Peds Exam 3 GU Practice Questions

Patient S is a sexually active adolescent; which of the following instructions would be included in the preventive teaching plan about urinary tract infections? A. Drinking acidic juices B. Avoiding urinating before intercourse C. Wearing nylon underwear D. Wiping back to front

A Drinking acidic juices, such as cranberry juice, helps keep the urine at its desired pH and reduces the chance of infection. The client should wipe from front to back, wear cotton underwear, and void before and after intercourse.

12-year-old Caroline has recurring nephrotic syndrome; which of the following areas of potential disturbances should be a prime consideration when planning ongoing nursing care? A. Body image B. Sexual maturation C. Muscle coordination D. Intellectual development

A

7-year-old Damon has cystitis; which of the following would Nurse Elena expect when assessing the child? A. Dysuria B. Costovertebral tenderness C. Flank pain D. High fever

A

A 9-year-old female is brought to the provider for a recent history of new daytime wetting accidents since the start of the school year. What history would the nurse want to obtain? Select all that apply. A. How often do the accidents occur? B. Do they occur just at school or at home as well? C. What are your bowel movements like? D. What kinds of things do you drink? E. Do you spread your legs when you void?

A, B, C, D, E

Which of the following should be included when developing a teaching plan to prevent urinary tract infection? Select all that apply. A. Maintaining adequate fluid intake B. Avoiding urination before and after intercourse C. Emptying bladder with urination D. Wearing underwear made of synthetic material such as nylon E. Keeping urine alkaline by avoiding acidic beverages F. Avoiding bubble baths and tight clothing

A, C, F

What is most likely the underlying physiology of primary enuresis? A. Psychogenic stress B. Delayed bladder maturation C. Urinary tract infection D. Vesicoureteral reflux

B

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 Vomiting is a clinical manifestation observed in an infant with a urinary tract infection (UTI) and can be related to poor feeding. Persistent diaper rash is a clinical manifestation of UTI in an infant. Failure to gain weight is a clinical manifestation of UTI in an infant related to poor feeding and vomiting. Jaundice is not a clinical manifestation of UTI in an infant. Swelling of the face is not a clinical manifestation of UTI in an infant.

You obtain a history from the mother of a child with glomerulonephritis about how he became ill. Which of the following would you expect her to tell you she noticed? A. Headache, loss of appetite B. Dark brown urine C. Loss of weight, oliguria D. Diuresis and pallor

B

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 do which of the following actions? A. Give the child fluids and report back to the nurse in a few hours. B. Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone. C. Give the child a diuretic and report back to the nurse in a few hours. D. Weigh the child in the same clothes she had been weighed in the day before and report the two weighs to the nurse while the nurse is on the phone.

B

Most urinary tract infections seen in children are caused by which of the following? A. Hereditary causes B. Intestinal bacteria C. Dietary insufficiencies D. Fungal infections

B

The clinical manifestations of minimal change nephrotic syndrome (MCNS) are due to which of the following? A. Chemical changes in the composition of albumin. B. Increased permeability of the glomeruli. C. Obstruction of the capillaries of the glomeruli. D. Loss of the kidney's ability to excrete waste and concentrate urine.

B

A 5-year-old female child has been sent to the school nurse for urinary incontinence 3 times in the past 2 days. The nurse should recommend to her 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 the urinary tract

C

A child with minimal change nephrotic syndrome (MCNS) has generalized edema. The skin appears stretched, and areas of breakdown are noted over the bony promi- nences. The child has been receiving Lasix twice daily for several days. Which does the nurse expect to be included in the treatment plan to reduce edema? A. An increase in the amount and frequency of Lasix. B. Addition of a second diuretic, such as mannitol. C. Administration of intravenous albumin. D. Elimination of all fluids and sodium from the child's diet.

C

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? A. Sacrum B. Abdomen C. Eyes D. Fingers

C

A child has been diagnosed with acute glomerular nephritis. Which of the following changes would the nurse expect to see in the child's laboratory reports? A. Urine white blood cell count: elevated B. Urine creatinine clearance: decreased C. Urine specific gravity: decreased D. Urine red blood cell count: elevated

D

A parent asks the nurse how to prevent the child from having minimal change nephrotic syndrome (MCNS) again. Which is the nurse's best response? A. "It is very rare for a child to have a relapse after having fully recovered." B. "Unfortunately, many children have cycles of relapses, and there is very little that can be done to prevent it." C. "Your child is much less likely to get sick again if sodium is decreased in the diet." D. "Try to keep your child away from sick children because relapses have been associated with infectious illnesses."

