Maternity 2, Exam 2 REVIEW QUESTIONS

A male child who had surgery to correct hypospadias is seen in a primary health care provider's office for a well-baby checkup. The nurse provides instructions to the mother, knowing that which long-term complication is associated with hypospadias? 1.Infertility 2.Renal anomalies 3.Erectile dysfunction 4.Decreased urinary output

2.Renal anomalies The nurse should ask the child's parents about the child's kidney function because hypospadias may be associated with renal anomalies. The incorrect options are not associated with a long-term effect of hypospadias.

A child after a brain tumor after morning report had an episode of projectile vomiting, what should the nurse do to help the child?

Give snacks until breakfast tray arrives.

The nurse is preparing the medication leucovorin to provide to a child receiving methotrexate for a brain tumor. What should the nurse explain to the child and parents regarding the purpose of this medication? A

ANS it prevents methotrexate that is not incorporated into leukemia cells from entering normal cells.

The nurse is providing a child with oxybutynin (Ditropan) as prescribed following surgical repair of hypospadias. What should the nurse teach the patient about the purpose of this medication? A) Acidifies urine B) Relives bladder spasms C) Stimulate kidney function D)Prevents nausea and vomiting

ANS: B Relives bladder spasms The child may notice painful bladder spasms as long as the catheter is in placater surgical repair of hypospadias. An Anticholinergic medication, which relives bladder spasms such as oxybutynin, may be prescribed for pain relief.

When a child is undergoing chemotherapy which drug is given to premeditate for this procedure?

Antiemetics- Ondansetron to reduce effects of nausea

A child being treated for leukemia is diagnosed with neutropenia. What should the nurse instruct the parents and child to prevent infections?

Avoid larg crowds inspect skin daily of scratches or scrapes No flowers in the area stay away from people that are sick

A 5-year-old child with type 1 diabetes is brought to the clinic by his mother for afollow-up visit after having his hemoglobin A1C level drawn. Which result wouldindicate to the nurse that the child is achieving long-term glucose control? A) 9.0% B) 8.2% C) 7.3% D) 6.9%

B) 8.2%

The nurse is caring for an 8-year-old girl with hyperpituitarism. Which of the followingordered treatments will the nurse expect to perform? A) Give desmopressin acetate intranasally B) Inject octreotide acetate C) Give 1 mg/kg/day of methimazole D) Administer glipizide orally

B) Inject octreotide acetate

A child is diagnosed with hyperthyroidism. Which agent would the nurse expect thephysician to prescribe? A) Mineralocorticoid B) Methimazole C) Levothyroxine D) Dexamethasone

B) Methimazole

The nurse is caring for an 8-year-old girl with an endocrine disorder involving theposterior pituitary gland. Which of the following would the nurse expect to implement? A) Instructing the parents to report adverse reactions to the growth hormone treatment B) Teaching the parents how to administer the desmopressin acetate C) Informing the parents that treatment stops when puberty begins D) Educating the parents to report signs of acute adrenal crisis

B) Teaching the parents how to administer the desmopressin acetate

The nurse suspects that a 4-year-old with type 1 diabetes is experiencing hypoglycemiabased on which of the following? Select all that apply. A) Blurred vision B) Dry, flushed skin C) Diaphoresis D) Slurred speech E) Fruity breath odor F) Tachycardia

CDF

The nurse is caring for a 13-year-old girl with delayed puberty. Based on the nurse'sknowledge of this condition, the nurse would include which nursing diagnosis in thechild's plan of care? A) Disabled family coping related to the child's disorder B) Imbalanced nutrition, less than body requirements related to the child's short stature C) Noncompliance related to the need for lifelong hormone therapy D) Deficient knowledge related to the administration of estradiol

D) Deficient knowledge related to the administration of estradiol

A group of students are reviewing information about the various types of insulin used totreat type 1 diabetes. The students demonstrate understanding of the information whenthey identify which insulin listed below as having the longest duration? A) Lispro B) Regular C) NPH D) Glargine

D) Glargine

The nurse is planning outcomes for a teen male diagnosed with Hodgkin lymphoma. Which outcome should the nurse address feeling of powerlessness with the disease?

