Peds Quiz 8
A 12-year-old child has just been diagnosed with end-stage renal disease. The nurse gives the child instructions in which foods to avoid, including: A. Apricots B. Cranberry juice C. Apples D. Peach Italian ice
A. Apricots
The client has been diagnosed to have glomerulonephritis. What should the nurse observe in the urine? A. Blood B. White blood cells C. Glucose D. Albumin
A. Blood
A child, in renal failure, has hyperkalemia. The nurse plans to instruct that the child should avoid the following foods: A. Carrots and green, leafy vegetables. B. Chips, cold cuts, and canned foods. C. Spaghetti and meat sauce, breadsticks. D. Hamburger on a bun, cherry gelatin.
A. Carrots and green, leafy vegetables.
A child with nephrotic syndrome has been placed on prednisone for several weeks. An important point of teaching with the parents should include: A. Never stop the medication suddenly. B. This drug is taken once a week on Sunday. C. The child should always take the medication at night before bed. D. This drug should be taken without food, on an empty stomach.
A. Never stop the medication suddenly.
A child with nephrotic syndrome is severely edematous. The primary health-care provider has placed the child on bed rest. An important nursing intervention for this child should be to A. Reposition the child every two hours. B. Monitor blood pressure every 30 minutes. C. Encourage fluids. D. Limit visitors. E. Institute a protein-restricted diet.
A. Reposition the child every two hours.
Accurate fluid intake and output records and daily weights are particularly important in patients with kidney disease because: A. They aid in assessing kidney damage B. They help to determine nutritional adequacy C. They are important in assessing hypertension D. They provide a reliable method of determining infection
A. They aid in assessing kidney damage
Which of the following conditions or factors places the child at risk for development of renal failure? (Select-all-that-apply) A. Dehydration B. Enuresis C. Hypospadias D. Not being circumcised E. Hydronephrosis F. Vesicoureteral reflux G. Glomerulonephritis H. Pyelonephritis I. Nephroticsyndrome J. Taking aspirin K. Gentamicin use L. History of intravenous pyelogram
A. Dehydration E. Hydronephrosis F. Vesicoureteral reflux G. Glomerulonephritis H. Pyelonephritis I. Nephrotic syndrome K. Gentamicin use L. History of intravenous pyelogram
A 10-year-old patient is admitted to 2 West by the family nurse practitioner who suspects a diagnosis of acute glomerulonephritis. The pediatric nurse would expect to see which of the following findings? A. Serum creatinine of 2.2 mg/dL. B. Massive proteinuria. C. Gross hematuria. D. Urine output of 350 ml in 24 hours. E. Mild periorbital edema. F. Brown ("tea-colored") urine. G. Hypertension. H. Blood urea nitrogen (BUN) of 40 mg/dL.
A. Serum creatinine of 2.2 mg/dL. C. Gross hematuria. D. Urine output of 350 ml in 24 hours. E. Mild periorbital edema. F. Brown ("tea-colored") urine. G. Hypertension H. Blood urea nitrogen (BUN) of 40 mg/dL.
The nurse admitting and assessing a teenage boy with suspected testicular torsion (twisted testicle) will most likely find which of the following manifestations in addition to possible nausea and vomiting and acute testicular pain? (Select the one best answer.) A. Relief of pain with elevation of the testicle B. Cremasteric reflex depressed or absent C. Pain, burning, or discomfort upon urination D. White blood cells and bacteria in the urine E. Blue swollen scrotum
B. Cremasteric reflex depressed or absent
A nurse is taking care of a school-age child with acute glomerulonephritis who is taking potassium-sparing diuretics. The nurse anticipates discussing the diet with the child and his parents. The diet should include: A. Potassium-rich foods B. Foods low in cholesterol C. An increase in calories D. A sodium restriction
D. A sodium restriction
A child has been diagnosed with stage 3 chronic kidney disease (CKD). The nurse would question the medical order for: A. ACE inhibitor to control blood pressure B. Erythropoietin therapy and iron replacement therapy for anemia C. Long-acting insulin (Lantus) to control blood sugar levels D. Intravenous pyelogram with contrast to visualize kidneys
D. Intravenous pyelogram with contrast to visualize kidneys
Scenario: A child with acute poststreptococcal glomerulonephritis (APSGN) is admitted to the pediatric ICU for overnight observation. When obtaining a nursing history from the child's mother, the nurse should expect a recent ________________ infection. (fill in the blank)
streptococcal
A 4-year-old has acute glomerulonephritis and is admitted to the hospital. An appropriate nursing diagnosis for this child should be A. Risk for Urinary Tract Injury Related to Loss of Blood in Urine. B. Excess Fluid Volume Related to Decreased Plasma Filtration. C. Risk for Infection Related to Hypertension. D. Disturbed Personal Identity Related to a Chronic Disease.
