🤓CHP 21 PREP U
The child has been sexually abused, maybe on the fishing trip
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?
Creatinine clearance rate
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?
Report redness or swelling on the penile shaft
The nurse is planning the discharge instructions for the parents of a 1-month-old infant who has had a circumcision completed. Which information should be included in the education provided?
"Let's meet with the dietitian and plan some meals."
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?
Administer in the morning; encourage fluids and voiding during and after administration
The nurse is administering cyclophosphamide as ordered for a 12-year-old boy with nephrotic syndrome. Which instruction is most accurate regarding administration?
heart rate and blood pressure
The nurse is assessing a hospitalized child diagnosed with nephrotic syndrome. What set of assessments is most important for the nurse to complete to help identify hypoalbuminemia in this child?
obtaining a clean catch voided urine
The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is:
Palpate the scrotum for the testes
The nurse is caring for a 9-month-old with cryptorchidism noted on the medical record. In which manner will the nurse assess this condition?
Mittelschmerz
The nurse is most accurate to instruct the client that which occurs during a female's mid-cycle?
Severe cramping and pain should not occur with an infusion
A 10-year-old child in renal failure is on continuous cycling peritoneal dialysis (CCPD). What would be important to teach the parents?
"What have you heard about it that makes you worried?"
A 12-year-old girl who has not yet reached menarche comes to the pediatrician's office for her annual well-child check. As the nurse is weighing and measuring her, the child says emphatically that she does not want to get her period. Which response would be most appropriate for the nurse to make to this child?
Test her urine for glucose to rule out diabetes mellitus
A 14-year-old girl visits her gynecologist and is found to have vaginal candidiasis. She is obese, claims to not be sexually active, and is not on oral contraceptive pills. Which intervention should be considered for this client?
Reassess the client's testes at 6 months of age
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?
some discomfort at the surgery site
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?
The boy has only begun wetting the bed and his pants recently, 1 year after being successfully potty-trained
A 5-year-old boy occasionally wets his bed at night and his pants during the day. Which finding would indicate an organic cause—as opposed to a functional cause—of this enuresis?
Cystoscopy
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?
Proteinuria, hypoalbuminemia, and hypercholesterolemia
A child is getting a diagnostic work-up for nephrotic syndrome. Which lab results would the nurse expect to see?
This may indicate a urinary tract infection
A child is having the urine checked for a routine well visit. When analyzing the results, what would positive leukocytes indicate?
weight, daily
A child is hospitalized with nephrotic syndrome. Which measurement is best for the nurse to determine the child's edema?
The peritoneal dialysis should help the child with his or her growth and blood pressure
A child needs to undergo peritoneal dialysis. What type of education would the nurse provide to the family about this process?
Have the child sit in a sitz bath of warm water to void
A child, diagnosed with a urinary tract infection, is afraid to void because it hurts. What action should the nurse recommend to the parent to help relieve this fear?
"A pelvic exam is necessary at 18 to 20 years of age."
A client's mother asks the nurse, "When should my daughter have a pelvic examination?" Which response by the nurse is most appropriate?
The foreskin is needed for repair
A newborn is diagnosed with hypospadias and the parents want the newborn to be circumcised. What would be the best response by the nurse?
Assess usual voiding patterns
A nurse has admitted a 3-year-old female diagnosed with a urinary tract infection. When developing the plan of care, what should the nurse do first?
vulvovaginitis
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?
"She can eat whatever she wants on dialysis days."
A nurse is caring for a 12-year-old girl recently diagnosed with end-stage kidney disease. The nurse is discussing dietary restrictions with the girl's mother. Which response indicates a need for further teaching?
Withhold his routine medication until after dialysis is completed
A nurse is caring for a 13-year-old boy with end-stage kidney disease who is preparing to have his hemodialysis treatment in the dialysis unit. Which nursing action is appropriate?
Prevent constipation in the child
A nurse is caring for a child who has had a urethral stent. What would be included in the care of this child?