The patient attends to recommended appointments

what is an adverse effect of Vincristine?

numb fingertips

Which symptom should the nurse expect the parents to observe when their child has retinoblastoma?

one of the pupils appears white

Cushing's triad

r/t ICP ( HTN, bradycardia, irritability, sleep, widening pulse pressure)

A child is admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which findings should the nurse expect to observe? Select all that apply. 1.Ascites 2.Anorexia 3.Weight loss 4.Proteinuria 5.Decreased serum lipids 6.Periorbital and facial edema

1.Ascites 2.Anorexia 4.Proteinuria 6.Periorbital and facial edema Nephrotic syndrome is a kidney disorder that is characterized by massive proteinuria, hypoalbuminemia, periorbital and facial edema, ascites, elevated serum lipids, and anorexia. The urine volume is decreased and the urine is dark and frothy in appearance. The child with this condition gains weight.

A nurse caring for a 2-month-old febrile infant is asked to collect a urine specimen for a culture and sensitivity. The nurse collects the specimen by performing which action? 1.Catheterizing the infant using the smallest available straight catheter 2.Attaching a urinary collection device to the infant's perineum for collection 3.Place cotton balls in the diaper and then after the infant voids aspirating the urine with a syringe 4.Noting the time of the next expected voiding and preparing to collect the specimen into a cup when the infant voids

1.Catheterizing the infant using the smallest available straight catheter In young infants less than 3 months of age who are febrile, urine specimens should be collected by bladder catheterization with a straight catheter. A urine collection bag would not get a sterile specimen and may take too long. For some types of urine testing, such as specific gravity, ketones, glucose, and protein, the nurse can aspirate urine directly from the cotton balls in the diaper. But would not be appropriate for a culture and sensitivity urine specimen. It is not reasonable to try to identify the time of the next voiding to attempt to collect the specimen

The nurse is assigned to care for a child who is suspected of having glomerulonephritis. The nurse reviews the child's record and notes that which findings are associated with the diagnosis of glomerulonephritis? Select all that apply. 1.Headache 2.Hypotension 3.Red-brown urine 4.Periorbital edema 5.Increased urine output 6.A low blood urea nitrogen (BUN) level

1.Headache 3.Red-brown urine 4.Periorbital edema Signs of glomerulonephritis include headache, abdominal or flank pain, gross hematuria resulting in dark, smoky, cola-colored or red-brown urine and periorbital edema or facial edema. Clients are hypertensive and have decreased urine output. BUN levels may be elevated.

The nurse is planning care for a child with hemolytic-uremic syndrome (HUS). The child has been anuric and will be receiving peritoneal dialysis treatment. The nurse should plan to include which interventions in the care of the child? Select all that apply. 1.Provide adequate nutrition. 2.Restrict fluids, as prescribed. 3.Institute measures to prevent infection. 4.Monitor the arteriovenous (AV) fistula. 5.Administer blood products to treat severe anemia. 6.Anticipate the child will have central nervous system involvement.

1.Provide adequate nutrition. 2.Restrict fluids, as prescribed. 3.Institute measures to prevent infection. 5.Administer blood products to treat severe anemia. 6.Anticipate the child will have central nervous system involvement. HUS is thought to be associated with bacterial toxins, chemicals, and viruses that cause acute kidney injury in children. A child with HUS who is undergoing peritoneal dialysis for the treatment of anuria will be prescribed fluid restrictions. The treatment also involves providing adequate nutrition, preventing infection and anticipating CNS involvement which may include seizure, stupor, and coma. Peritoneal dialysis does not require an AV fistula (only hemodialysis does).

An infant, weighing 12 kg, is receiving diuretic therapy, and the nurse is closely monitoring the intake and output. Which is the amount of hourly urine output should the nurse expect as adequate? 1.5 to 11 mL/hour 2.12 to 24 mL/hour 3.25 to 30 mL/hour 4.32 to 40 mL/hour

2.12 to 24 mL/hour Normal urinary output for an infant is 1 to 2 mL/kg/hr. Therefore for an infant weighing 12 kg, 12 to 24 mL/hour would be the expected amount as adequate.