B. Excess Fluid Volume Related to Decreased Plasma Filtration.
The administration of prednisone to children with nephrotic syndrome creates the problem of: A. Intolerance of foods. B. Increased risk of infection. C. Decreased serum sodium. D. Weight loss. E. Hypoglycemia. F. Increased serum potassium.
B. Increased risk of infection.
A child with acute glomerulonephritis is in the playroom and experiences blurred vision and headache. Which of the following actions should be taken by the nurse? A. Check the urine to see if hematuria has increased. B. Obtain a blood pressure on the child; notify the physician. C. Reassure the child, and encourage bed rest until the headache improves. D. Obtain serum electrolytes, and send a urinalysis to the lab.
B. Obtain a blood pressure on the child; notify the physician.
A child has undergone a kidney transplant and is receiving tacrolimus and cyclosporine. The parents ask the nurse about the reason for these two medications. The nurse should explain that these medications are given to A. Boost immunity. B. Suppress rejection. C. Decrease pain. D. Improve circulation.
B. Suppress rejection.
A nurse is teaching a client to perform peritoneal dialysis in preparation for discharge to home. The nurse tells the client to use which of the following to prevent infection when connecting and disconnecting the peritoneal dialysis system? A. gloves only B. gloves and mask C. gloves, mask, and goggles D. gloves, mask, and apron
B. gloves and mask
Which of the following problems is expected in a child who is in end-stage renal failure? A. Anemia B. Diarrhea C. Hypotension D. Renal calculi
A. Anemia
Nocturnal enuresis (bedwetting) is a common problem that can be troubling for children and their families. The evaluation of nocturnal enuresis requires a thorough history, a complete physical examination, and urinalysis. Treatment options include nonpharmacologic and pharmacologic measures. Which of the following are recommended treatment strategies for this condition? (Select-all-that-apply) A. A bed-wetting alarm system B. Encourage the child to drink caffeinated beverages C. A positive reinforcement system, such as rewarding the child with a prize for staying dry at night D. Desmopressin (DDAVP) by nasal spray or by tablet E. Scheduled awakenings during the night to void F. Limit fluid intake in the evening and before the child goes to bed G. Have the child urinate before going to bed H. Daily laxatives or enemas I.Have the child go to the bathroom about ten minutes after eating breakfast, lunch and dinner J. Include more fiber and pure water in the diet
A. A bed-wetting alarm system C. A positive reinforcement system, such as rewarding the child with a prize for staying dry at night D. Desmopressin (DDAVP) by nasal spray or by tablet E. Scheduled awakenings during the night to void F. Limit fluid intake in the evening and before the child goes to bed G. Have the child urinate before going to bed
The nurse is providing teaching to the mother to help prevent another UTI. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) A. Avoid giving the child bubble baths. B. Change the child's bathing suit immediately after swimming. C. Encourage the child to go to the bathroom every 6 hours. D. Have the child wear cotton, rather than nylon, underpants. E. Instruct the child to wipe from front to back after voiding
A. Avoid giving the child bubble baths. B. Change the child's bathing suit immediately after swimming. D. Have the child wear cotton, rather than nylon, underpants E. Instruct the child to wipe from front to back after voiding
An infant is born with bladder exstrophy. The nurse should: Select all that apply. A. Cover exposed bladder tissue with sterile plastic wrap. B. Assess skin surace around the exposed area for excoriation. C. Abduct the infant's legs. D. Irrigate bladder mucosa with warm saline. E. Tie umbilical cord with 2.0 silk suture. F. Clamp the umbilical cord before it is cut with a plastic umbilical cord clamp. G. Maintain the newborn in Fowler's position.
