PN108 PrepU Chapter 39

A home health care nurse is providing follow up care to a child with nephrotic syndrome. Which of the following would the nurse include as part of the child's plan of care?

The need to withhold immunizations if the child is on steroids.

A child has a Tenckhoff catheter in place. Which of the following would be most important to include in the child's plan of care?

The nurse administering dialysis should perform a dressing change once per week initially.

While presenting a panel discussion to a group of parents about urinary tract infections (UTIs) in children, one of the parents asks the nurse, "Why would my daughter be more at risk than my son?" Which response by the nurse would be most accurate?

"A girl's urethra is closer to the rectal opening."

A concerned mother brings her 3-year-old to the primary care office because of nighttime voiding. Which response made by the nurse is best?

"Children are not expected to stay dry through the night until the age of 5."

After teaching nursing students about menstrual disorders in children and adolescents, the nursing instructor determines that the teaching was successful when the students state which of the following about dysmenorrhea?

"It is considered organic or primary if there is no underlying disease."

The nurse is caring for a 4-year-old with a suspected urinary tract infection. What would be most appropriate to say to the child when obtaining a urine specimen from him?

"Let your mom help you tinkle in this cup."

You care for a 6-year-old boy with acute glomerulonephritis. When planning care for him, you should be aware that glomerulonephritis usually follows an infection of what organism?

A beta-hemolytic streptococcus

The nurse is conducting a presentation for a group of nurses who work with adolescents. The group of nurses discusses dysmenorrhea. Which statement is most accurate related to dysmenorrhea?

A contributing factor in dysmenorrhea is the increased secretion of prostaglandins.

The nurse is caring for a 12-year-old girl with nephrotic syndrome. The girl confides that she feels like a "freak" compared to her peers because of her weight, edema, and moon face. Which response by the nurse would be most appropriate?

"Let's put you in touch with some other girls who are also having the same body changes."

After teaching the parents of a child with a hydrocele about this condition, which statement indicates that the teaching was successful?

"This condition should gradually go away on its own."

To determine if ascites is increasing in amount in a child with nephrotic syndrome, which measurements would be most appropriate?

Abdominal circumference

The nurse is assessing a child with acute poststreptococcal glomerulonephritis. What would the nurse expect to assess? Select all that apply.

Abdominal pain Hypertension Crackles

A nurse is interviewing an adolescent girl about her menstrual history. The girl asks the nurse what she can use to relieve pain during her periods. Upon further questioning, the adolescent reports bloating and light cramping about a day before menses and then sharp and also nagging pain across the lower abdomen during her period. Which of the following would be most appropriate for the nurse to suggest? Select all that apply.

Aspirin Ibuprofen Naproxen

A nurse identifies a nursing diagnosis of impaired urinary elimination related to urinary tract infection. When developing the plan of care, what would be most important for the nurse to do first?

Assess usual voiding patterns.

A parent asks if her 1-year-old son's testicles will descend on their own without surgery? What is the best response by the nurse?

At 1 year old, it is highly unlikely they would descend on their own.

A parent asks if her 9-month-old son's testicles will descend on their own without surgery? What is the best response by the nurse?

At 9 months of age, it is highly unlikely they would descend on their own.

The nurse is collecting data on a child recently diagnosed with acute glomerulonephritis. Which of the following clinical manifestations was likely noted in this child?

Bloody urine

The nurse is preparing a teaching plan for the parents of a child with a urinary tract infection (UTI). What would the nurse encourage the parents to avoid?

Caffeine

The nurse is teaching the caregiver of a 5-year-old child diagnosed with nephrotic syndrome regarding the no-added-salt diet the child has been placed on. In addition to not adding salt to foods, the nurse has discussed with the caregiver that helping the child avoid foods high in sodium is also recommended. The caregiver marks the following foods on the child's menu selection for the next day. The nurse recognizes the caregiver needs further teaching when which of the following foods high in sodium was selected? Select all that apply.

Cheddar cheese omelet Blueberry muffin Hot dog in bun

The condition in which one or both of the testes does not descend in the male infant is referred to as:

Cryptorchidism

The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. What would the nurse least likely expect to find?

Decreased blood urea nitrogen (BUN)

A 15-year-old girl has been experiencing dysmenorrhea for the past year. Over the past 6 months, she has been taking ibuprofen and oral contraceptives, with no improvement. What underlying condition should be assessed for in this client at this point?

Endometriosis

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause?

Escherichia coli

The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child?

Eyes

An infant is diagnosed with a urinary tract infection. What would the nurse expect on assessment?

Failure to thrive

The child with nephrotic syndrome who has ascites and difficulty breathing is probably most comfortable sleeping in which position?

Fowler's

A home health nurse is providing follow-up care to a child with nephrotic syndrome. What would be included in the care of this child?

Immunizations may need to be held if the child is on steroids.

A nurse is teaching the parents about the kidney transplant their child is going to receive. What would be included in the teaching?

