GU Pediatrics Practice Questions
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 girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily."
The nurse is providing discharge teaching to an adolescent who has been treated for pelvic inflammatory disease (PID). What would the nurse include as a preventive measure?
Insisting the sexual partners use condoms. (PID is an STI; use of condoms prevents PID)
The nurse is preparing a 7-year-old girl for discharge after treatment for nephrotic syndrome. Which instructions would the nurse include in the discharge teaching plan for the parents?
Let's meet with the dietitian and plan some meals
Which dietary change is most important to decrease the symptoms of premenstrual syndrome?
Maintain a low-sodium diet (This decreased fluid retention)
A nurse is caring for a client with a diagnosis of acute glomerulonephritis. Which intervention would the nurse expect to be included in the treatment plan? Select all that apply.
1 to 2 week course of antibiotics, keeping the client in semi-fowler position, antihypertensive therapy, and high protein diet
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.
1. Confirm the client's identity. 2. Provide education to the client about the prescribed diagnostic test. 3. Document the time of the client's next voiding time. 4. Begin the testing time period. 5. Collect urine in a chilled container. 6. End the test at the 24-hour mark.
The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder?
hypertension (Complications of hydronephrosis include renal insufficiency, hypertension, and eventually renal failure.)
Most urinary tract infections seen in children are caused by:
intestinal bacteria (particularly E coli account for 80% of acute episodes.)
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." What would be the most appropriate response by the nurse?
"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."
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 voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents?
The VCUG will rule out vesicoureteral reflux. (a condition in which urine from the bladder is able to flow back up into the utter and kidney) (VCUG is performed by having the bladder filled with a contrast medium via catheterization. VCUG is used to rule out reflux in the urinary tract, causes of hematuria, urinary tract infection and structural anomalies.)
A 5-year-old boy occasionally wets his bed at night and his pants during the day. Which finding would indicate an organic cause—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. (Enuresis is primary, or functional, if bladder training was never achieved. It is considered acquired, secondary, or organic if control was established but has now been lost.)
A pediatric client is scheduled for an intravenous pyelogram (IVP) of the kidney this afternoon. Which situation would require immediate attention by the nurse?
The child does not have intravenous access. (An IVP is an x-ray study of the upper urinary tract in which a radio opaque dye is injected into a peripheral vein, requiring intravenous access.)
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?
The client remains continent throughout the night.
A newborn is diagnosed with hypospadias and the parents want the newborn to be circumcised. What would be the best response by the nurse?
The foreskin is needed for repair. (Hypospadias occurs when the metal opening Is on the ventral surface of the penis rather than at the end of the penis. Once repaired, circumcision can be performed, ususally after a year.)
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?
Weigh the old dialysate (Should be weighed to determine the amount of fluid removed from the child. Fluid must be weighed prior to emptying it.
In caring for a child with nephrotic syndrome, which intervention will be included in the child's plan of care?
Weighing on the same scale each day (Child with nephrotic syndrome is very edematous. Must monitor child's fluid gain and loss)
Which instructions should a nurse give to a client who has a history of urinary tract infections to prevent recurrence? Select all that apply.
Wipe from front to back. encourage fluids throughout the day, and finish all antibiotics prescribed
A 16-year-old adolescent tells the nurse about having severe dysmenorrhea. Which action would be the best health teaching measure?
Take over-the-counter ibuprofen for its prostaglandin action.
The nurse is conducting a presentation for a group of nurses who work with adolescents. The group discusses dysmenorrhea. Which statement is most accurately related to dysmenorrhea?
A contributing factor in dysmenorrhea (menstrual cramps) is the increased secretion of prostaglandins. (The increased secretion of prostaglandins, which occurs in the last few days of the menstrual cycle, is thought to be the contributing factor in primary dysmenorrhea.)
A client's mother asks the nurse, "When should my daughter have a pelvic examination?" Which response by the nurse is most appropriate?
A pelvic exam is necessary at 18 to 20 years old
A child, diagnosed with a urinary tract infection, is afraid to void because it hurts. What action should the nurse recommend to the parent to help relieve this fear?
Have the child sit in a sitz bath of warm water to void
The nurse knows that which statement is a description of peritoneal dialysis when compared to hemodialysis:
The child can live a more normal lifestyle. (It is a 7 day a week procedure but there are less diet restrictions and more freedom. It can be done at home.)
The parents of an 8-year-old child with nocturnal enuresis bring the child to the clinic for a follow-up. History reveals that the parents have tried numerous behavioral and motivational therapies without success. The nurse anticipates medication therapy. Which agents would the nurse identify as being used? Select all that apply.
oxybutynin, imipramine, desmopressin
The nurse is providing care to a child with acute kidney injury. What assessment is priority for the nurse to determine if this child is developing hyperkalemia?
pulse rate and rhythm (When potassium levels rise, the child will develop symptoms such as a weak irregular pulse, muscle weakness and abdominal cramping. The priority assessment is the pulse rate and rhythm, because potassium is directly linked to heart functioning.)
An adolescent girl and her caregiver present at the pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease (PID) 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:
take the child to a private room and interview her regarding her sexual history and partners.
The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is:
Obtaining a clean catch voided urine (in the case the child is toilet trained)
The nurse is triaging clients as they come in to an urgent care facility. Which assessment finding is clinically significant for early nephrotic syndrome?
Periorbital edema (Periorbital edema and edema in the ankles are the initial presenting symptoms. As the swelling advances, the edema becomes generalized with a pendulous abdomen full of fluid.)
