Peds gen
A 10-year-old child diagnosed with acute glomerulonephritis is admitted to the pediatric unit. The nurse should ensure that which action is a part of the child's care? A-taking vital signs every 4 hours and obtaining daily weight B-obtaining a blood sample for electrolyte analysis every morning C-checking every urine specimen for protein and specific gravity D-ensuring that the child has accurate intake and output and eats a high-protein diet
A
A child, age 4, with a recent history of nausea, vomiting, and diarrhea is admitted to the pediatric unit with a diagnosis of gastroenteritis. During the physical examination, the nurse detects tenting. This finding supports a nursing diagnosis of A-deficient fluid volume related to dehydration. B-risk for injury related to capillary fragility. C-ineffective peripheral tissue perfusion related to peripheral cyanosis. D-activity intolerance related to hypoxia.
A
A child, age 5, is diagnosed with chronic renal failure. When teaching the parents about diet therapy, the nurse should instruct them to restrict which foods from the child's diet? A-meats B-carbohydrates C-fats D-dairy products
A
A client is admitted to the facility with nephrotic syndrome. The nurse carefully monitors the client's fluid intake and output and checks urine specimens regularly with a reagent strip. Which finding is the nurse most likely to see? A-proteinuria B-glycosuria C-ketonuria D-polyuria
A
A client was treated for a streptococcal throat infection 2 weeks ago. The client now has been diagnosed with acute poststreptococcal glomerulonephritis. The client asks the nurse how he could have prevented this condition. What should the nurse tell the client? A-"See your health care provider (HCP) for an early diagnosis and treatment of a sore throat." B-As long as you don't have a fever, it's sufficient to gargle daily with an antibacterial mouthwash." C- "You may continue to utilize the previously prescribed antibiotics until they're gone." D-"Unscented bar soap may be used in showers."
A
A nurse is providing health teaching to a group of adolescent girls. The focus is on urinary tract infections. One of the girls tells the nurse that she wants to know more about cystitis. Which statement by the nurse is the most appropriate response? A-"This condition can result from irritation and inflammation from sexual activity." B-"This is a serious condition that occurs after intercourse or vaginal cleanses." C-"This condition happens frequently in young women and is not harmful." D-"This is a minor bacterial infection of the bladder that can occur at anytime."
A
A recent history of which problem should alert the nurse to gather additional information about the possibility of a urinary tract infection in a toddler who is exhibiting fever and fussiness? A-abdominal pain B-swollen lymph glands C-skin rash D-back pain
A
The nurse determines that interventions for decreasing fluid retention have been effective when the nurse makes which assessment in a child with nephrotic syndrome? A-decreased abdominal girth B-increased caloric intake C-increased respiratory rate D-decreased heart rate
A
The nurse is administering a high dose of furosemide to a client with nephrotic syndrome. What potential complication is the nurse most concerned with for the client? A-electrolyte imbalance B-visual disturbances C-altered level of consciousness D-increased urination
A
The nurse is caring for a 3-year-old child with acute kidney injury. Which laboratory finding should the nurse immediately report to the healthcare provider? A-potassium level of 6.5 mEq/L (6.5 mmol/L) B-creatinine 2.5 mg/dL (221 umol/L) C-sodium 130 mEq/L (130 mmol/L) D-blood urea nitrogen (BUN) 40 mg/dL (urea 14.3 mmol/L)
A
The nurse is planning interventions for a school-aged child hospitalized with acute poststreptococcal glomerulonephritis in need of diversional activity. Which activity should the nurse expect to include? A-playing a card game with someone the same age B-putting together a puzzle with mother C-playing video games with a 4-year-old D-watching a movie with a younger brother
A
To prevent recurrence of cystitis, the nurse should plan to encourage the female client to include which measure in her daily routine? A-wearing cotton underpants B-increasing citrus juice intake C-douching regularly with 0.25% acetic acid D-using vaginal sprays
A
When the nurse is assessing an infant with suspected inguinal hernia, which finding would be most concerning? A-The inguinal swelling is reddened, and the abdomen is distended. B- The infant is irritable, and a thickened spermatic cord is palpable. C- The inguinal swelling can be reduced, and the infant has a stool in the diaper. D-The infant's diaper is wet with urine, and the abdomen is nontender.