Immunosuppression is common after a kidney transplant.

A child with autosomal dominant polycystic kidney disease is undergoing evaluation. The nurse understands that this child would be at risk for which of the following?

Intracranial aneurysms Mitral valve prolapse Abdominal wall hernias

An adolescent is diagnosed with a trichomonal infection. Which medication would the nurse include when teaching the adolescent about treatment for this infection?

Metronidazole

After teaching a group of nursing students about acute kidney injury, the instructor determines that the teaching was successful when the students identify which of the following as often the first sign of this condition?

Oliguria

At a well-child visit, a urine specimen is obtained from a child for testing. The nurse is reviewing the results which reveal positive leukocytes. The nurse interprets this as indicating which of the following?

Possible urinary tract infection

A nurse is caring for a child that has had a ureteral stent. Which of the following would be appropriate for the nurse to include in the child's plan of care?

Preventing constipation in the child.

A child is getting a diagnostic work-up for nephrotic syndrome. Which lab results would the nurse expect to see?

Proteinuria, hypoalbuminemia, and hypercholesterolemia

A child diagnosed with acute glomerulonephritis will most likely have a history of:

Recent illness such as strep throat

The mother of 6-month-old girl is concerned about her daughter getting a urinary tract infection. What should the nurse mention to the mother to help prevent this condition?

Report any abnormally colored urine to the child's primary care provider.

A nurse needs to obtain a urine specimen from a child. Which of the following would be most helpful in encouraging the child to void?

Run water in the sink to trigger the sensation to void.

Which of the following techniques would help encourage urine collection in a child?

Run water in the sink to trigger the sensation to void.

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?

Sexual activity

A 16-year-old tells you she has terrible dysmenorrhea. Which action would be the best health teaching measure regarding this?

Take over-the-counter ibuprofen for its prostaglandin action.

To prevent further urinary tract infections in a preschooler, what measures would you teach her mother?

Teach her to wipe her perineum front to back after voiding.

The nurse is caring for a 5-month-old boy with an undescended left testis. What would the nurse identify as indicative of true cryptorchidism?

Testis cannot be "milked" down inguinal canal

A 12-year-old girl reports pain and a burning sensation on urination. The nurse suspects a urinary tract infection. Which diagnostic test would be most appropriate for confirming this condition?

Urine culture

A 6-month-old boy is found to have undescended testes. The parents are concerned. What should the nurse anticipate as the next step for this client?

Wait a year or two to see whether the testes will descend on their own

The nurse is working with a child with altered genitourinary status. The child demonstrates excess fluid volume. Which of the following would the nurse most likely do?

Weigh the child 2 times a day on the same scale.

The nurse is working with a child with altered genitourinary status. Which intervention would be included in the plan of care with excess fluid volume?

Weigh the child twice a day on the same scale.

In caring for a child with nephrotic syndrome, which interventions will be included in the child's plan of care?

Weighing on the same scale each day

A 4-year-old boy with nephrotic syndrome has extensive edema. The best implementation to reduce periorbital edema would be to

elevate the head of the bed.

While obtaining a history from a 15-year-old girl, the girl tells the nurse that she often experiences cramping abdominal pain about in the middle of her menstrual cycle. The nurse documents this as:

mittelschmerz.

An adolescent asks you how to best prevent vulvovaginitis. Your best answer would be to:

wipe from front to back after urinating or defecating.

An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep throat a little over a week ago. Which condition should the nurse suspect?

Acute glomerulonephritis

In caring for a child with a urinary tract infection, the nurse would do all of the following nursing interventions. Which two interventions would be the priority for the nurse?

Collect a "clean catch" voided urine. Observe the child for signs of any reactions to the antibiotics.

A parent is asking how she can help her son deal with the peer ridicule at school in regards to enuresis. What is the best response by the nurse?

Demonstrate love and acceptance at home.

A parent is asking how she can help her son deal with the peer ridicule at school in regards to enuresis. Which response by the nurse would be most therapeutic?

Demonstrate love and acceptance at home.

The nurse obtains a history from the mother of a child with glomerulonephritis about how he became ill. What would the nurse expect her to tell you she noticed?

Dirty green urine

A 5-year-old boy occasionally wets his bed at night and his pants during the day. Which finding would indicate an organic as opposed to a functional cause of this enuresis?

The boy has only begun wetting the bed and his pants recently, 1 year after being successfully potty-trained

A nurse is discussing with a family the various causes of their child's vulvovaginitis. What would be included in the education?

The use of cleansing towelettes may have caused the vulvovaginitis.

A parent asks if their newborn's undescended testicles will need surgery to repair. What is the best response by the nurse?

There is a chance the testicles will descend on their own.

The nurse is caring for a 2-year-old girl with suspected vulvovaginitis. The nurse suspects the cause as Candida albicans based on which finding?

White cottage cheese-like discharge

An adenosarcoma found in the region of the kidney in a child would most likely be which of the following?

Wilms's Tumor