A. Cover exposed bladder tissue with sterile plastic wrap. B. Assess skin surace around the exposed area for excoriation. D. Irrigate bladder mucosa with warm saline. E. Tie umbilical cord with 2.0 silk suture.
The pediatric nurse understands that which of the following is normal and expected for a child with end-stage renal disease (ESRD)? (Select all that apply) A. Serum hemoglobin of 7.2 g/dL B. History of glomerulonephritis or nephrotic syndrome. C. Body temperature of 100.6° F. D. Oliguria and hypertension. E. Increased serum glucose. F. Early sexual maturation. G. History of pyelonephritis. H. Lack or loss of appetite.
A. Serum hemoglobin of 7.2 g/dL B. History of glomerulonephritis or nephrotic syndrome. D. Oliguria and hypertension. G. History of pyelonephritis. H. Lack or loss of appetite.
A child is undergoing hemodialysis. The child should be monitored closely for (Select all that apply): A. Shock. B. Hypotension. C. Infections. D. Migraines. E. Fluid overload. F. Bleeding at the access site.
A. Shock. B. Hypotension. C. Infections. F. Bleeding at the access site.
Which of the following are characteristic or descriptive of an intravenous pyelogram (IVP)? (Select-all-that-apply) A. Visualize kidneys, ureters and bladder B. Laxatives or enemas may be ordered prior to remove gas or fecal material C. Noninvasive D. Nephrotoxic dye E. Use of intravenous contrast medium F. Uses reflected soundwaves to evaluate kidneys for possible hydronephrosis G. Ask about allergies to contrast or shellfish H. Increase fluids afterwards to flush contrast
A. Visualize kidneys, ureters and bladder B. Laxatives or enemas may be ordered prior to remove gas or fecal material D. Nephrotoxic dye E. Use of intravenous contrast medium G. Ask about allergies to contrast or shellfish H. Increase fluids afterwards to flush contrast
The nurse is reviewing discharge instructions with the child and his parent for a school-age child with acute glomerulonephritis. Which of the following should the nurse include? (Select all that apply.) A. Weigh the child daily. B. Check the child's blood pressure daily. C. Resume usual physical activity. D. Continue the prescribed antibiotics. E. Elevate edematous body parts.
A. Weigh the child daily. B. Check the child's blood pressure daily. D. Continue the prescribed antibiotics. E. Elevate edematous body parts.
The RN is reviewing the discharge plans for a newborn with hypospadias. What statement by the parents indicates their understanding of the plan of care for hypospadias? (In other words, which one of the following is correct?) A. "Our child will need frequent blood tests." B. "Our child won't be circumcised until after surgery so the skin can be used during the repair." C. "Our child will have to be catheterized frequently." D. "A special support will be worn after surgery."
B. "Our child won't be circumcised until after surgery so the skin can be used during the repair."
A child is being treated for strep throat. The nurse tells the parent to report any abrupt onset of mid-abdominal pain along with malaise, irritability and fever. The nurse is teaching the parent signs of: A. Sodium retention. B. Acute post-streptococcal glomerulonephritis. C. Hemolytic-uremic syndrome. D. Renal insufficiency.
B. Acute post-streptococcal glomerulonephritis.
A nurse is preparing to admit a child with possible hydronephrosis. What labs should the nurse expect to draw on this child? A. Platelet count. B. Blood urea nitrogen (BUN) and creatinine. C. Partial thromboplastin time (PTT). D. Blood culture.