A
Which is a risk factor for testicular cancer? A-undescended testes B-sexual relations at an early age C-seminal vesiculitis D-epididymitis
A
The nurse is asked to assess urine output for a client. Which statements would be expected outcomes of adequate output? Select all that apply. A-Daily early morning weight helps to identify retention of fluids. B-If the client perspires from a fever, there will be increased urine output. C-The presence of pitting edema will determine dehydration status. D- Urine output is increased with diuretic administration. E-Skin is warm and dry to touch with appropriate color.
A D
An adolescent client has been diagnosed with acute glomerulonephritis and has been in the hospital for 1 day. Which finding requires immediate action? A-large amount periorbital edema B-urine specific gravity of 1.030 C-large amounts of red blood cells in the urine D-24-hour output of 1,000 mL
B
The nurse is performing a newborn assessment on a neonate in the childbirth suite. The nurse notes epispadias. Which documentation of the defect would the nurse note? A- tip of penis B-top side of penis C- Under side of penis
B
The toddler with nephrotic syndrome responds to treatment and is ready to go home. When helping the family plan for home care, the nurse should include which instruction in the teaching? A-Administer pain medication as needed. B-Keep the child away from others with an infection. C-Notify the health care provider (HCP) if there is an increase in the child's urine output. D-Administer acetaminophen daily.
B
What is the most important intervention for the nurse to include in the care plan for a male infant following surgical repair of hypospadias? A-sterile dressing changes every 4 hours B-frequent assessment of the tip of the penis C-removal of the suprapubic catheter on the second postoperative day D-urethral catheterization if voiding doesn't occur over an 8-hour period
B
Which diet plan would be appropriate for the nurse to discuss with the family of a child with acute renal failure? A-high carbohydrate and protein B-high fat and carbohydrate C-low fat and protein D-low in carbohydrate and fat
B
The nurse is assessing a client's data with primary glomerular disease. Which assessment data will the nurse expect to verify progression to nephrotic syndrome? Select all that apply. A-hypotension B-proteinuria C-diffuse edema D-low serum cholesterol E-hypoalbuminemia
B C E
The nurse is caring for an infant newly admitted with a diagnosis of exstrophy of the bladder. Which interventions are most appropriate? Select all that apply. A-Gather supplies in anticipation of Foley catheter insertion. B-Implement a latex-free environment for the infant. C-Maintain the infant in a prone position. D-Cover the defect with a non-adherent dressing. E-Place the infant in a thermo-controlled environment. F-Place a diaper snugly over the genitalia to ensure accurate output monitoring.
B D E
A client who has a history of an inguinal hernia is admitted to the hospital with sudden, severe abdominal pain, vomiting, and abdominal distention. The nurse should assess the client further for which complication? A-peritonitis B-incarcerated hernia C-strangulated hernia D-intestinal perforation
C
A nurse notices that a newborn has a swelling in the scrotal area. The nurse interprets this swelling as indicative of hydrocele if what else occurs? A-The swollen bulge can be reduced. B-The increase in scrotal size is bilateral. C-The scrotal sac can be transilluminated. D-The bulge appears during crying.
C
A school-age client admitted to the hospital because of decreased urine output and periorbital edema is diagnosed with acute poststreptococcal glomerulonephritis. Which assessment gives the nurse the best indication of the child's fluid balance? A-Assess vital signs every 4 hours. B-Monitor intake and output every 12 hours. C-Obtain daily weight measurements. D-Draw serum electrolyte levels daily.
C
The nurse develops a teaching plan for the client about how to prevent the transmission of hepatitis A. Which discharge instruction is appropriate for the client? A-Spray the house to eliminate infected insects. B-Tell family members to try to stay away from the client. C-Ask family members to wash their hands frequently. D-Disinfect all clothing and eating utensils.
