Maternity Chap 29

Which physical assessment technique will the nurse omit when caring for a 2-year-old diagnosed with Wilms tumor? a. Performing range-of-motion exercises on lower extremities b. Palpating the abdomen c. Assessing for bowel sounds d. Percussing ankle and knee reflexes

b

A 6-year-old child with daytime enuresis complains of dysuria and urgency. What does the nurse recognize these signs and symptoms indicate? a. Urinary tract infection b. Nephrotic syndrome c. Acute glomerulonephritis d. Vesicoureteral reflux

a

A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. What is the most appropriate nursing intervention for this child? a. Providing activities for the child on restricted activity b. Feeding the child a protein-restricted diet c. Carefully handling edematous extremities d. Observing the child for evidence of hypotension

a

Parents are speaking with the urologist about their sons undescended testicle. Which statement by the childs father causes the nurse to determine he understands the information presented? a. An undescended testicle can reduce fertility. b. The testicle usually descends spontaneously during the first month of life. c. Surgical correction reduces the risk for testicular tumors. d. The optimal time to surgically correct the condition is at diagnosis.

a

What is it important to assess in a child receiving prednisone to treat nephrotic syndrome? a. Infection b. Urinary retention c. Easy bruising d. Hypoglycemia

a

What will the nurse caution the parents of a child who has had a nephrectomy that he will have to avoid? a. Contact sports b. Horseback riding c. Alcohol d. Diuretic medications

a

A 7-year-old child has a BUN of 25 mg/dL. What is the nurse aware this lab value might indicate? (Select all that apply.) a. Dehydration b. Renal disease c. Need for steroid therapy d. Diabetes e. Pituitary malfunction

a, b, c

The nurse is aware that genitourinary surgery is especially stressful for preschool children. What factor(s) lend to this stress? (Select all that apply.) a. They may perceive the treatment as punishment. b. They are especially prone to separation anxiety. c. They are sexually curious and developmentally fixated on their genitals. d. They have a fear of castration. e. They fear death

a, b, c, d

The nurse caring for a child with nephrotic syndrome is alert to which classic symptoms of this disorder? (Select all that apply.) a. Proteinuria b. Grossly bloody urine c. Hyperalbuminemia d. Fatigue e. Generalized edema

a, b, d, e

What special considerations are related to long-term prednisone therapy in preschoolers? (Select all that apply.) a. Delayed immunization b. Hypertension c. Enlargement of the sex organs d. Alteration in nutrition e. Increased risk for infection

a, e

What is an appropriate intervention for the edematous child with reduced mobility related to nephrotic syndrome? a. Reach the child to minimize body movements. b. Change the childs position frequently. c. Keep the head of the childs bed flat. d. Keep edematous areas moist and covered.

b

What is an initial sign of nephrosis that the nurse might note in a child? a. Raspberry-like rash b. Periorbital edema c. Temperature elevation d. Abdominal pain

b

When asked about correcting the hypospadias of a newborn, what does the nurse explain about this condition? a. No intervention is necessary as the defect will correct itself over time. b. Surgical repair of the hypospadias is done before 18 months of age. c. Corrective surgery is usually delayed until the preschool age. d. Repairing the defect will increase the risk of testicular cancer

b

Which urinary diversion procedure is the least damaging to the body image of the adolescent? a. Urostomy b. Ileal conduit c. Nephrostomy d. Suprapubic placement

b

What will the nurse caring for a newborn with exstrophy of the bladder include in the care? (Select all that apply.) a. Diaper infant tightly. b. Protect skin around bladder. c. Position infant on back. d. Prepare for surgical closure. e. Cover exposed bladder with shield

b, c, d, e

A parent tells the nurse that her child is scheduled for an x-ray of the bladder and urethra that is done while the child is urinating. What is this test known as? a. Cystometrogram b. Cystoscopy c. Voiding cystourethrogram d. Intravenous pyelogram

c

An adolescent male is admitted to the ED with severe acute scrotal pain. When documenting medical history the nurse notes cryptorchidism at birth. What diagnosis does the nurse expect? a. Urinary tract infection b. Nephrosis c. Torsion d. Phimosis

c

During a physical assessment of a hospitalized 5-year-old, the nurse notes that the foreskin has been retracted and is very tight on the shaft of the penis; the nurse is unable to return it over the head of the penis. What action should the nurse implement? a. Forcibly push the foreskin down over the head of the penis. b. Place a warm compress on the penis. c. Notify the charge nurse. d. Wait a few hours and try again.

c

The 6-year-old scheduled for an orchiopexy shyly asks the nurse, What are they going to do to me down there? What is the nurses best response? a. They are going to fix you up down there. b. They will move your testicle from your abdomen to your scrotum. c. What do you think your doctor is going to do? d. You shouldnt worry. Your doctor knows exactly what to do.

c

The nurse discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching? a. My daughter should wash and wipe the perineal area from front to back. b. I am only going to have my daughter wear cotton underwear. c. It is acceptable to take frequent bubble baths. d. She needs to drink lots of fluids and void frequently.

c

The nurse is explaining to a 17-year-old female the actions to prevent urinary tract infection. Which is the best beverage for the nurse to recommend to keep urine acidic? a. Milk b. Grape juice c. Apple juice d. Orange juice

c

The parents of a newborn are concerned that their sons scrotum is enlarged and swollen on one side. What is the nurses best response? a. It is very common in the newborn that one gonad is larger than the other. b. Birth trauma caused bruising to the scrotum. It will reduce in size in a few days. c. It is a collection of fluid that will most likely correct itself in a year. d. The doctor will drain this collection of blood before your baby is discharged.

c

Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching? a. I will make sure he gets his measles vaccine as soon as he gets home. b. He can stop taking his medication next week. c. I should check his urine for protein when he goes to the bathroom. d. He should eat a low-protein diet for the next few weeks.

c

A 5-year-old boy is admitted to the hospital with acute glomerulonephritis. In taking the childs history, what does the nurse recognize as the probable cause? a. Recovery from German measles 2 months ago b. Dysuria since the previous night c. A history of allergy d. A sore throat 2 weeks ago

d

Diuresis has not occurred on a child with nephrotic syndrome after a month on corticosteroids. What protocol can the nurse encourage to bring about diuresis? a. Ibuprofen, an anti-inflammatory agent b. Furosemide (Lasix), a diuretic c. Ciprofloxacin (Cipro), an antibiotic d. Cyclophosphamide (Cytoxan), an antisuppressant

d

The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. What does the nurse clarify about receiving immunizations while on prednisone? a. Can interfere with the treatment for nephrosis b. Require that the child have antibiotic coverage c. Can be given in smaller, divided doses d. Should be delayed

d

The nurse is providing information to parents of a child born with bilateral cryptorchidism. What information is accurate to include? a. This is the most common form. b. Fertility will be unaffected. c. Surgical intervention is not recommended. d. An inguinal hernia may be present.

d

What foods does the nurse recommend the child with acute glomerulonephritis avoid to prevent hyperkalemia? a. Dairy products b. Whole-grain cereals c. Organ meats d. Bananas

d