarcoma

The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child?

Eyes

The child diagnosed with muscular dystrophy uses a method of rising from the floor which is referred to as which of the following?

Gower sign

The nurse is caring for a child admitted with juvenile idiopathic arthritis (JIA). Which of the clinical manifestation would likely have been noted in the child with this diagnosis?

Inflammation of the joints

A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage tube patency?

Monitor output

The nurse is caring for a child with a possible diagnosis of muscular dystrophy. The nurse explains to the parents that which of the following will likely be used to confirm this child's diagnosis?

Muscle biopsy

The nurse is triaging clients as they come in to an express care facility. Which assessment finding is clinically significant for early nephrotic syndrome?

Periorbital edema

A nurse is caring for a newborn client who is diagnosed with myelomeningocele. Which nursing intervention would protect the newborn from injury?

Place the newborn in a prone or lateral position.

A nurse is providing care to a toddler with nephroblastoma and is being evaluated. Which nursing action would be most important?

Placing a "no abdominal palpation" sign above the child's bed

Which intervention prevents a 17-month-old child with spastic cerebral palsy from going into a scissoring position?

Placing the child on your hip

A child diagnosed with muscular dystrohy has recently developed kyphosis. The home health nurse stresses to the caregivers that the child is at an increased risk for which injury?

Possibility of respiratory infection

Which diagnostic measure is most accurate in detecting neural tube defects?

Significant level of alpha-fetoprotein present in amniotic fluid

The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to take which action?

Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.

The nurse is caring for a child admitted with acute glomerulonephritis. Which clinical manifestation would likely have been noted in the child with this diagnosis?

Tea colored urine

A client has just completed a renal biopsy. Which manifestation should be given priority attention?

The child is not voiding.

In caring for a child being treated for scoliosis, the highest priority goal is which of the following?

The child will remain free of injury

The nurse is discussing urinary tract infections (UTI's) in children with a group of peers. Which fact is the most accurate regarding urinary tract infection seen in children?

The most common age for UTIs in children is 2 to 6 years of age.

A treatment team meeting is focused on care of children with bone tumors. The nurse is most correct to identify which characteristics anticipated in a client diagnosed with osteogenic sarcoma? Select all that apply.

The most common site is the distal femur. The lungs are a common site of metastasis.

The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease. What is the most important nursing intervention for the nurse to include in working with this child and his caregivers?

The nurse should help the caregivers to understand and help the child to effectively use the corrective devices.

The community health nurse is preparing a presentation which will illustrate the various forms of spina bifida for a health fair. Which explanation should the nurse use to explain spina bifida with meningocele?

The spinal meninges protrude through the bony defect and form a cystic sac.

A nurse is providing education to parents of a child diagnosed with vesicoureteral reflux (VUR). Which would be included in the parental education?

This occurs when there is backflow of urine into the bladder and sometimes the kidneys.

Legg-Calvé-Perthes disease is more likely to be seen in which group?

White boys

In the infant diagnosed with spina bifida with myelomeningocele, the infant will likely have:

a partial to complete paralysis in the lower extremities.

The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have:

acute glomerulonephritis.

A type of traction sometimes used in the treatment of the child with scoliosis is called:

halo traction

Congenital myelomeningocele is commonly associated with which condition?

hydrocephalus

The nurse is assessing a child and notes S-shaped curvature of the spine. What terminology would the nurse use when documenting this assessment finding?

idiopathic scoliosis

Most urinary tract infections seen in children are caused by:

intestinal bacteria.

The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is:

obtaining a clean catch voided urine.

The nurse is teaching a group of nursing students about genitourinary conditions. The nurse tells these students about a condition that occurs when there is an inflammation of the kidney and renal pelvis. The condition the nurse is referring to is:

pyelonephritis

A child diagnosed with acute glomerulonephritis will most likely have a history of:

recent illness such as strep throat.

Which of these laboratory results would be most important for the nurse to assess in a child who has a diagnosis of urinary tract infection?

urinalysis

The nurse is caring for a child diagnosed with Duchenne muscular dystrophy and notes the presence of a Gower sign on the assessment form. What action by the child would support this assessment?

when on the floor, rising to the knees and pressing the hands against the ankles, knees, and thighs to stand

When examining the musculoskeletal system of the child, which would be indicative of a potential kidney problem?