"The kidneys help control blood pressure, so our child's blood pressure needs to be checked often."
A nurse is conducting a discussion group with parents of children who have genitourinary disorders. As part of the discussion, the nurse reviews the major functions of the kidneys. The nurse determines that the teaching was successful based on which statement by the group?
Encouraging fluid intake after dinner
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?
The use of cleansing towelettes may have caused the vulvovaginitis
A nurse is discussing with a family the various causes of their child's vulvovaginitis. What would be included in the education?
Encourage high fluid intake
A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms?
Monitor output
A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage tube patency?
Immunosuppression is common after a kidney transplant
A nurse is teaching the parents about the kidney transplant their child is going to receive. What would be included in the teaching?
Assess for bladder distention
A school-aged child has come to the clinic with symptoms of a urinary tract infection. The child reports dysuria, frequency and hesitancy. What nursing assessment is most important for the nurse to complete?
"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."
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?
Oliguria and jaundice
A teacher sends a child to see the school nurse for irritability and bruising. Which symptom would be indicative of hemolytic uremic syndrome?
The VCUG will rule out vesicoureteral reflux
A voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents?
"The pain most likely occurs when the egg is released from the ovary."
An adolescent female client reports experiencing abdominal pain about halfway through her menstrual cycle. The adolescent describes the pain and asks the nurse why it is occurring. How should the nurse respond?
take the child to a private room and interview her regarding her sexual history and partners
An adolescent girl and her caregiver present at the pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease (PID) is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. The most appropriate action by the nurse would be to:
Weighing on the same scale each day
In caring for a child with nephrotic syndrome, which intervention will be included in the child's plan of care?
intestinal bacteria
Most urinary tract infections seen in children are caused by:
The infant does not urinate within 6 to 8 hours
The nurse is educating the parents of an infant after a circumcision. The parents demonstrate understanding when they reiterate the need to report which concerning development to the health care provider?
"Emotional stress can be a cause of this disorder."
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?
Peritoneal dialysis
The nurse is educating the parents of a child requiring renal replacement therapy The parents express concern because they live in a remote, rural area with no access to pediatric specialty dialysis units. Which would the nurse recommend to the parents?
"The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."
The caregiver of a 1-year-old boy calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse most accurately clarifies the caregiver's question by making which statement regarding the son's treatment?
Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone
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?
acute glomerulonephritis
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:
Positive culture for group A streptococcus
The nurse is caring for a 6-year-old child with acute glomerulonephritis. When reviewing the client's laboratory results, which result is most important to review with the health care provider?
fluid overload
The nurse is administering an IV infusion of albumin to a child with nephrotic syndrome. What is the primary concern for the nurse when administering this medication to the child?
hemolytic anemia, thrombocytopenia, and acute renal failure
The nurse is assessing an infant with suspected hemolytic uremic syndrome. Which characteristics of this condition should the nurse expect to assess or glean from chart review?
Sodium bicarbonate tablets
The nurse is caring for a 10-year-old boy with end-stage kidney disease (ESKD) with metabolic acidosis. What would the nurse expect to administer if ordered?
"There are several things we can do to help you achieve this goal."
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?
urinalysis
The nurse is caring for a 10-year-old girl presenting with fever, dysuria, flank pain, urgency, and hematuria. The nurse would expect to help obtain which test first?
White cottage cheese-like discharge
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?
The catheter insertion site will leave only a minimal scar
The nurse is caring for a 3-year-old child with the surgical repair of hypospadias. The preschooler returned from the postanesthesia care unit with an indwelling urinary catheter. What parental teaching is most helpful?
Testis cannot be "milked" down inguinal canal
The nurse is caring for a 5-month-old boy with an undescended left testis. What would the nurse identify as indicative of true cryptorchidism?
hypertension
The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder?
Weigh the old dialysate
The nurse is caring for a child who is undergoing peritoneal dialysis. Immediately after draining the dialysate, which action should the nurse should take immediately?
absence of a thrill
The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician?
scrotal elevation
The nurse is caring for a child with epididymitis. When planning care, which intervention may be included?
