GU - 24
The nurse is collecting data on a child recently diagnosed with acute glomerulonephritis. Which clinical manifestation was likely noted in this child? a. hypotension b. decreased specific gravity c. bloody urine d. increased nocturia
c
A nurse is providing care to a child with chronic kidney disease. The child is classified as having stage II disease. Which of the following would the nurse most likely include in the child's plan of care? Select all that apply. a. Administering erythropoietin alfa subcutaneously b. Ensuring intake of a low potassium diet c. Administering phosphate binders d. Preparing the child for renal replacement therapy e. Administering daily subcutaneous injections of growth hormone
a, b
After teaching a group of nursing students about treatment for urinary tract infection, the instructor determines that the teaching was successful when the students identify which of the following as being used as treatment? Select all that apply. a. Trimethoprim-sulfamethoxazole b. Nitrofurantoin c. Cephalosporins d. Tetracyclines e. Penicillins
a, b, c, e
The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician? a. dialysate without fibrin or cloudiness b. presence of a thrill c. absence of a thrill d. presence of a bruit
c
The nurse is discussing urinary tract infections (UTI's) in children with a group of peers. Which fact is the most accurate regarding urinary tract infection seen in children? a. Urinary tract infections are rarely seen after toilet training. b. Males between the ages of 10 to 12 years of age commonly get UTIs. c. The most common age for UTIs in children is 2 to 6 years of age. d. Girls who have gone through puberty most commonly get UTIs.
c
The nurse is doing an in-service training with a group of peers on the topic of the genitourinary system. Which function is a major task of the kidneys? a. produce white blood cells b. remove carbon dioxide c. circulate cerebrospinal fluid d. regulate blood pressure
d
The health care provider has prescribed a 24-hour urine specimen on a 15-year-old client. Review the steps below and place them in the correct order. Use all options. a. collect urine in a chilled container b. begin the testing time period c. Provide education to the client about the prescribed diagnostic test d. End the test at the 24-hour mark e. Document to time of the client's next voiding time f. confirm the client's identity
f, c, e, b, a, d
Urinary tract infections are usually successfully treated by what means? a. Administering antibiotics b. Performing bladder irrigations c. Administering diuretics d. Increasing fluids, such as cranberry juice
a
When assessing the infant for cryptorchidism, the nurse would be prepared for which of the following? a. A bulge in the inguinal area b. Failure to gain weight c. Vomiting d. Thickening of the scrotal sac
a
A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate? a. Creatinine clearance rate b. Computed tomography scan c. Urinalysis d. Kidneys, ureter, and bladder x-ray
a
A client has just been admitted to the unit with a history of recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would suspect which condition? a. acute glomerulonephritis b. urinary tract infection c. prune belly syndrome d. renal failure
a
The nurse is collecting data for a child diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's history? a. The child recently had an ear infection. b. The child had a congenital heart defect. c. The child has a sibling with the same diagnosis. d. The child is being treated for asthma.
a
The nurse is collecting data on a 6-year-old child admitted with a possible urinary tract infection. Which vital sign might indicate the possibility of an infection? a. Pulse rate 135 bpm b. Respirations 22 per minute c. Blood Pressure 100/70 d. Pulse oximetry 93% on room air
a
The nurse is reinforcing teaching with the caregiver of 5-year-old twins regarding urinary tract infections (UTIs). 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 statement 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. "It is unlikely that your daughter is practicing good cleaning habits after she voids." c. "Girls tend to urinate less frequently than boys, making them more susceptible to UTI's." d. "Girls need more vitamin C than boys to keep their urinary tract healthy, so your daughter may be deficient in vitamin C."
a
Which of these laboratory results would be most important for the nurse to assess in a child who has a diagnosis of urinary tract infection? a. urinalysis b. chemical reagent strip c. specific gravity d. blood urea nitrogen (BUN)
a
A child in renal failure is prescribed aluminum hydroxide gel. The parents ask how the medication is going to help their child. Which answer is most accurate? a. The medication prevents gastrointestinal ulceration. b. The medication assists with the absorption of calcium. c. The medication reduces the absorption of phosphorus from the GI tract. d. The medication enables the elimination of potassium.
c
A 4-year-old boy with nephrotic syndrome has extensive edema. The best intervention to reduce periorbital edema would be to: a. encourage him to eat low-protein foods. b. elevate the head of the bed. c. apply cool, sterile soaks to his head. d. apply warm compresses to his eyes at bedtime.
b
A teacher sends a child to see the school nurse for irritability and bruising. Which symptom would be indicative of hemolytic uremic syndrome? a. Weight gain and high fever b. Oliguria and jaundice c. Polyuria and diarrhea d. Dysuria and lethargy
b
A nursing instructor is teaching a group of nursing students about dialysis. The instructor determines that the teaching was successful when the students identify which of the following as being associated with peritoneal dialysis when compared to hemodialysis? a. There are strict diet and fluid restrictions. b. The child must go into a facility to get peritoneal dialysis. c. The child can live a more normal lifestyle. d. Therapy occurs only 3 to 4 days per week.
c
Most urinary tract infections seen in children are caused by: a. dietary insufficiencies. b. hereditary causes. c. intestinal bacteria. d. fungal infections.
c
A child is scheduled to undergo a voiding cystourethrogram (VCUG). When teaching the parents about this procedure, which information would the nurse include? a. The test will identify if kidney stones are present. b. The test will help to rule out vesicoureteral reflux (VUR). c. The test will detect if the infection is gone. d. The test will prevent further complications of the urinary tract infection.