A urinalysis has been prescribed for an infant and the nurse plans to collect the specimen. The nurse implements which appropriate method to collect the specimen? 1.Catheterizes the infant, using a No. 5 French Foley 2.Attaches a urinary collection device to the infant's perineum 3.Obtains the specimen from the diaper, using a syringe, after the infant voids 4.Monitors the urinary patterns and prepares to collect the specimen into a cup when the infant voids

2.Attaches a urinary collection device to the infant's perineum Although many methods have been used to collect urine from an infant, the most reliable method is the urine collection device. This device is a plastic bag that has an opening lined with adhesive so that it may be attached to the perineum. Urine for certain tests, such as specific gravity, may be obtained from a diaper. Urinary catheterization is not to be done unless specifically prescribed because of the risk of infection. It is not reasonable to monitor urinary patterns and attempt to collect the specimen in a cup when the infant voids.

The nurse collects a urine specimen preoperatively from a child with epispadias who is scheduled for surgical repair. The nurse reviews the child's record for the laboratory results of the urine test and would most likely expect to note which finding? 1.Hematuria 2.Bacteriuria 3.Glucosuria 4.Proteinuria

2.Bacteriuria Epispadias is a congenital defect that involves the abnormal placement of the urethral orifice of the penis. In clients with this condition, the urethral opening is located anywhere on the dorsum of the penis. This anatomical characteristic leads to the easy access of bacterial entry into the urine. Options 1, 3, and 4 are not characteristically noted with this condition.

The nurse caring for a child with nephrotic syndrome reviews the medication record. The nurse notes that prazosin hydrochloride is prescribed for the child. The nurse determines that this medication has been prescribed to achieve which result? 1.Reduce proteinuria. 2.Control hypertension. 3.Decrease inflammation. 4.Suppress the autoimmune response.

2.Control hypertension. Prazosin hydrochloride may be used to control hypertension. The child also may be placed on diuretic therapy until protein loss is controlled. Corticosteroids, such as prednisone, may be prescribed to decrease inflammation. Corticosteroids also suppress the autoimmune response and stimulate vascular reabsorption of edema. Cyclophosphamide is an alkylating agent.

The nurse is assisting with gathering admission assessment data on a 2-year-old child who has been diagnosed with nephrotic syndrome. The nurse collects data knowing that which is a common characteristic associated with nephrotic syndrome? 1.Hypotension 2.Generalized edema 3.Increased urinary output 4.Frank, bright red blood in the urine

2.Generalized edema Nephrotic syndrome is defined as massive proteinuria, hypoalbuminemia, and edema. The urine is dark, foamy, and frothy, but microscopic hematuria may be present. Frank, bright red blood in the urine does not occur. Urine output is decreased and the blood pressure is normal or slightly decreased

The nurse is collecting data on a child recently diagnosed with glomerulonephritis. Which question to the mother should elicit information about the cause of this disease? 1."Has your child had any diarrhea?" 2."Have you noticed any rashes on your child?" 3."Did your child recently complain of a sore throat?" 4."Did your child sustain any injuries to the kidney area?"

3."Did your child recently complain of a sore throat?" Group A beta-hemolytic streptococcal infection is a cause of glomerulonephritis. Often the child becomes ill with streptococcal infection of the upper respiratory tract and then develops symptoms of acute poststreptococcal glomerulonephritis after an interval of 1 to 2 weeks. The questions to the mother in options 1, 2, and 4 are unrelated to a diagnosis of glomerulonephritis.

The nurse has reinforced discharge instructions to the mother of an 18-month-old child following surgical repair of hypospadias. Which statement by the mother indicates a need for further teaching? 1."I should encourage fluid intake." 2."I should avoid toilet training right now." 3."I should carry my child by straddling the child on my hip." 4."I should use double diapers to hold the surgery site in place."

3."I should carry my child by straddling the child on my hip." Parent teaching following hypospadias repair includes restricting the child from activities that put pressure on the surgical site. Straddling the child on the hip will cause pressure on the surgical site. The parents should be instructed to use double diapers to hold the stent in place and should be instructed how to hold the child during the postoperative period. Fluids should be encouraged to maintain hydration. Toilet training should not be an issue during this stressful period.

