Chapter 24 Alterations in Genitourinary Function
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? A. Possible urinary tract infection B. Diabetes C. Renal disease D. Bleeding
A. Possible urinary tract infection
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? A. "Let's put you in touch with some other girls who are also having the same body changes." B. "Luckily, this is just a temporary, unfortunate part of your condition; you need to accept it." C. "Your real friends do not care about your appearance and just want you to get well." D. "You are beautiful in your own way; what matters is what is on the inside."
A. "Let's put you in touch with some other girls who are also having the same body changes."
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? A. Acute glomerulonephritis B. Kidney agenesis C. Polycystic kidney D. Nephrosis
A. Acute glomerulonephritis
A 10-year-old girl is experiencing acute renal failure due to dehydration. The nurse is preparing to administer IV fluid. Which of the following interventions should the nurse take in caring for this child? A. Administer the IV fluid slowly B. Make sure the IV fluid contains potassium C. Increase oral intake of fluid D. Provide a diet high in protein and sodium
A. Administer the IV fluid slowly
The nurse is teaching the parent of a child with chronic renal failure on high-potassium foods that should be restricted. Which foods will the nurse include in this teaching? Select all that apply. A. Bananas, carrots, nuts, and milk B. Peaches, broccoli, and red meat C. Oranges, potatoes, wheat, and bran D. Spinach, chicken, fish, and green beans
A. Bananas, carrots, nuts, and milk
A nurse is developing a teaching plan for the parents of an 8-year-old experiencing nocturnal enuresis. The nurse determines that additional teaching is needed when the parents identify what as an appropriate measure? A. Encouraging fluid intake after dinner B. Practicing bladder-stretching exercises C. Giving desmopressin intranasally D. Engaging the child in stress reduction measures
A. Encouraging fluid intake after dinner
A nurse is assessing a child who may have peritonitis. Which of the following would be signs of this problem? A. Increased white blood cell count of dialysate outflow B. Diarrhea C. Increased red blood cell count of dialysate outflow D. Syncope
A. Increased white blood cell count of dialysate outflo
A voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents? A. The VCUG will rule out vesicoureteral reflux. B. The VCUG will detect if the infection is gone. C. The VCUG will rule out kidney stones. D. The VCUG will prevent further complications of the urinary tract infection (UTI).
A. The VCUG will rule out vesicoureteral reflux.
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. What is the most important reason the child needs increased fluids? A. To dilute the urine and flush the bladder B. To fill the bladder so a specimen can be obtained C. To prevent the child from developing a fever D. To decrease the pain of urination
A. To dilute the urine and flush the bladder
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? A. Weigh the child 2 times a day on the same scale. B. Hold all medication until the fluid retention improves. C. Avoid administering IV fluids. D. Measure the amount of nitrates present in the urine.
A. 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 for the client with excess fluid volume? A. Weigh the child daily on the same scale. B. Hold all medication until the fluid retention is improving. C. Avoid administering IV therapies. D. Measure the amount of nitrates present in the urine.
A. Weigh the child daily on the same scale.
A child is diagnosed with hemolytic-uremic syndrome (HUS). Review of the child's laboratory test results would reveal which finding? A. Decreased blood urea nitrogen (BUN) and creatinine B. Decreased platelets and leukocytosis C. Hypernatremia and hypokalemia D. Respiratory acidosis and proteinuria
B. Decreased platelets and leukocytosis
A child is having their urine checked for complaints of polyuria. When analyzing the results, what would positive glucose indicate? A. This may indicate a urinary tract infection. B. This determines the presence of sugar in the urine. C. This indicates renal disease. D. This determines the presence of bacteria in the urine.
B. This determines the presence of sugar in the urine. This could signify diabetes and needs to be evaluated immediately.
The nurse is caring for a child who is undergoing peritoneal dialysis. Immediately after draining the dialysate, which action should the nurse should take immediately? A. Empty the old dialysate B. Weigh the old dialysate C. Weigh the new dialysate D. Start the process over with a fresh bag
B. Weigh the old dialysate
The nurse instructs a school-age patient and the parents on continuous cycling peritoneal dialysis. Which statement indicates that teaching has been effective? A. "The solution should be infused cold." B. "Redness and warmth around the tube insertion site is expected." C. "We should notify the health care provider if the drainage is cloudy." D. "Weight gain and a productive cough are expected with the treatments."
C. "We should notify the health care provider if the drainage is cloudy."
The nurse is assessing an infant with suspected hemolytic uremic syndrome. Which characteristics of this condition should the nurse expect to assess or glean from chart review? A. Hemolytic anemia, acute renal failure, and hypotension B. Dirty green colored urine, elevated erythrocyte sedimentation, and depressed serum complement level C. Hemolytic anemia, thrombocytopenia, and acute renal failure D. Thrombocytopenia, hemolytic anemia, and nocturia several times each night
C. Hemolytic anemia, thrombocytopenia, and acute renal failure
The nurse is caring for a female preschool-aged patient with a urinary tract infection. What measures should the nurse teach the mother to prevent future infections? A. Suggest the child drink less fluid daily to concentrate urine. B. Encourage the child to be more active to increase urine output. C. Teach the child to wipe the perineum front to back after voiding. D. Teach the child to take frequent tub baths to clean the perineal area.
C. Teach the child to wipe the perineum front to back after voiding.
A female preschool patient with a urinary tract infection is scheduled to have a voiding cystourethrogram. What should the nurse include when teaching the patient about this procedure? A. A headache is a common occurrence after the procedure. B. A local anesthetic will be injected prior to the procedure. C. The patient will be expected to void during the procedure. D. The patient will have to drink three glasses of water during the procedure.
C. The patient will be expected to void during the procedure.
A nurse is caring for a 13-year-old boy with end-stage renal disease who is preparing to have his hemodialysis treatment in the dialysis unit. Which nursing action is appropriate? A. Administer his routine medications as scheduled B. Take his blood pressure measurement in extremity with AV fistula C. Withhold his routine medication until after dialysis is completed D. Assess the Tenckhoff catheter site
C. Withhold his routine medication until after dialysis is completed
A nurse is performing an assessment on a child. What would be indicative of a potential for a urinary tract infection? A. Washing the genital area with water daily B. Not using cleansing towelettes routinely C. Not using soap when cleaning the urethral area D. Holding urine while at school
D. Holding urine while at school