Muscle weakness

The nurse is preparing a 7-year-old girl for discharge after treatment for nephrotic syndrome. Which instructions would the nurse include in the discharge teaching plan for the parents?

"Let's meet with the dietitian and plan some meals."

A child and mother come into the orthopedic clinic. The mother is concerned about her child who has recently been diagnosed with scoliosis. The mother asks about surgical treatment and if it will be necessary. The nurse bases her response on knowledge that surgery is implicated for curvatures greater than:

40 degrees

When assessing Barlow sign, the nurse lays the infant supine and flex the knees. To which degree does the nurse flex the knees at the hips? Record your answer using a whole number.

90

An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep throat a little over a week ago. Which condition should the nurse suspect?

Acute glomerulonephritis

The nurse is collecting data on a school-aged child with the following symptoms: Abrupt beginning to urinary symptoms Gross hematuria VS -99 (F), 39.2 (C), 92, 22, 142/92 Mild edema Which disease condition does the nurse anticipate?

Acute glomerulonephritis

Which child has the highest risk of urinary tract infection?

An 18-year-old female who is sexually active

Which of the following congenital anomalies in the fetus is associated with a high alpha fetoprotein level?

Anencephaly

The caregivers of a child with juvenile idiopathic arthritis are asking the nurse about exercise for their child. The nurse explains to the caregivers that gentle daily exercise is needed to prevent which condition from occurring?

Ankylosis

Immediately after birth, the nurse is caring for a newborn with a myelomeningocele. What intervention should the nurse provide to prevent drying out of the sac to avoid damage?

Apply a sterile dressing moistened in a warm, sterile saline solution.

A nurse is applying a cast to a 12-year-old boy with a simple fracture of the radius in the arm. What is most important for the nurse to do when she has finished applying the cast?

Assess the fingers for warmth, pain, and function

The nurse is observing a group of children diagnosed with various types of cerebral palsy. One of the children has an awkward and wide-based gait. The nurse recognizes this characteristic as common in which type of cerebral palsy?

Ataxic cerebral palsy

The nurse asks the caregivers of a child diagnosed with cerebral palsy whether the child, "seems to be in a state of constant motion." The question is designed to identify what form of cerebral palsy?

Athetoid

A 4-year-old child diagnosed with Wilms tumor is admitted for surgery. What information would be most important for the nurse to include in the child's preoperative plan of care?

Avoiding further abdominal palpation

The nurse is collecting data on a child recently diagnosed with acute glomerulonephritis. Which of the following clinical manifestations was likely noted in this child?

Bloody urine

A child who has been diagnosed with minimal change nephrotic syndrome (MCNS) is being discharged after a 3-week hospitalization. Her edema has been greatly reduced and her appetite is beginning to return. Her caregivers have promised to have a family party to celebrate her return. The child has requested the following food for the party. Which food would the nurse suggest would be appropriate for the diet this child is on?

Banana splits

Which health care provider assessment technique does the nurse anticipate being used to determine developmental dysplasia of the hip (DDH) on a newborn?

Barlow sign and Ortolani click

The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis?

Blood pressure 136/84

A young girl is diagnosed with acute poststreptococcal glomerulonephritis. Which medication classifications would the nurse expect to administer? Select all that apply.

Calcium channel blocker Phosphate binder Potassium removing resin

A nurse is caring for a 7-year-old girl scheduled for an intravenous pyelogram (IVP). Which action would be the priority before the test?

Checking with the parents for any allergies

The parents of a newborn are struggling with the news that their infant has spina bifida. Which technique should the nurse prioritize teaching to the parents that will help increase the infant's comfort and development?

Cuddle the baby in a chest-to-chest position.

The parent has brought a 2-year-old to the public clinic for immunizations. The nurse documents the following characteristics: A duck waddle gait Shortened extremity Asymmetry of the gluteal folds Protruding abdomen The nurse then refers the toddler to the health care provider for potential diagnosis of which?

DDH

The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. What would the nurse least likely expect to find?

Decreased blood urea nitrogen (BUN)

The caregivers of an 8-year-old child diagnosed with muscular dystrophy are discussing appropriate activities for their child. The nurse might suggest to these caregivers that they take which action in regard to their child's activities?

Find a Little League team that encourages participation of kids at all disability levels.

