Ch. 46, 47
The nurse obtains a history from the mother of a child with glomerulonephritis about how he became ill. What would the nurse expect her to tell you she noticed? A) Dirty green urine B) Diuresis and pallor C) Headache, loss of appetite D) Loss of weight, oliguria
A
A child in renal failure develops hyperkalemia because of poor glomerular function. Which of the following would you expect to administer to him? A) Sodium and increased fluid B) Glucose and insulin C) A diet high in fruit juice D) A fluid high in calcium
B
An 8-year-old develops balanoposthitis. A finding of this is A) a bloody uretheral discharge and pain on urination. B) denuded, reddened surface of the glans of the penis. C) pallor of the prepuce of the penis. D) reduced production of sperm.
B
A 16-year-old tells you she has terrible dysmenorrhea. Which action would be the best health teaching measure regarding this? A) Take over-the-counter ibuprofen for its prostaglandin action. B) Take acetaminophen beginning with the first day of a menstrual flow. C) Drink a minimum of fluid if having pain. D) Use ice to help in reducing inflammation and pain.
A
A child in renal failure is prescribed aluminum hydroxide gel. The parents ask how the medication is going to help their child. Which answer is most accurate? A) The medication reduces the absorption of phosphorus from the GI tract. B) The medication assists with the absorption of calcium. C) The medication prevents gastrointestinal ulceration. D) The medication enables the elimination of potassium.
A
A female child has been diagnosed with precocious puberty at the age of 8. Which of the following would be an important teaching priority to tell the parents? A) "Your daughter is physically able to become pregnant." B) "Your daughter will be unable to have children." C) "Your daughter will need medication to suppress further development." D) "Your daughter will need psychological counseling."
A
A sexually active adolescent is scheduled for a pelvic examination. What should the nurse do to help the patient relax during the examination? A) Show her a speculum prior to the exam. B) Assure her that no part of the exam will hurt. C) Coach her to hold her breath during the exam. D) Advise her to keep one hand on her abdomen.
A
An adolescent female is diagnosed with fibrocystic breast disease. What advice can the nurse provide the adolescent about this diagnosis? A) Caffeine may increase the size of lesions. B) Fibrocystic lesions are precancerous lesions. C) Lesions will fade with the full growth of breasts. D) The lesions make breast self-examination ineffective.
A
An adolescent is diagnosed as having gonorrhea. You can anticipate that her management will include A) identification of sexual contacts. B) catheterization for a urine specimen. C) administration of a corticosteroid. D) prescription of a diaphragm.
A
The child with nephrotic syndrome who has ascites and difficulty breathing is probably most comfortable sleeping in which position? A) Fowler's B) Prone C) Supine D) Sims' position
A
The nurse reviews the 2020 National Health Goals for sexual health prior to preparing a presentation for high school students. On what should the nurse focus when preparing this teaching for the students? A) Prevention of sexually transmitted infections B) Communicating health needs to the primary care physician C) Importance of staying current with recommended immunizations D) Creating a work-life balance between school and extracurricular activities
A
To determine if ascites is increasing in amount in a child with nephrotic syndrome, which measurements would be most appropriate? A) Abdominal circumference B) Urine for protein C) Blood pressure D) Bowel sounds
A
An adolescent female is concerned about developing toxic shock syndrome. What teaching can the nurse provide to allay this patient's fears about the disorder? (Select all that apply.) A) Avoid feminine hygiene sprays. B) Change tampons at least every 4 hours. C) Take acetaminophen (Tylenol) should a fever occur during menstruation. D) Use the largest absorbency tampon possible adequate for the menstrual flow. E) Tampons are to be avoided for 1 month after treatment for toxic shock syndrome.
A, B
An 8-year-old female child has been diagnosed with precocious puberty. When teaching the parents about this diagnosis, what should the nurse include as a priority? A) "The child will be unable to have children." B) "The child will need psychological counseling." C) "The child is physically able to become pregnant." D)"The child will not need medication to suppress further development
C
The nurse is caring for a child experiencing hyperkalemia from renal failure. What should the nurse prepare to administer to this patient? A) Milk B) Fruit juice C) Glucose and insulin D) Sodium and increased fluid
C
A 10-year-old in renal failure is on continuous ambulatory peritoneal dialysis (CAPD). What would it be important to teach the parents? A) Dialysis solution must be infused over a period of 30 minutes. B) Slight bleeding from the exchange catheter is to be expected. C) The return solution will be cloudy because of urea in it. D) Cramping should not occur with an infusion.