A 2-year-old child is admitted to the hospital with a diagnosis of nephrotic syndrome. In planning care for this child, which nursing intervention should be of highest priority? 1.Weigh morning and afternoon. 2.Maintain a strict intake and output. 3.Dipstick the urine for protein every 4 hours. 4.Take vital signs with blood pressure every 2 hours.

3.Dipstick the urine for protein every 4 hours. Continuous monitoring of fluid retention and excretion is an important nursing intervention in the care of the child with nephrotic syndrome. Although it is important to maintain a strict intake and output in monitoring fluid retention and excretion, the goal of treatment with this child is to decrease the amount of protein lost in the urine. Because this is the goal, option 3 has the highest priority. Although weight is monitored, it is not necessary to check the weight morning and evening. Taking vital signs with blood pressure is important but is not the priority in this situation and does not have to be monitored every 2 hours.

The nurse is administering medications to a 6-year-old child with nephrotic syndrome. To reduce proteinuria, the nurse would expect which medication to be prescribed? 1.Enalapril 2.Prednisone 3.Furosemide 4.Cyclophosphamide

3.Furosemide The child is usually placed on diuretic therapy with furosemide until protein loss is controlled. Enalapril is most commonly used to control hypertension. Corticosteroids, such as prednisone, may be prescribed to decrease inflammation. Corticosteroids also suppress the autoimmune response and stimulate vascular reabsorption of edema. Cyclophosphamide is an alkylating agent.

The nurse assists in preparing a plan of care for the infant with bladder exstrophy. The nurse identifies which immediate problem as the priority for the infant? 1.Infection 2.Elimination 3.Skin disruption 4.Lack of parental understanding

3.Skin disruption In bladder exstrophy, the bladder is exposed and external to the body. The highest priority is skin disruption related to the exposed bladder mucosa. Although the infant needs to be monitored for elimination patterns and kidney function, this is not the priority concern for this condition. Lack of parental understanding related to the diagnosis and treatment of the condition will need to be addressed, but again, is not the priority. Although infection related to the anatomically located defect can be a problem, it is not the immediate one.

The nurse is assigned to care for an infant with cryptorchidism. One testis cannot be palpated. The nurse anticipates that which diagnostic study will be prescribed to determine where the undescended testis is located in the body? 1.Cystocopy 2.Abdominal x-ray 3.Urodynamic study 4.Computed tomography scan

4.Computed tomography scan If the testis is not palpable, an ultrasonography, computed tomography scan, or magnetic resonance imaging can determine its location. The missing testis may be found at any point along the process vaginalis, may be located in the abdomen, or may follow an aberrant course and come to lie in the inguinal area, base of the penis, or perineum. A cystoscopy is an examination of the bladder and lower urinary tract. An abdominal x-ray would not show the presence of the testis in the abdominal cavity. A urodynamic study is done to determine voiding dysfunction and an abnormal urinary tract.

A nursing instructor is observing a nursing student caring for an infant with a diagnosis of bladder exstrophy. The nursing student provides appropriate care to the infant by performing which action? 1.Covering the bladder with a dry sterile dressing 2.Covering the bladder with a wet-to-dry dressing 3.Applying sterile water soaks to the bladder mucosa 4.Covering the bladder with a nonadhering plastic wrap

4.Covering the bladder with a nonadhering plastic wrap Care should be taken to protect the exposed bladder tissue from drying while allowing drainage of urine. This is best accomplished by covering the bladder with a nonadhering plastic wrap. The use of wet-to-dry dressings should be avoided because this type of dressing adheres to the mucosa and may damage the delicate tissue when removed. Sterile dressings and dressings soaked in solutions can also dry out and damage the mucosa when removed.

The nurse is assisting with preparing a plan of care for a 4-year-old child hospitalized with nephrotic syndrome. Which intervention is most appropriate for this child? 1.Provide a high-salt diet. 2.Provide a high-protein diet. 3.Discourage visitors at mealtimes. 4.Encourage the child to eat in the playroom.

4.Encourage the child to eat in the playroom. Mealtimes should center on pleasurable socialization. The child should be encouraged to eat meals with other children on the unit. A diet that is normal in protein with a sodium restriction is normally prescribed for a child with nephrotic syndrome. Parents or other family members should be encouraged to be present at mealtimes with a hospitalized child.

