Chapter 21

A client's mother asks the nurse, "When should my daughter have a pelvic examination?" Which response by the nurse is most appropriate?

"A pelvic exam is necessary at 18 to 20 years of age."

A single male caregiver of a 14-year-old girl accompanies his daughter to her pre-high school physical. In the course of discussion about how his daughter is developing, he remarks, "She's terrific most of the time. Of course when she gets her period, she's miserable and mean, but I tell her that's just what it's like to be a woman." What would be the most appropriate response by the nurse?

"There are nutritional and medical things she can do to lessen the symptoms; I'll give both of you information about some strategies and we'll track her for a few months."

The nurse is caring for a 10-year-old child experiencing nocturnal enuresis with no physiologic cause. The child states, "I am embarrassed and I wish I could stop this right now!" How will the nurse respond?

"There are several things we can do to help you achieve this goal."

A nurse has just admitted a client with symptoms of vulva inflammation, pain, odor, and pruritus. Based on these findings, the nurse could conclude that this client will be diagnosed with which condition?

vulvovaginitis

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

Which nursing diagnosis would be the priority when caring for a child in renal failure following a kidney transplant?

Risk for infection related to immunocompromised state

The nurse is doing a presentation for a group of nursing students about the topic of menstrual disorders. After discussing the disorder secondary amenorrhea, the students make the following statements. Which statement made by the nursing students is the most accurate regarding the cause of secondary amenorrhea?

Emotional stress can be a cause of this disorder."

A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this?

Encourage the child to take all the antibiotics if diagnosed with strep throat.

A nurse is developing a teaching plan for the parents of an 8-year-old experiencing nocturnal enuresis. The nurse determines that additional teaching is needed when the parents identify what as an appropriate measure?

Encouraging fluid intake after dinner

The nurse is providing discharge teaching to an adolescent who has been treated for pelvic inflammatory disease (PID). What would the nurse include as a preventive measure?

Insisting that sexual partners use condoms

A 3-month-old boy is found to have undescended testes. The parents are concerned. What should the nurse anticipate as the next step for this client?

Reassess the client's testes at 6 months of age.

A 16-year-old adolescent tells the nurse about having severe dysmenorrhea. Which action would be the best health teaching measure?

Take over-the-counter ibuprofen for its prostaglandin action

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.

A pediatric client is scheduled for an intravenous pyelogram (IVP) of the kidney this afternoon. Which situation would require immediate attention by the nurse?

The child does not have intravenous access.

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.

While assessing a child with end-stage kidney disease, the nurse notes that the child has fallen into a coma. The nurse interprets this finding as resulting from which complication?

Uremia

The nurse is caring for a 2-year-old girl with suspected vulvovaginitis. The nurse suspects the cause as Candida albicans based on which finding?

White cottage cheese-like discharge

A 15-year-old female adolescent visits the school nurse. The client appears anxious and states they have been dating a couple of different friends. The client states that they went to a party the other night and does not remember the entire night. The client states "I woke up and some of my clothes were missing. Now I have been experiencing some pain when I pee and there is yellow, green drainage that smells awful."

a sexually transmitted infection; yellow, green odorous drainage

The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician?

absence of a thrill

The nurse is performing an assessment on a child. Which finding indicates to the nurse the child is at risk for a urinary tract infection (UTI)?

holding urine while at school

Most urinary tract infections seen in children are caused by:

intestinal bacteria.

The nurse is concerned about the pediatric client's immune system after taking corticosteroids. Which laboratory study is the nurse most correct to assess?

leukocyte count

Which condition is a risk factor for the development of pelvic inflammatory disease (PID)?

multiple sexual partners

A 3-year-old child is scheduled for a surgery to correct undescended testes. For what postoperative consideration would the nurse want to prepare the parents?

some discomfort at the surgery site

A child is hospitalized with nephrotic syndrome. Which measurement is best for the nurse to determine the child's edema?

weight, daily

The nurse is providing care to a child with acute renal failure. What assessment would be a priority for the nurse to determine if this child is developing hyperkalemia?

pulse rate and rhythm