The nurse is caring for a 6-year-old child with acute glomerulonephritis. When reviewing the client's laboratory results, which result is most important to review with the health care provider?
Positive culture for group A streptococcus (Acute glomerulonephritis may result as an autoimmune response to the invasion of group A streptococcus. This group affects the glomeruli of the kidneys.)
A nurse is caring for a child who has had a urethral stent. What would be included in the care of this child?
Prevent constipation in the child.
The nurse is taking a history from an adolescent girl with suspected pelvic inflammatory disease (PID). What data will be most helpful in determining this girl's risk factors for PID?
Number of sexual partners. (Multiple sex partners are a risk for PID)
A client has just been admitted to the unit with a history of recent streptococcal infection, hematuria, and proteinuria. Based on these findings, the nurse suspects which condition?
Acute glomerulonephritis
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?
Blood pressure 136/84 (Hypertension appears in 60% to 70% of clients during the first 4 or 5 days with a diagnosis of glomerulonephritis)
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?
Creatinine clearance rate (The glomerular filtration rate is measured by creating clearance rate.)
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?
Emotional stress can be a cause of this disorder. (Secondary amenorrhea can be a result of discontinuing contraceptives, a sign of pregnancy, the result of physical or emotional stress, or a symptom of an underlying medical condition.)
A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms?
Encourage high fluid intake
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 state that ___________ is appropriate?
Encouraging fluid intake after dinner. (Limiting fluids after dinner can be helpful for nocturnal enuresis.)
A 16-year-old girl visits her gynecologist with a complaint of metrorrhagia, or bleeding between menstrual periods, since her last visit 3 months ago. On consulting the client's chart, the nurse learns that she was prescribed an oral contraceptive at her last visit. Which intervention should the nurse implement in this situation?
Explain that breakthrough bleeding is normal during the first 3 or 4 months of oral contraceptive use but that it should go away after that.
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
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. (Immunosuppressants are given to prevent rejection but not 100% guaranteed)
A 3-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?
Reassess the client's testes at 6 months of age (Treatment is usually delayed until ay least 6 months of age.)
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?
Report any abnormally colored urine to the child's primary care provider
When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority?
Risk for infection (When vesicoureteral reflux is present, the primary goal is to avoid urine infection so that infected urine cannot gain access to the kidneys.)
Which nursing diagnosis would be the priority when caring for a child in renal failure following a kidney transplant?
Risk for infection related to immunocompromised state
A 10-year-old child in renal failure is on continuous cycling peritoneal dialysis (CCPD). What would be important to teach the parents?
Severe cramping and pain should not occur with an infusion. (CCPD allows a child to go to school or participate in activities while receiving dialysis. A permanent dialysis catheter is inserted and sutured into place at the abdomen.)
The nurse is caring for a 10-year-old boy with end-stage kidney disease (ESKD) with metabolic acidosis. What would the nurse expect to administer if ordered?
Sodium bicarbonate tablets. (BIcitra or sodium bicarbonate tablets are used for the correction of acidosis)
A 3-year-old child is scheduled for a surgery to correct undescended testes. For what postoperative consideration would the nurse want to prepare the parents?
Some discomfort at the surgery site (An orchiopexy is the surgical procedure to release the spermatic cord and pull testes into scrotum. Testes are then sutured into place to prevent them from returning to the abdominal cavity.)
The nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which assessment finding would indicate testicular torsion?
Sudden onset of severe scrotal pain with significant hemorrhagic swelling. (Testicular torsion is characterized by a testicle that is abnormally attached to the scrotum and twisted. S/S include sudden onset of severe scrotal pain with significant hemorrhagic swelling)
The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to take which action?
Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.
A nurse is caring for a 13-year-old boy with end-stage kidney disease who is preparing to have his hemodialysis treatment in the dialysis unit. Which nursing action is appropriate?
Withhold his routine medication until after dialysis is completed. ( The medication would be filtered out through the dialysis process.)
The nurse is caring for a child who receives dialysis via an AV fistula. Which finding indicates an immediate need to notify the physician?
absence of a thrill (Nurse should always auscultate the site for presence of a bruit and palpate for presence of a thrill)
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:
acute glomerulonephritis
The nurse is assessing an infant with suspected hemolytic uremic syndrome. Which set of assessment findings most likely led the nurse to this conclusion?
hemolytic anemia, thrombocytopenia, and acute kidney injury. (HUS affects the kidneys and blood clotting functions of infected people.)
A client has been admitted to the emergency department with nausea, vomiting, and severe scrotal pain. These findings indicate what condition?
testicular torsion (evidenced by symptoms and is a surgical emergency)
Which cause of pediatric enuresis must be ruled out before psychological causes are investigated? Select all that apply.
urinary tract infection, small bladder capacity, and lack of awareness
A nurse has just admitted a client with symptoms of vulva inflammation, pain, odor, and pruritus. Based on these findings, the nurse could conclude that this client will be diagnosed with which condition?
vulvovaginitis (Diagnosed with clients experiencing vaginal or vulval inflammation, pain, odor, and pruritus.
A child is hospitalized with nephrotic syndrome. Which measurement is best for the nurse to determine the child's edema?
weight, daily
A parent asks if her newborn's undescended testicles will need surgery to repair. What is the bestresponse by the nurse?
There is a chance the testicles will descend on their own
The caregiver of a 1-year-old boy 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 statement regarding the son's treatment?
"The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."