D
A 15-year-old girl who is sexually active comes to a health care facility because she is concerned that she has contracted gonorrhea from a partner who has the disease. Upon history of present illness, which symptom is anticipated? A) A low-grade fever for 3 days B) Painful ulcers on the perineum C) A white, frothy vaginal discharge D) No noticeable symptoms
D
A 4-year-old boy with nephrotic syndrome has extensive edema. The best implementation to reduce periorbital edema would be to A) apply cool, sterile soaks to his head. B) encourage him to eat low-protein foods. C) apply warm compresses to his eyes at bedtime. D) elevate the head of the bed.
D
A baby is born with ambiguous genitalia. When discussing this with her parents, you could accurately assure them that A) all children with ambiguous genitalia are chromosomally female. B) ambiguous genitalia will develop fully with estrogen therapy. C) ambiguous genitalia result from hypothalamus stimulation. D) their child's true sex can be determined by a genetic karyotype.
D
A child is administered oxybutynin (Ditropan) following surgical repair of a hypospadias. The purpose of this drug is to: A) prevent nausea and vomiting. B) stimulate kidney function. C) acidify urine. D) relieve bladder spasms.
D
The male partner of a married couple has genital herpes. What should the nurse advise the couple to prevent the spread of infection to the female partner? A) Use a condom during intercourse. B) Avoid intercourse until a Pap test is negative. C) Delay coitus until 10 days after penicillin is started. D) Apply acyclovir topically to lesions prior to intercourse.
A
The nurse is caring for a 3-year-old with the surgical repair of hypospadias. The preschooler returned from the post-anesthesia care unit with an indwelling urinary catheter. What parental teaching is most helpful? A) The catheter insertion site will leave only a minimal scar. B) Back pressure from such drainage may result in nephrotic syndrome. C) He must be reevaluated at puberty for testicular function. D) He will always have tenderness on penile erection.
A
The nurse is caring for a school aged child diagnosed with nephrotic syndrome. The child is prescribed prophylactic antibiotic administration intramuscularly. Which administration site would be the nurse's first choice for intramuscular administration? A) Deltoid muscle B) Anterior thigh C) Maximus gluteus D) Ventral-gluteal site
A
The nurse is teaching the parent of a child with chronic renal failure on high-potassium foods that should be restricted. Which foods will the nurse include in this teaching? (Select all that apply.) A) Bananas, carrots, nuts, and milk B) Peaches, broccoli, and red meat C) Oranges, potatoes, wheat, and bran D) Spinach, chicken, fish, and green beans
A
What should the nurse instruct an adolescent who asks about the best way to prevent vulvovaginitis? A) Wipe from front to back after urinating or defecating. B) Apply personal hygiene sprays if vaginal odor develops. C) Soak in a strong bubble bath solution to maintain hygiene. D) Use nylon rather than cotton underpants to decrease moisture.
A
You are counseling a couple about sexually transmitted diseases. The male partner has genital herpes. To prevent spread of the infection to the female partner, you advise the couple that A) a condom should be used during intercourse. B) coitus should be delayed until 10 days after penicillin is begun. C) acyclovir should be applied topically prior to intercourse. D) intercourse should be avoided until a Pap test is negative.
A
The nurse is planning a community health program to improve awareness of renal disease as one of the 2020 National Health Goals. What information should the nurse include in this program? (Select all that apply.) A) Instruct on organ transplantation procedures. B) Explain the importance of restricting fluids after 6 PM. C) Review recommended foods to promote renal functioning. D) Teach to limit the intake of milk and dairy products with meals. E) Remind parents to provide antibiotics for streptococcal throat infections.
A, E
A 3-year-old is scheduled for a surgery to correct undescended testes. An important postoperative consideration the nurse would want to prepare the parents for is: A) the need for complete bed rest for 10 days. B) some discomfort at the surgery site. C) a liquid diet for 3 days. D) the need for maintaining a semi-Fowler position.
B
A baby is born with ambiguous genitalia. What should the nurse emphasize when discussing this with the parents? A) Ambiguous genitalia result from hypothalamus stimulation. B) The child's true sex can be determined by a genetic karyotype. C) Ambiguous genitalia will develop fully with estrogen therapy. D) All children with ambiguous genitalia are chromosomally female.
B
An adolescent has fibrocystic breast disease. What is the best advice you can give her regarding this? A) Fibrocystic lesions are precancerous lesions. B) Caffeine may increase the size of lesions. C) The lesions make breast self-examination ineffective. D) Lesions will fade with the full growth of breasts.
B
An adolescent female is experiencing dysmenorrhea. What should the nurse teach the patient to help with this disorder? A) Take acetaminophen (Tylenol). B) Restrict fluid when having pain. C) Take over-the-counter ibuprofen. D) Use ice to help in reducing inflammation and pain.