C
Two weeks after being diagnosed with a streptococcal infection, a client develops fatigue, a low-grade fever, and shortness of breath. The nurse auscultates bilateral crackles and observes jugular vein distention. Urinalysis reveals red and white blood cells and protein. After the physician diagnoses poststreptococcal glomerulonephritis, the client is admitted to the medical-surgical unit. Which immediate action should the nurse take? A-Encourage activity as tolerated. B-Provide a high-protein, fluid-monitored diet. C-Monitor patient blood pressure. D-Place the client on a sheepskin, and monitor for increasing edema.
C
When assessing an infant with an undescended testis, the nurse should be alert for which symptom? A-abnormal lower extremity reflexes B-a history of frequent emesis C-a bulging in the inguinal area D-poor weight gain
C
A nurse is caring for a 4-year-old child who developed acute renal failure after a traumatic injury with hemorrhaging. Place the following events in the order in which they most likely occurred during progression of the severe renal deterioration. All options must be used. A. azotemia B. severe hypocalcemia C. oliguria D. acidosis
C A D B
The nurse is providing discharge information to the parents of a child who has had surgical repair of hypospadias. Which instructions would be most appropriate? Select all that apply. A-care of the circumcision B-techniques for providing tub baths C-care for the indwelling catheter or stent D-encouraging the child to void every 2 hours E-avoiding toys that the child will ride by straddling
C E
A client with chronic kidney disease (CKD) has a blood urea nitrogen (BUN) of 100 mg/dL, serum creatinine of 6.5 mg/dL, potassium of 6.1 mEq/L, and lethargy. What is the priority nursing assessment? A-blood pressure B-arterial blood gases C-weight changes D-cardiac rhythm
D
A graduate nurse is asking for information about chronic renal failure. Which statement by the nurse would be most accurate when providing teaching? A-"It is most commonly caused by recurrent pyelonephritis." B-"It results in an increase in erythropoietin, leading to chronic anemia and fatigue." C-"It results in an inability of the kidneys to convert waste products to creatinine and blood urea nitrogen." D-"It is characterized by azotemia, fluid volume excess, and hyperkalemia."
D
A nurse is approached by the mother of a child with hypospadias. She says to the nurse, "Why did this have to happen to my baby? Why couldn't he be perfect? How could this have happened?" What should the nurse say in response? A-"I'm sure you are upset about what happened to your baby." B-"Don't worry. The problem is easily corrected." C- "I'll ask the healthcare provider to explain to you how this defect occurs." D- "You seem upset. Tell me about it."
D
A nurse is providing in-home management instructions to the parents of a child who is receiving desmopressin acetate (DDAVP). What is the most important instruction for the nurse to include? A-Give DDAVP only when urine output begins to decrease. B-Cleanse skin with alcohol before application of the DDAVP dermal patch. C-Increase the DDAVP dose if polyuria occurs just before the next scheduled dose. D-Call the healthcare provider if the child has an upper respiratory infection or allergic rhinitis.
D
A toddler diagnosed with nephrotic syndrome has a fluid volume excess related to fluid accumulation in the tissues. Which measure should the nurse anticipate including in the child's plan of care? A-Limit visitors to 2 to 3 hours a day. B-Maintain strict bed rest. C-Test urine specific gravity every shift. D-Weigh the child before breakfast.
D
The client asks the nurse, "How did I get this urinary tract infection?" What should the nurse tell the client causes cystitis? A-congenital strictures in the urethra B-an infection elsewhere in the body C-urinary stasis in the urinary bladder D-an ascending infection from the urethra
D
While assessing a male neonate whose mother desires him to be circumcised, the nurse observes that the neonate's urinary meatus appears to be located on the ventral surface of the penis. The nurse notifies the healthcare provider because the nurse suspects which disorder? A-phimosis B-hydrocele C-epispadias D-hypospadias
D