D

A child diagnosed acute glomerulonephritis will most likely have a history of which of the following? A. Recent illness such as strep throat B. Hemorrhage or history of bruising easily C. Sibling diagnosed with the same disease D. Hearing loss with impaired speech development

A

A nurse is performing an assessment on a child. Which of the following would be indicative of a potential for a urinary tract infection? A. Holding urine while at school. B. Not using cleansing towelettes routinely. C. Washing the genital area with water daily. D. Not using soap when cleaning the urethral area.

A

Chronic hypertension in the child who has chronic renal failure (CRF) is due to which of the following? A. Retention of sodium and water. B. Obstruction of the urinary system. C. Accumulation of waste products in the body. D. Generalized metabolic alkalosis.

A

In planning care for a child diagnosed with minimal change nephrotic syndrome, the nurse should understand the relationship between edema formation and: A. Decreased colloidal osmotic pressure in the capillaries B. Reduced tubular reabsorption of sodium and water C. Increased retention of albumin in the vascular system D. Fluid shift from interstitial spaces into the vascular space

A

Nurse Kai is evaluating a female child with acute post-streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement? A. Increased urine output B. Increased appetite C. Increased energy level D. Decreased diarrhea

A

The nurse is caring for a child admitted with acute glomerulonephritis. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis? A. Smoky colored urine B. Jaundiced skin C. Strawberry red tongue D. Loose, dark stools

A

To prevent further urinary tract infections in a preschooler, what measures would you teach her mother? A. Teach her to take frequent tub baths to clean her perineal area. B. Teach her to wipe her perineum front to back after voiding. C. Suggest she drink less fluid daily to concentrate urine. D. Encourage her to be more ambulatory to increase urine output

B

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 which of the following as an appropriate measure? A. Engaging the child in stress reduction measures B. Giving desmopressin intranasally C. Encouraging fluid intake after dinner D. Practicing bladder-stretching exercises

C

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 complains of 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 degrees Fahrenheit. The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have: A. Rheumatic fever B. A urinary tract infection C. Acute glomerulonephritis D. Lipoid nephrosis (idiopathic nephrotic syndrome)

C

The nurse is collecting data on a 6-year-old child admitted with a possible urinary tract infection. Which of the following vital signs might indicate the possibility of an infection? A. Respirations 22 per minute B. Blood Pressure 100/70 C. Pulse rate 135 bpm D. Pulse oximetry 93% on room air

C

The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTI's). 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 of the following statements would be accurate for the nurse to tell this mother? A. "It is unlikely that your daughter is practicing good cleaning habits after she voids." B. "Girls need more vitamin C than boys to keep their urinary tract healthy, so your daughter may be deficient in vitamin C." C. "A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily." D. "The position of the urethra in girls makes girls more susceptible than boys to UTI's."

C

The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. The nurse's BEST reply is: A. "Blood pressure changes are a common side effect of antibiotic therapy." B. "Blood pressure changes are a sign that the condition has become chronic." C. "Acute hypertension, or high blood pressure, must be anticipated and identified." D. "Hypotension, or low blood pressure, leading to sudden shock can develop at any time."

C

Which of the following is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)? A. Reduce blood pressure B. Lower serum protein levels C. Minimize excretion of urinary protein D. Increase ability of tissue to retain fluid

C

Which of the following organisms is the most common cause of urinary tract infection (UTI) in children? A. Klebsiella B. Staphylococcus C. Escherichia coli D. Pseudomonas

C

Alaric was diagnosed with minimal-change nephrotic syndrome; which of the following signs and symptoms are characteristics of the said disorder? A. Hypertension, edema, hematuria B. Hypertension, edema, proteinuria C. Gross hematuria, fever, proteinuria D. Poor appetite, edema, proteinuria

D

Which of the following is an important nursing consideration when caring for a child with end-stage renal disease (ESRD)? A. Children with ESRD usually adapt well to 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 children's lives are maintained by drugs and artificial means.

D

Which of the following should the nurse recommend to prevent urinary tract infections (UTIs) in young girls? A. Avoid public toilets B. Limit long baths as much as possible C. Cleanse perineum with water after voiding D. Ensure clear liquid intake of 2L/day

D