CHAPTER 39

A 12-year-old girl who has not yet reached menarche comes to the pediatrician's office for her annual well-child check. As the nurse is weighing and measuring her, the child says emphatically that she does not want to get her period. Which of the following responses would be most appropriate for the nurse to make to this child? A) "What have you heard about it that makes you worried?" B) "But it's a good thing, having a period is a part of growing up." C) "Are you afraid of getting pregnant?" D) "Do you think it will hurt?"

A

16. The nurse is discussing urinary tract infections (UTI's) in children with a group of peers. Which of the following is the most accurate regarding urinary tract infection seen in children? A) Urinary tract infections are rarely seen after toilet training. B) The most common age for UTI's in children is 2 to 6 years of age. C) Males between the ages of 10 to 12 years of age commonly get UTI's. D) Girls who have gone through puberty most commonly get UTI's.

B

A single male caregiver of a 14-year-old girl accompanies his daughter to her pre-high school physical. In the course of discussion about how his daughter is developing, he remarks, "She's terrific most of the time. Of course when she gets her period, she's miserable and mean, but I tell her that's just what it's like to be a woman." Of the following statements, which would be the most appropriate response by the nurse? A) "PMS is a problem for a lot of women, but sometimes it's worse in the beginning. She might outgrow it." B) "There are nutritional and medical things she can do to lessen the symptoms; I'll give both of you information about some strategies and we'll track her for a few months." C) "That must be hard on you, especially because you are raising her by yourself." D) "That doesn't make being a woman sound very good. It would probably be easier for her if you could be more supportive."

B

A symptom often seen in acute glomerulonephritis is edema. The most common site the edema is first noted is in which area of the body? A) Ankles B) Hands C) Eyes D) Sacrum

C

The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is which of the following? A) Performing a suprapubic aspiration B) Placing a cotton ball in the underwear to catch urine C) Placing an indwelling urinary catherter D) Obtaining a clean catch voided urine

D

The nurse is caring for a child admitted with nephrotic syndrome. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis? A) Oliguria B) Amenorrhea C) Pyelonephritis D) Ascites

D

A child who has been diagnosed with minimal change nephrotic syndrome (MCNS) is being discharged after a 3-week hospitalization. Her edema has been greatly reduced and her appetite is beginning to return. Her caregivers have promised to have a family party to celebrate her return. The child has requested the following food for the party. Which of the following foods would the nurse suggest would be appropriate for the diet this child is on? A) Banana splits B) Popcorn C) Potato chips D) Orange soda

A

The nurse is caring for an 8-year-old hospitalized child with nephrotic syndrome. Which of the following nursing interventions would be appropriate for this child? A) Measure the abdominal girth daily. B) Weigh the child once a week. C) Test the urine for ketones twice a day D) Administer antipyretics as needed.

A

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) Pulse rate 135 bpm C) Respirations 22 per minute B) Pulse oximetry 93% on room air D) Blood Pressure 100/70

A

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) "A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily." B) "The position of the urethra in girls makes girls more susceptible than boys to UTI's." C) "Girls need more vitamin C than boys to keep their urinary tract healthy, so your daughter may be deficient in vitamin C." D) "It is unlikely that your daughter is practicing good cleaning habits after she voids."

A

The nurse is teaching a group of nursing students about acute glomerulonephritis genitourinary conditions. A student asks the about a condition that occurs when there is a decreased volume of urine output. The condition the student is referring to is which of the following? A) Oliguria B) Amenorrhea C) Pyelonephritis D) Ascites

A

An adolescent girl and her caregiver present at the pediatrician's office. The adolescent complains of severe abdominal pain. A diagnosis of pelvic inflammatory disease is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. The most appropriate action by the nurse would be to A) Contact the necessary authorities to report a suspected case of sexual abuse B) Take the child to a private room and interview her regarding her sexual history and partners C) Take the caregiver to a private room and tell her that the child's diagnosis can only come from sexual activity D) Talk to the child and caregiver together and explain that the condition is often a result of a sexually transmitted disease and discuss the importance of safe sex practices

B

The location of the kidneys in the child in relationship to the location of the kidneys in the adult makes which of the following a greater likelihood in the child? A) The adult has less fat to cushion the kidney B) The child has a greater risk for trauma to the kidney C) The child has more frequent urges to empty the bladder. D) The adult has a greater chance of retaining fluids than the child.

B

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) Loose, dark stools C) Strawberry red tongue B) Smoky colored urine D) Jaundiced skin

B

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. The nurse tells the caregiver that the most important reason the child needs increased fluids is for which of the following reasons? A) To fill the bladder so a specimen can be obtained. B) To dilute the urine and flush the bladder. C) To prevent the child from developing a fever. D) To decrease the pain of urination.

B

The nurse is caring for a child who is being evaluated for a possible nephroblastoma. Which of the following nursing interventions would be important for this child? The nurse should A) Monitor for protein in the urine at each voiding. B) Protect the child from having the abdomen palpated. C) Check blood pressure every 2 hours. D) Measure the child's intake and output every hour.