C
The mother of a child with cryptorchidism asks the nurse why having an undescended testis brought down is important. What is the most accurate response? A) "This procedure will prevent malignant changes in the testis." B) "Your son will have an increased risk of urinary tract infections." C) "This procedure will enable your son to examine the testis for malignant changes." D) "The procedure is done for purely cosmetic reasons."
C
The nurse is caring for a child recovering from a kidney transplant. Which nursing diagnosis should the nurse identify as the priority to guide the care for this patient? A) Pain related to tissue rejection B) Constipation related to effects of administered drugs C) Risk for infection related to immunocompromised state D) Deficient fluid volume related to fluid intake restrictions postoperatively
C
A child with chronic renal failure does not want to take the prescribed aluminum hydroxide gel because of the taste. What should the nurse tell the patient about the purpose of this medication? A) Prevents an upset stomach B) Assists with the absorption of calcium C) Assists with elimination of potassium D) Reduces absorption of phosphorus from the GI tract
D
An 8-year-old child is diagnosed with balanoposthitis. What will the nurse most likely assess in this disorder? A) Reduced production of sperm B) Pallor of the prepuce of the penis C) Bloody urethral discharge and pain on urination D) Denuded, reddened surface of the glans of the penis
D
The nurse is caring for a client newly diagnosed with vulvovaginitis. Which nursing instruction is most helpful in relieving the symptoms of pain and itch? A) Liberally applying talcum powder to the perineum. B) Coating the perineum with petroleum ointment (Vaseline). C) Applying a heating pad for 20 minutes at a time. D) Administering cornstarch to the perineum.
D
The nurse is teaching manifestations of nephrotic syndrome to the parents of a child with the disorder. What should the nurse instruct the parents to monitor to determine if edema is increasing? A) Appetite B) Breathing rate C) Tightness of shoes D) Abdominal circumference
D
The parents of a child with acute glomerulonephritis ask the nurse to explain the cause of the disease. What organism should the nurse instruct the parents as being the cause for the disorder? A) Group B streptococci B) One of the rhinoviruses C) Staphylococcus viridans D) Group A beta-hemolytic streptococci
D
To prevent further urinary tract infections in a preschooler, what measures would you teach her mother? A) Encourage her to be more ambulatory to increase urine output. B) Teach her to take frequent tub baths to clean her perineal area. C) Suggest she drink less fluid daily to concentrate urine. D)Teach her to wipe her perineum front to back after voiding
D
You are counseling an adolescent being treated for syphilis. The most common symptom of first-stage syphilis is A) a fishy smelling vaginal discharge. B) a red macular rash on the palms of the hands. C) gray, warty growths on the genitalia. D)a painless ulceration on the labia or vagina
D
The nurse is discussing recommended immunizations with the mother of an adolescent female. Which immunization would be important for the nurse to include during this discussion? A) Gardasil B) Influenza C) Pneumonia D) Hepatitis B
A
The nurse instructs an adolescent on preventing the sexually transmitted infection syphilis. Which statement indicates that teaching about the spread of the infection has been effective? A) "In the future, I'll void immediately after sex to prevent this." B) "Next time, I'll be smart enough to look at my partner to see if he has any sores." C) "I'm lucky I got this early in life. Now, I don't have to worry about getting it again." D) "Can't I be prescribed birth control pills so I'll have some protection from getting this again?"
B
The nurse is providing a child with oxybutynin (Ditropan) as prescribed following surgical repair of a hypospadias. What should the nurse teach the patient about the purpose of this medication? A) Acidifies urine B) Relieves bladder spasms C) Stimulates kidney function D) Prevents nausea and vomiting
B
Which measure would help an adolescent relax best during a pelvic examination? A) Help her hold her breath during the exam. B) Show her a speculum prior to the exam. C) Assure her that no part of the exam will hurt. D) Advise her to keep one hand on her abdomen.