B. Blood urea nitrogen (BUN) and creatinine.
A child with a renal condition has developed oliguria. Which action(s) should the nurse anticipate performing? (Select all that apply) A. Administer IV fluids. B. Continue monitoring intake and output. C. Draw blood to check potassium and creatinine. D. Push oral fluids. E. Weigh the child. F. Monitor the child's blood pressure.
B. Continue monitoring intake and output. C. Draw blood to check potassium and creatinine. E. Weigh the child. F. Monitor the child's blood pressure.
Scenario: A nurse is caring for a 9-year-old child who is being seen for the second time with a UTI. Which of the following findings should the nurse expect during an initial assessment? (Select all that apply.) A. Light-colored urine B. Dysuria C. Foul-smelling urine D. Epigastric pain E. Oliguria
B. Dysuria C. Foul-smelling urine
Which of the following clinical manifestations of a lower urinary tract infection (UTI) are commonly seen in infants? (Select-all-that-apply) A. Dysuria B. Fever of unknown origin C. Failure to thrive D. Urgency and frequency E. Burning with urination F. Poor feeding G. Foul-smelling urine H. Vomiting and/or diarrhea I. Hematuria J. Irritability and lethargy K. Failure to gain weight
B. Fever of unknown origin C. Failure to thrive F. Poor feeding G. Foul-smelling urine H. Vomiting and/or diarrhea J. Irritability and lethargy K. Failure to gain weight
Hemodialysis and peritoneal dialysis are both used to treat kidney failure. Which of the following are correct statements? (Select all that apply) A. Hemodialysis does not require as many food and fluid restrictions as peritoneal dialysis. B. Hemodialysis uses a man-made membrane (dialyzer) to filter wastes and remove extra fluid from the blood. C. With hemodialysis, peritonitis may occur. Signs of periotonitis include fever, abdominal pain, and cloudy dialysate. D. Peritoneal dialysis uses the lining of the abdominal cavity (peritoneal membrane) and a solution (dialysate) to remove wastes and extra fluid from the body. E. With hemodialysis, disequilibrium syndrome can occur. Disequilibrium syndrome of dialysis has essentially the same symptoms as cerebral edema: dizzy, faint, lightheaded, ringing in the ears, racing pulse, feeling warm, sweating, nausea, vomiting, yawning, itching and severe muscle cramps (anywhere on the body). It is due to a shift of water to the intracellular spaces as a result of the loss of urea. F. With peritoneal dialysis, the child can ambulate and interact with the environment. G. Hemodialysis usually is done 3 days a week and takes 3 to 5 hours a day. H. With peritoneal dialysis, the fluid remains in the peritoneal cavity for 4 to 8 hours.
B. Hemodialysis uses a man-made membrane (dialyzer) to filter wastes and remove extra fluid from the blood. D. Peritoneal dialysis uses the lining of the abdominal cavity (peritoneal membrane) and a solution (dialysate) to remove wastes and extra fluid from the body. E.With hemodialysis, disequilibrium syndrome can occur. Disequilibrium syndrome of dialysis has essentially the same symptoms as cerebral edema: dizzy, faint, lightheaded, ringing in the ears, racing pulse, feeling warm, sweating, nausea, vomiting, yawning, itching and severe muscle cramps (anywhere on the body). It is due to a shift of water to the intracellular spaces as a result of the loss of urea. F. With peritoneal dialysis, the child can ambulate and interact with the environment. G. Hemodialysis usually is done 3 days a week and takes 3 to 5 hours a day. H. With peritoneal dialysis, the fluid remains in the peritoneal cavity for 4 to 8 hours.