b
The location of the kidneys in the child in relationship to the location of the kidneys in the adult makes which fact 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 adult has a greater chance of retaining fluids than the child. d. The child has more frequent urges to empty the bladder.
b
The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder? a. hypothermia b. hypotension c. hypertension d. tachycardia
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 1-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 what possible explanation for the bedwetting? 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
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 foods for the party. Which of these foods would the nurse suggest is appropriate for this child's diet? a. popcorn b. potato chips c. orange soda d. banana splits
d
The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is: a. placing an indwelling urinary catheter. b. placing a cotton ball in the underwear to catch urine. c. performing a suprapubic aspiration. d. obtaining a clean catch voided urine.
d
The mother of a child brings the child in for an evaluation because "she is urinating all of the time." A child is having her urine checked. When reviewing the results, the nurse notes that the urine is positive for glucose. The nurse interprets as which of the following? a. This indicates renal disease. b. This may indicate a urinary tract infection. c. This determines the presence of bacteria in the urine. d. This may suggest diabetes mellitus.
d
The nurse is teaching an in-service program to a group of colleagues on the topic of children diagnosed with acute glomerulonephritis. In which age range is the peak incidence of this disorder noted? a. 15 to 17 years of age b. 2 to 4 years of age c. 12 to 13 years of age d. 6 to 7 years of age
d
The nurse knows that which statement is a description of peritoneal dialysis when compared to hemodialysis: a. The child must go into a facility to get peritoneal dialysis. b. Therapy is only 3 to 4 days per week. c. There are strict diet and fluid restrictions. d. The child can live a more normal lifestyle.
d
The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis? a. Blood pressure 136/84 b. Respirations 24 per minute c. Pulse oximetry 93% on room air d. Pulse rate 112 bpm
a
A newborn is diagnosed with hypospadias and the parents want him to be circumcised. Which response by the nurse would be most appropriate? a. "Circumcision now would increase the risk that your son will develop renal failure." b. "It's important to have your son see by a urologist because the foreskin is needed for repair." c. "Circumcision in a child with your son's condition is not possible because the urethral opening is narrow." . d. "Your son will have to wait until he is about a year old before the circumcision can be done." .
b
The mother of a child diagnosed with pyelonephritis asks if the kidneys were damaged because of this. Which of the following responses would be most appropriate? a. "Yes, all children who get pyelonephritis have renal scarring." b. "The child's risk for renal scarring is increased with pyelonephritis." c. "No, if the child is urinating normally, the kidneys were not damaged." d."As long as IV antibiotics are started, there is no risk of renal damage."
b
The nurse determines that interventions for a voiding disorder have been effective when the family of a child with enuresis demonstrates evidence of which of the following? a. Parents take the child for surgery. b. Parents/family use positive coping mechanisms in response to the child and the voiding disorder. c. Parents administer medications for enuresis. d. Parents/family accept the child and the voiding disorder.
b
The nurse is caring for a 1-year-old patient with nephritis who is receiving intravenous (IV) antibiotic therapy. Which of the following would be most important for the nurse to document for this infant? a. The end time of the infusion on the MAR b. The amount of solution infused on the I&O record c. The infusion length of time on the MAR d. The method of infusion used (piggy back, infusion pump) on the MAR
b
The nurse is collecting data on a school-aged child with the following symptoms: Abrupt beginning to urinary symptoms Gross hematuria VS: 99 (F), 37.2 (C), 92, 22, 142/92 Mild edema Which disease condition does the nurse anticipate? a. Wilms tumor b. Acute glomerulonephritis c. Nephrotic syndrome d. Urinary tract infection
b
Which child has the highest risk of urinary tract infection? a. A 15-month-old male who has been circumcised b. An 18-year-old female who is sexually active c. A 3-year-old female who is not potty trained d. A 2-year-old male who has not been circumcised
b
Which instructions should a nurse give to a client who has a history of urinary tract infections to prevent recurrence? Select all that apply. a. Limit bathing to once a week. b. Wipe from front to back. c. Finish all antibiotics prescribed. d. Use bubble bath to wash. e. Encourage fluids throughout the day.
b, c, e
A 16-year-old girl has had several cases of cystitis in the past year. Which of the following should the nurse suspect as the cause, based on this finding? a. wiping from front to back after voiding b. regular participation in a strenuous sport c. sexual activity d. frequent voiding
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 has 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℉ (37.8℃). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have: a. lipoid nephrosis (idiopathic nephrotic syndrome). b. a urinary tract infection. c. acute glomerulonephritis. d. rheumatic fever.
c
Which goal of therapy would be appropriate for a nurse to establish with a client's family and a client who has a diagnosis of enuresis? a. The parent takes the client to the bathroom at night. b. The client wets only when involved in an activity. c. The client remains continent throughout the night. d. The child wakes up once during the night for a glass of water.
c
The LPN is working with the RN to develop a plan of care for a child with nephrotic syndrome. Which of the following would be appropriate goals of treatment for this child? Select all that apply. a. restricting protein intake b. encouraging a high-salt diet c. preventing infection d. conserving energy e. promoting coping
c, d, e
The parent of 6-month-old girl is concerned about the child getting a urinary tract infection. What should the nurse mention to the parent regarding this concern? a. Wipe from back to front when changing the girl's diaper. b. Bathe the child with bubble bath once a week. c. Discontinue prescribed antibiotics once symptoms of UTI have disappeared. d. Report any abnormally colored urine to the child's primary care provider.
d