B
Which nursing diagnosis would be the priority when caring for a child in renal failure following a kidney transplant? A) Deficient fluid volume related to fluid intake restrictions postoperatively B) Risk for infection related to immunocompromised state C) Constipation related to effects of administered drugs D) Pain related to tissue rejection
B
A female adolescent is diagnosed with polycystic ovary syndrome. Which information should the nurse prepare to instruct the patient about the treatment for this disorder? (Select all that apply.) A) Importance of exercise B) Use of antiandrogen medication C) Eating plan to reach appropriate weight D) Use of fertility medications to regulate menstrual cycles E) Use of oral combined estrogen/progesterone contraceptive
B, C, E
The nurse is concerned that a school-age child receiving intranasal desmopressin acetate (DDAVP) for enuresis is experiencing an adverse effect of the medication. What did the nurse assess in this patient? (Select all that apply.) A) Thirst B) Nausea C) Flushing D) Itchy skin E) Headache
B, C, E
The nurse is instructing a female adolescent about the medication leuprolide acetate (Lupron Depot-Ped), which has been prescribed to reduce the level of testosterone. What should the nurse include when teaching the patient about this medication? (Select all that apply.) A) Inject in the same region every month. B) Ensure effective birth control if sexually active. C) Transfer the medication into another syringe before injecting. D) Mark on a calendar when the injections are needed every 3 months. E)Notify the health care provider if nausea and vomiting occurs after taking the medication
B, D
A 4-year-old girl with a urinary tract infection is scheduled to have a voiding cystourethrogram. When preparing her for this procedure, the nurse would want to prepare her to: A) have a local anesthetic injected prior to the procedure. B) drink three glasses of water during the procedure. C) void during the procedure. D) anticipate a headache afterward.
C
A child in kidney failure has had a kidney transplantation. You would prepare the child for which of the following to occur postoperatively? A) Full-body irradiation that will leave him nauseated B) A transient rash from T-cell suppression C) Infection-control precautions that may cause him to be lonely D) Burning on urination from high uric acid content
C
A female preschool patient with a urinary tract infection is scheduled to have a voiding cystourethrogram. What should the nurse include when teaching the patient about this procedure? A) A headache is a common occurrence after the procedure. B) A local anesthetic will be injected prior to the procedure. C) The patient will be expected to void during the procedure. D) The patient will have to drink three glasses of water during the procedure.
C
A preschool-age child recovering from a surgery to correct undescended testes expresses fear about having a "body part cut off." Which nursing diagnosis should the nurse use to guide care while addressing this child's concern? A) Risk for insufficient fluid balance B) Ineffective coping related to altered physical appearance C) Disturbed body image related to change in physical appearance D) Deficient knowledge related to child's inexperience with surgical procedure
C
A sexually active adolescent female is concerned that she has contracted gonorrhea. Which finding should the nurse expect to assess if gonorrhea is present in this patient? A) A low-grade fever for 3 days B) Painful ulcers on the perineum C) Slight yellow vaginal discharge D) A white, frothy vaginal discharge
C
An adolescent asks you how to best prevent vulvovaginitis. Your best answer would be to: A) apply personal hygiene sprays if vaginal odor develops. B) use nylon rather than cotton underpants to decrease moisture. C) wipe from front to back after urinating or defecating. D) soak in a strong bubble bath solution to maintain hygiene.
C
The nurse instructs a school-age patient and the parents on continuous cycling peritoneal dialysis. Which statement indicates that teaching has been effective? A) "The solution should be infused cold." B) "Redness and warmth around the tube insertion site is expected." C) "We should notify the health care provider if the drainage is cloudy." D) "Weight gain and a productive cough are expected with the treatments."
C
The nurse is caring for a female preschool-age patient with a urinary tract infection. What measures should the nurse teach the mother to prevent future infections? A) Suggest the child drink less fluid daily to concentrate urine. B) Encourage the child to be more active to increase urine output. C) Teach the child to wipe the perineum front to back after voiding. D) Teach the child to take frequent tub baths to clean the perineal area.
C
The parents of child recovering from surgery to repair vesicoureteral reflux ask the nurse if they can do anything to help with the care of their child. What should the nurse encourage the parents to do at this time? A) Help the child with a tub bath. B) Bring in games and other diversions to keep the child distracted while on bed rest. C) Assist the child out of bed while keeping the drainage bags below the level of the catheter. D) Provide hard candy to help with mouth dryness because the child will be on a fluid restriction.
C
Which comment suggests that an adolescent has grasped the concept of how syphilis is spread? A) "I'm lucky I got this early in life. Now I don't have to worry about getting it again." B) "Can't I be prescribed birth control pills so I'll have some protection from getting this again?" C) "Next time I'll be smart enough to look at my partner to see if he has any sores." D)"In the future I'll void immediately after sex to prevent this."
C
A school-age child is returning home after a renal biopsy. What teaching should the nurse provide to the patient and parents at this time? (Select all that apply.) A) Remove the dressing in 2 hours. B) Resume regular activity level at home. C) Drink a glass of fluid every hour while awake. D) Expect the first voided urine to be blood-tinged. E) Teach how to keep serial urine samples for 24 hours.
C, D, E