The nurse is assessing a newborn and suspects developmental dysplasia of the hip. Which sign is the nurse prioritizing for in this potential diagnosis?

Limited abduction of the affected hip

The nurse is caring for an infant with a myelomeningocele prior to surgical repair. Which nursing consideration is the highest priority?

Maintaining a clean environment

The nurse is caring for an 8-year-old child hospitalized with nephrotic syndrome. Which nursing intervention would be appropriate for this child?

Measure the abdominal girth daily.

A nurse is caring for a neonate diagnosed with cerebral palsy. In instructing the parents on areas that the infant may experience deficits, which content is included? Select all that apply

Musculoskeletal disorders Language disorders Neurobehavioral disorders Respiratory infections

The nurse is caring for a neonate with epispadias. In which location will the nurse assess the anomaly?

On the dorsal end of the penis

The nurse is caring for a client newly diagnosed with acute glomerulonephritis? When receiving the pediatric client's history, which is anticipated?

Onset of a streptococcus infection last week

A nursing student tells the staff nurse on the pediatric orthopedic unit that she has heard of a musculoskeletal disorder in which there is an infection of the bone. Which disorder does this statement describe?

Osteomyelitis

The nurse is caring for a newborn with congenital hip dysplasia. Which nursing diagnoses would the nurse prioritize for this infant after the application of a hip spica cast? Select all that apply.

Risk for delayed growth and development Risk for impaired skin integrity

When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority?

Risk for infection

Which nursing diagnosis is most relevant in the first 12 hours of life for a neonate born with a myelomeningocele?

Risk of infection

The school nurse is doing a presentation to a group of caregivers of children diagnosed with scoliosis. One of the caregivers asks the nurse about structural scoliosis. Which condition is involved with the diagnosis of structural scoliosis?

Rotated and malformed vertebrae

A 16-year-old girl has had several cases of cystitis in the past year. Which of the following should the nurse suspect as the cause, based on this finding?

Sexual activity

The caregivers of a child who has had difficulty learning to walk notice that when the child attempts to pull himself up to stand, he can't seem to get his legs uncrossed and beside each other. When he is in a standing position, he stays up on his toes. This is different from what they saw with their older children and they are concerned. Further diagnostic tests indicate the child has cerebral palsy. When instructing on the types of cerebral palsy, which type will the nurse present?

Spastic cerebral palsy

To prevent further urinary tract infections in a preschooler, what measures would you teach her mother?

Teach her to wipe her perineum front to back after voiding.

A 14-year-old girl with a fractured leg is receiving instructions from the nurse on how to use crutches. Which intervention should the nurse implement to help prevent nerve palsy in the client?

Teach the client not to rest with the crutch pad pressing on the axilla.

The nurse is collecting data for a child diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's history?

The child recently had an ear infection.

A child is having the urine checked for a routine well visit. When analyzing the results, what would positive leukocytes indicate?

This may indicate a urinary tract infection.

The nurse is working with a child with impaired urinary elimination. What is the purpose of monitoring the electrolytes and arterial blood gases (ABGs)?

This will determine if there is an acid-base problem

The nurse is caring for a child diagnosed with a urinary tract infection. The caregiver asks the nurse why it is so important for the child to have so much fluid. The nurse tells the caregiver that the most important reason the child needs increased fluids is to:

dilute the urine and flush the bladder.

The nurse is assessing a toddler. The mother states that he constantly is tripping over his own feet. What is the best response by the nurse?

"We will have your child stand on a copier and make a print of the feet. It will show us if the feet are turning in. If they are, your child may need some stretching exercises for the feet."

The nurse is mentoring a new graduate in the newborn nursery. Which statement regarding a neonate with hypospadias would require the mentoring nurse to clarify?

The neonate will be circumcised before discharge.

The nurse is preparing a care plan for a toddler diagnosed with cerebral palsy (CP). Which intervention would be appropriate for the nursing diagnosis of Risk for disuse syndrome related to spasticity of muscle groups? Select all that apply.

Administer carbidopa/levodopa as prescribed. Administer benzodiazepines as prescribed. Teach parents exercises and games to help prevent contractures.

When developing the preoperative plan of care for an infant with bladder exstrophy, which intervention would the nurse least likely include?

Placing the infant in a side-lying position