B

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of urinary tract infection. When interviewing the caregivers, which of the following questions would be most important for the nurse to ask? A) "Is your child potty trained?" B) "Has your child complained of pain?" C) "How often do you bathe your child?" D) "Do any of your other children have a temperature?"

B

The nurse is discussing genitourinary conditions with a group of 16-year-old girls. One of the girls says she has heard about girls who have stopped taking birth control pills and now don't have periods. The condition the girl is referring to is which of the following? A) Oliguria B) Amenorrhea C) Pyelonephritis D) Ascites

B

The nurse is doing an in-service training with a group of peers on the topic of the genitourinary system. Which of the following is a major function of the kidneys? A) Produce white blood cells C) Circulate cerebrospinal fluid B) Remove carbon dixoide D) Regulate blood pressure

B

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with acute glomerulonephritis. In which of the following age ranges is the peak incidence of this disorder noted? A) 2 to 4 years of age C) 12 to 13 years of age B) 6 to 7 years of age D) 15 to 17 years of age

B

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with nephrotic syndrome. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of nephrotic syndrome? A) "These children have such a big appetite and are always hungry." B) "The child may look chubby, but they really are malnourished." C) "When you look at the urine of these children it is smoky and bloody." D) "Their lab work shows a decreased level of cholesterol."

B

Urinary tract infections are usually successfully treated by which of the following? A) Increasing fluids, such as cranberry juice B) Administering antibiotics C) Performing bladder irrigations D) Administering diuretics

B

A group of nursing students is discussing terminology related to the genitourinary system during a post-conference setting. One of the students asks what mittelschmerz is or what it means. A classmate of this student correctly answers that mittelschmerz is which of the following? A) A symptom of premenstrual syndrome B) The beginning of menstruation C) A dull, aching abdominal pain at ovulation D) A medication given to treat dysmenorrhea

C

If the child follows a normal development process, the child's kidneys will most likely have reached their full size and function by which of the following ages? A) 5 years of age B) 8 years of age C) 12 years of age D) 17 years of age

C

If the newborn is following a normal development process, the child will most likely void when which of the following amounts of urine is in the bladder? A) 3 mL B) 6 mL C) 15 mL D) 25 mL

C

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

C

The caregiver of a 1-year-old son calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse most accurately clarifies the caregiver's question by making which of the following statements regarding the son's treatment? A) "Without the hormone your son will have fluid that will collect in his scrotum." B) "Without the treatment your child's gonads will not reach normal size." C) "The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place." D) "Your child's testes have not dropped, so the hormone is being administered to avoid causing degeneration until they do."

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) A urinary tract infection B) Lipoid nephrosis (idiopathic nephrotic syndrome) C) Acute glomerulonephritis D) Rheumatic fever

C

The health care provider orders Prenisolone 2 mg/kg/day to be given every 8 hours for a child diagnosed with nephrotic syndrome. The child weighs 42 lb. The medication is available in a solution of 3mg/mL. What is the amount per dosage in mL for this child? A) 1.2 mL B) 3.8 mL C) 4.2 mL D) 12.6 mL

C

The nurse is caring for a child admitted with a urinary tract infection. In addition to foul smelling urine, which of the following clinical manifestations would likely have been noted in the child with this diagnosis? A) Weight gain. B) Decreased urination C) Vomiting D) Increased appetite

C

The nurse is collecting data for a child diagnosed with acute glomerulonephritis. Which of the following would the nurse likely find in this child's history? A) The child has a sibling with the same diagnosis. B) The child had a congenital heart defect. C) The child recently had an ear infection. D) The child is being treated for asthma.

C

The nurse is doing a presentation for a group of nursing students about the topic of menstrual disorders. After discussing the disorder secondary amenorrhea the students make the following statements. Which statement made by the nursing students is the most accurate regarding the cause of secondary amenorrhea? A) "It is caused from taking birth control pills when a girl is younger than 13 years old." B) "This disorder is usually seen after a girl has had a spontaneous abortion." C) "Emotional stress can be a cause of this disorder." D) "This is what happens if a 16-year-old girl has never had any periods at all."

C

The nurse is teaching a group of nursing students about genitourinary conditions. The nurse tells these students about a condition that occurs when there is an inflammation of the kidney and renal pelvis. The condition the nurse is referring to is which of the following? A) Oliguria B) Amenorrhea C) Pyelonephritis D) Ascites

C

A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a one week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out which of the following? A) The child has a urinary tract infection due to not bathing while on the fishing trip B) The child is out of the habit of waking himself up during the night to void C) The child did not want to go on the fishing trip and is now retaliating against being made to go D) The child has been sexually abused, maybe on the fishing trip

D

The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which of the following vital signs would the nurse anticipate with this child's diagnosis? A) Pulse rate 112 bpm C) Respirations 24 per minute B) Pulse oximetry 93% on room air D) Blood Pressure 136/84

D

The nurse recognizes that which of the following would be a likely physiologic cause for a child to have enuresis? A) Regression to get attention C) Sexual abuse B) Stress and stressful situations D) Sleeping too soundly

D