A child with diabetes insipidus is being treated with vasopressin. The nurse wouldassess the child closely for signs and symptoms of which of the following? A) Syndrome of inappropriate antidiuretic hormone (SIADH) B) Thyroid storm C) Cushing syndrome D) Vitamin D toxicity

A) Syndrome of inappropriate antidiuretic hormone (SIADH)

The nurse is working with a child with altered genitourinary status. The child demonstrates excess fluid volume. Which of the following would the nurse most likely do? A. Weigh the child 2 times a day on the same scale. B. Hold all medication until the fluid retention improves. C. Avoid administering IV fluids. D. Measure the amount of nitrates present in the urine.

A. Weigh the child 2 times a day on the same scale.

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? A. Encouraging fluid intake after dinner B. Practicing bladder-stretching exercises C. Giving desmopressin intranasally D. Engaging the child in stress reduction measures

ANS A. Encouraging fluid intake after dinner

A voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents? A. The VCUG will rule out vesicoureteral reflux. B. The VCUG will detect if the infection is gone. C. The VCUG will rule out kidney stones. D. The VCUG will prevent further complications of the urinary tract infection (UTI).

ANS A. The VCUG will rule out vesicoureteral reflux.

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. What is the most important reason the child needs increased fluids? A. To dilute the urine and flush the bladder B. To fill the bladder so a specimen can be obtained C. To prevent the child from developing a fever D. To decrease the pain of urination

ANS A. To dilute the urine and flush the bladder

A child is having their urine checked for complaints of polyuria. When analyzing the results, what would positive glucose indicate? A. This may indicate a urinary tract infection. B. This determines the presence of sugar in the urine. C. This indicates renal disease. D. This determines the presence of bacteria in the urine.

ANS B. This determines the presence of sugar in the urine. This could signify diabetes and needs to be evaluated immediately.

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."

ANS C. "We should notify the health care provider if the drainage is cloudy." Cloudy drainage could indicate an infection such as peritonitis and should be reported to the HCP.

A child is diagnosed with hemolytic-uremic syndrome (HUS). Review of the child'slaboratory test results would reveal which finding? A. Decreased blood urea nitrogen (BUN) and creatinine B. Decreased platelets and leukocytosis C. Hypernatremia and hypokalemia D. Respiratory acidosis and proteinuria

B. Decreased platelets and leukocytosis

The nurse is administering 10 units of NPH insulin to a child at 8 a.m. The nurse wouldexpect this insulin to begin acting at which time? A) By 8:15 a.m. B) Between 8:30 and 9 a.m. C) Between 9 and 11 a.m. D) Around 12 noon

C) Between 9 and 11 a.m.

The nurse is preparing a teaching plan for a 10-year-old girl with hyperthyroidism.Which of the following would the nurse include in the plan? A) Describing surgery to remove an anterior pituitary tumor B) Teaching her parents to give injections of growth hormone C) Explaining about the radioactive iodine procedure D) Showing her parents how to give DDAVP intranasally

C) Explaining about the radioactive iodine procedure

A group of nursing students are reviewing information about the endocrine system ininfants and children. The students demonstrate understanding of the information whenthey state which of the following? A) Endocrine glands begin developing in the third trimester of gestation. B) At birth, the endocrine glands are completely functional. C) Infants have difficulty balancing glucose and electrolytes. D) A child's endocrine system has little effect on growth and development.

C) Infants have difficulty balancing glucose and electrolytes.

A nurse is preparing a presentation for a group of parents with children diagnosed withdiabetes type 1. The children are all adolescents. Which of the following issues wouldthe nurse need to address? Select all that apply. A) Self-monitoring of blood glucose levels B) Feelings of being different C) Deficient decision-making skills D) Body image conflicts E) Struggle for independence

CDE

A nurse is teaching the parents of an infant with congenital adrenal hyperplasia aboutthe signs and symptoms of adrenal crisis. The nurse determines that the teaching wassuccessful when the parents identify which of the following? A) Bradycardia B) Constipation C) Fluid overload D) Persistent vomiting

D) Persistent vomiting

The nurse is observing signs of an infant with Wilm's tumor, which statement should the nurse post immediately?

Do not palpate the abdomen