Eyes
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?
Measure the abdominal girth daily
The nurse is caring for an 8-year-old child hospitalized with nephrotic syndrome. Which nursing intervention would be appropriate for this child?
Abdominal mass
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?
"This condition usually resolves spontaneously with no symptoms."
The nurse is caring for an infant with grade II vesicoureteral reflux (VUR). The parent is very fearful that the infant will have progressive renal damage. Which response by the nurse would be appropriate?
The child recently had an ear infection
The nurse is collecting data for a child diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's history?
"Has your child complained of pain?"
The nurse is collecting data on a 2-year-old child admitted with a diagnosis of urinary tract infection. When interviewing the caregivers, which question would be most important for the nurse to ask?
Blood pressure 136/84
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?
leukocyte count
The nurse is concerned about the pediatric client's immune system after taking corticosteroids. Which laboratory study is the nurse most correct to assess?
"I cannot have unprotected sex again until my partner is treated."
The nurse is conducting a follow-up visit for a 13-year-old girl who has been treated for pelvic inflammatory disease. Which remark indicates a need for further teaching?
A contributing factor in dysmenorrhea is the increased secretion of prostaglandins
The nurse is conducting a presentation for a group of nurses who work with adolescents. The group discusses dysmenorrhea. Which statement is most accurately related to dysmenorrhea?
pulse rate and rhythm
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?
"A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily."
The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why her daughter has had three urinary tract infections but her son has had none. She reports that their diets and fluid intake is similar. Which statement would be accurate for the nurse to tell this mother?
Sudden onset of severe scrotal pain with significant hemorrhagic swelling
The nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which assessment finding would indicate testicular torsion?
Teach her to wipe her perineum front to back after voiding
To prevent further urinary tract infections in a preschooler, what measures would you teach her mother?
Placing the infant in a side-lying position
When developing the preoperative plan of care for an infant with bladder exstrophy, which intervention would the nurse least likely include?
Muscle weakness
When examining the musculoskeletal system of the child, which would be indicative of a potential kidney problem?
Risk for infection
When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority?
7-year-old male with a recent history of an upper respiratory infection
Which child is at risk for acute glomerulonephritis?
multiple sexual partners
Which condition is a risk factor for the development of pelvic inflammatory disease (PID)?
Maintain a low-sodium diet
Which dietary change is most important to decrease the symptoms of premenstrual syndrome?
preventing skin breakdown
Which is a priority for the nurse caring for a client with bladder exstrophy?
This occurs when there is backflow of urine into the bladder and sometimes the kidneys
A nurse is providing education to parents of a child diagnosed with vesicoureteral reflux (VUR). Which would be included in the parental education?
Encourage the child to take all the antibiotics if diagnosed with strep throat
A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this?
"What do you like to do on the weekend?"
The nurse is conducting a routine wellness examination of a 13-year-old client. Which question would be best to ask first when opening a discussion on sexual behavior?
Metronidazole
An adolescent is diagnosed with a trichomonal infection. Which medication would the nurse include when teaching the adolescent about treatment for this infection?
Failure to thrive
An infant is diagnosed with a urinary tract infection (UTI). What corroborating finding would the nurse expect on assessment?
The client remains continent throughout the night
Which goal of therapy would be appropriate for a nurse to establish with a client's family and a client who has a diagnosis of enuresis?
Uremia
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?
Periorbital edema
The nurse is triaging clients as they come in to an urgent care facility. Which assessment finding is clinically significant for early nephrotic syndrome?
The child can live a more normal lifestyle
The nurse knows that which statement is a description of peritoneal dialysis when compared to hemodialysis:
Reddish-brown, smoky-colored urine
The nurse obtains a history from the parent of a child with glomerulonephritis about how the child became ill. What would the nurse expect the parent to report?
Sleeping too soundly
The nurse recognizes that what would be a likely physiologic cause for a child to have enuresis?