A child who has nephrotic syndrome is admitted to the pediatric unit. Which of the following should the nurse expect to find? (Select all that apply.) A. Decreased urine specific gravity B. Proteinuria C. Hypoalbuminemia D. Hyperlipidemia E. Hematuria
B. Proteinuria C. Hypoalbuminemia D. Hyperlipidemia
Match the structural genitourinary disorders with their definitions. Each item is used only once. Urethral meatus located on the ventral (lower) side of the glans penis Urethral meatus located on the dorsal (upper) side of the glans penis Narrowing of the preputial opening of the foreskin that prevents retraction of the foreskin over the glans penis Protrusion of bladder through lower abdominal wall Failure of one or both testicles to descend into the scrotum A fibrous band on the ventral side of the penis resulting in a ventral curvature of the penis Collection of fluid in the scrotal sac A. Bladder exstrophy B. Hypospadias C. Phimosis D. Hydrocele E. Cryptorchidism F. Chordee G. Epispadias
B. Urethral meatus located on the ventral (lower) side of the glans penis G. Urethral meatus located on the dorsal (upper) side of the glans penis C. Narrowing of the preputial opening of the foreskin that prevents retraction of the foreskin over the glans penis A. Protrusion of bladder through lower abdominal wall E. Failure of one or both testicles to descend into the scrotum F. A fibrous band on the ventral side of the penis resulting in a ventral curvature of the penis D. Collection of fluid in the scrotal sac
A nurse is assisting with the admission of a toddler who has nephrotic syndrome. Which of the following objective data should the nurse anticipate collecting from the child? A. Elevated blood pressure. B. Serum cholesterol and fat levels are lower than normal. C. 3+ to 4+ protein in the urine. D. Arms and legs appear thin with loose skin.
C. 3+ to 4+ protein in the urine.
A nurse if reviewing a patient's chart and notices that the child suffers from a urinary tract infection. Which of the following microorganisms is related to this condition? A. Clostridium botulinum B. Corynebacterium diphtheriae C. Escherichia coli D. Helicobacter pylori
C. Escherichia coli
Discharge instructions for care of a child who has just had an orchiopexy should include A. Information to the parents about the child's resuming normal vigorous activities. B. Discussion with the parents about the low incidence of testicular malignancy and no further need for any follow-up. C. Explanation to the parents about the need for loose, nonrestrictive clothing. D. Reassurance to the parents that infertility is not a future risk.
C. Explanation to the parents about the need for loose, nonrestrictive clothing.
An adolescent with a history of surgical repair for undescended testes (cryptorchidism) comes to the clinic for a sports physical. Anticipatory guidance for the parents and adolescent would focus on which of the following as most important? A. The adolescent sterility B. The adolescent future plans C. Technique for monthly testicular self-examinations D. Need for psychosocial support
C. Technique for monthly testicular self-examinations
The client in end-stage of renal failure had undergone kidney transplant. Which of the following assessment findings indicate kidney transplant rejection? A. increased urinary output, BUN = 15 mg/dL B. HCT = 50%, Hgb = 17 g/dl C. decreased urinary output, sudden weight gain D. decreased urinary output, sudden weight loss
C. decreased urinary output, sudden weight gain
A nurse enters the room of a teenager after the physician has obtained informed consent for a voiding cystourethrogram. The teenager asks the nurse to explain the procedure again. The nurse tells the client that the client is asked to void after: A. injection of a radioisotope into the bloodstream B. injection of contrast dye into the bloodstream C. injection of contrast dye into the bladder via a catheter D. injection of a radioisotope into the bladder via catheter
C. injection of contrast dye into the bladder via a catheter
A school-aged client admitted to the hospital because of decreased urine output and periorbital edema is diagnosed with glomerulonephritis. Which of the following interventions should receive the highest priority? A. assessing vital signs every four hours B. monitoring intake and output every 12 hours C. obtaining daily weight measurements D. obtaining serum electrolyte levels daily
C. obtaining daily weight measurements
A nurse is caring for a 4-year-old child who is being seen for the second time with a UTI. The child is to return to the office in 1 week for follow-up and is scheduled for a voiding cystourethrogram (VCUG) in 2 weeks. The purpose of the VCUG is as follows: The VCUG checks for problems of the urethra and bladder, specifically problems with bladder emptying. Having two UTIs in such a short time is unusual for an infant; therefore, it is important to find out the cause of the infection. The VCUG will be scheduled after eradication of the UTI. True or False?
True
