Chapter 26 NCLEX Style Review Questions

A nurse is caring for an infant with a suspected urinary tract infection (UTI). Based on the nurse's knowledge of UTIs, which clinical manifestation would be observed? (Select all that apply.) A. Vomiting B. Jaundice C. Swelling of the face D. Persistent diaper rash E. Failure to gain weight

A, D, E

Disorders of sexual development (DSD) present unique challenges to both the patient, family members and health care providers. In preparing for health promotion materials to be used in a teaching session for health care providers on this subject, which information should be included? A. Health care providers should understand their own feelings and implicit bias relative to DSD. B. There is no need for referrals to specialized treatment centers as DSD can be handled in any hospital setting. C. The primary concerns rest with the physical presentations rather than psychological/psychosocial concerns. D. Most of the issues regarding DSD resolve as the individual ages and becomes more mature.

A.

In a non-potty-trained child with nephrotic syndrome, what is the best way to detect fluid retention? A. Weigh the child daily. B. Test the urine for hematuria. C. Measure the abdominal girth weekly. Incorrect D. Count the number of wet diapers.

A.

In addition to presenting symptoms, what laboratory finding indicates nephrosis? A. Hypoalbuminemia B. Low specific gravity C. Decreased hematocrit D. Decreased hemoglobin

A.

In teaching a group of nursing students about factors that could lead to the development of urinary tract infections, which critical aspect should the nursing instructor focus on? A. Concept of urinary stasis B. Over distention of the bladder C. Urinary frequency D. Maintaining proper hydration

A.

The nurse is caring for a child with a Wilms' tumor. What is the most important nursing intervention preoperatively? A. Avoid abdominal palpation. B. Closely monitor the arterial blood gases. C. Prepare the child and family for long-term dialysis. D. Prepare the child and family for renal transplantation.

A.

Which urine test would be considered abnormal? A. pH: 4 B. Specific gravity: 1.020 C. Protein level: absent D. Glucose level: absent

A.

A 6-year-old child with acute renal failure (ARF) is being transferred out of the intensive care unit. Which children, considering their diagnoses, would be the most appropriate roommate for this child? A. 6-year-old child with pneumonia B. 4-year-old child with gastroenteritis C. 5-year-old child who has a fractured femur D. 7-year-old child who had surgery for a ruptured appendix

C.

A child is receiving cyclosporine following a kidney transplant. The child's parents ask the nurse the reason for the cyclosporine. The nurse's response is based on the knowledge that the medication's purpose is to A. decrease pain. B. boost immunity. C. suppress rejection. D. improve circulation to the kidney.

C.

A young child is diagnosed with vesicoureteral reflux. The nurse should know that this is usually associated with A. incontinence. B. urinary obstruction. C. recurrent kidney infections. D. infarction of renal vessels.

C.

Urine specimen results for a pediatric patient note greater than 100,000 colony forming units (CFUs) but the patient denies any complaints with urination. Based on this information the nurse would suspect that the patient has A. subacute pyelonephritis. B. pyuria. C. asymptomatic bacteriuria. D. febrile UTI.

C.

What is an advantage to teach to the family about continuous cycling peritoneal dialysis (CCPD) or continuous ambulatory peritoneal dialysis (CAPD) for adolescents who require dialysis? A. Hospitalization is only required several nights per week. B. Dietary restrictions are no longer necessary. C. Adolescents can carry out procedures themselves. D. Insertion of a catheter does not require surgical placement.

C.

The parent of a child hospitalized with acute glomerulonephritis (AGN) asks the nurse why blood pressure readings are being taken so often. Based on the nurse's knowledge of AGN, the most appropriate response by the nurse is A. blood pressure fluctuations are a common side effect of antibiotic therapy. B. blood pressure fluctuations are a sign that the condition has become chronic. C. acute hypertension must be anticipated and identified. D. hypotension leading to sudden shock can develop at any time.

C>

What is an appropriate nursing intervention while the child with nephrotic syndrome is confined to bed? A. Restrain the child as necessary. B. Discourage the parents from holding the child. C. Do passive range-of-motion exercises once a day. D. Adjust activities to the child's tolerance level.

D.

What is an important nursing consideration when caring for a child with end-stage renal disease (ESRD)? A. Children with ESRD usually adapt well to the minor inconveniences of treatment. B. Children with ESRD require extensive support until they outgrow the condition. C. Multiple stresses are placed on children with ESRD and their families until the illness is cured. D. Multiple stresses are placed on children with ESRD and their families because their lives are maintained by drugs and artificial means.

D.

Which parameters would confirm clinical diagnosis of urinary infections (UTI) in young children? (Select all that apply.) A. Fever B. Pyuria C. Clean catch specimen reported as being cloudy in appearance. D. 50,000 or greater colonies per mL indicating uropathic organism.

B, C

Parents of a newborn bring their male son to the emergency room. The infant appears fretful and the parents state that he has not voided in several hours. Inspection of the penis reveals edema and the nurse is unable to retract the foreskin. Based on this assessment, what would the nurse anticipate as the priority action? A. Perform an ultrasound to determine if there is urinary retention. B. Inform the ER physician of the patient's condition. C. Ask the parents specifically how long the infant has not voided. D. Continue to monitor the patient in the ER setting.

B.

A 3-year-old child is scheduled for surgery to remove a Wilms' tumor from one kidney. The parents ask the nurse about what treatments, if any, will be necessary after recovery from surgery. The nurse's explanation should be based on knowledge that A. no additional treatments are usually necessary. B. chemotherapy is usually not necessary. C. chemotherapy with or without radiotherapy is indicated. D. kidney transplant will be indicated within the year.

C.

A 5-year-old child has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to the child's parent that the first action is to have the child evaluated for A. school phobia. B. emotional causes. C. possible urinary tract infection. D. possible structural defects of urinary tract.

C.

A child in renal failure has hyperkalemia. Which foods should be avoided? A. Cold cuts, chips, and canned foods B. Hamburger on a bun and lime Jell-O C. Spaghetti with meat sauce and breadsticks D. Bananas, carrots, and green leafy vegetables

D.

A toddler is hospitalized with acute renal failure (ARF) secondary to severe dehydration. The nurse should assess the child for what possible complications? A. Hypotension B. Hypokalemia C. Hypernatremia D. Water intoxication

D.

An appropriate nursing intervention for a child with nephrotic syndrome on bed rest is to A. restrain the child as necessary. B. discourage the parents from holding the child. C. do passive range-of-motion exercises once a day. D. adjust activities to the child's tolerance level.

D.

External defects of the genitourinary tract, such as hypospadias, are usually repaired as early as possible to ensure A. prevention of urinary tract complications. B. prevention of separation anxiety. C. acceptance of hospitalization. D. development of normal body image.

D.