Peds - Chapter 21: Nursing Care of the Child With a Genitourinary Disorder
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) A beta-hemolytic streptococcus b) One of the rhinoviruses c) Staphylococcus viridans d) Group B streptococci
A beta-hemolytic streptococcus
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? a) White cottage cheese-like discharge b) Foul yellow-gray discharge c) Irritation of labia and vaginal opening d) Thin gray vaginal discharge with fishy odor
White cottage cheese-like discharge
The nurse is assessing a child diagnosed with nephritic syndrome and observes generalized edema. The nurse documents this as: a) hydronephrosis. b) enuresis. c) phimosis. d) anasarca.
anasarca
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) Regulate blood pressure b) Remove carbon dixoide c) Circulate cerebrospinal fluid d) Produce white blood cells
Regulate blood pressure
A parent asks if their newborn's undescended testicles will need surgery to repair. What is the best response by the nurse? a) If the infant is having swelling or pain, then surgery will be performed. b) This problem needs to be corrected immediately in the newborn period. c) Surgery is not needed for this type of problem. d) There is a chance the testicles will descend on their own.
There is a chance the testicles will descend on their own.
The nurse is caring for a child who has been admitted to the acute care facility with manifestations consistent with hydronephrosis. Which tests will confirm the diagnosis? Select all that apply. a) Renal ultrasound b) Urinalysis c) Complete blood cell count (CBC) d) Intravenous pyelogram (IVP) e) Voiding cystourethrogram (VCUG)
• Intravenous pyelogram (IVP) • Voiding cystourethrogram (VCUG) • Renal ultrasound
The nurse knows this is a description of peritoneal dialysis when compared to hemodialysis: a) The child must go into a facility to get peritoneal dialysis. b) The child can live a more normal lifestyle. c) Therapy is only 3 to 4 days per week. d) There are strict diet and fluid restrictions.
The child can live a more normal lifestyle.
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) "It is unlikely that your daughter is practicing good cleaning habits after she voids." b) "Girls need more vitamin C than boys to keep their urinary tract healthy, so your daughter may be deficient in vitamin C." c) "A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily." d) "Girls tend to urinate less frequently than boys, making them more susceptable to UTI's."
"A girl's urethra is much shorter and straighter than a boy's, so it can be contaminated fairly easily."
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 is what happens if a 16-year-old girl has never had any periods at all." c) "This disorder is usually seen after a girl has had a spontaneous abortion." d) "Emotional stress can be a cause of this disorder."
"Emotional stress can be a cause of this disorder."
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? a) "Here is some written information from the dietitian." b) "Let's meet with the dietitian and plan some meals." c) "She should try to avoid protein." d) "She must severely restrict her sodium intake."
"Let's meet with the dietitian and plan some meals."
The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder? a) Hypothermia b) Hypertension c) Hypotension d) Tachycardia
Hypertension
The nurse is caring for the parents of a newborn who has an undescended testicle. Which comment by the parents indicates understanding of the condition? a) "Our son will likely have a high risk of cancer in his teen years as a result of this condition." b) "Our son's condition may resolve on its own." c) "Our son may have to go through life without two testes." d) "Our son may need surgery on his testes before we are discharged to go home."
"Our son's condition may resolve on its own."
A nurse is caring for a 12-year-old girl recently diagnosed with end-stage renal disease. The nurse is discussing dietary restrictions with the girl's mother. Which response indicates a need for further teaching? a) "She needs to restrict her potassium intake." b) "My daughter can eat what she wants when she is hooked to the machine." c) "She can eat whatever she wants on dialysis days." d) "My daughter must avoid high sodium foods."
"She can eat whatever she wants on dialysis days."
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 statement regarding the son's treatment? a) "Without the hormone your son will have fluid that will collect in his scrotum." b) "Your child's testes have not dropped, so the hormone is being administered to avoid causing degeneration until they do." c) "The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place." d) "Without the treatment your child's gonads will not reach normal size."
"The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."
A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage tube patency? a) Allow tubes to dangle freely to encourage flow. b) Provide a low-sodium diet. c) Maintain fluid restriction. d) Monitor output.
Monitor output.
A nurse is caring for a 10-year-old boy with nocturnal enuresis with no physiologic cause. He says he is embarrassed and wishes he could stop immediately. How should the nurse respond? a) "There are almost 5 million people that have enuresis." b) "There are several things we can do to help you achieve this goal." c) "The pull-ups look just like underwear; no one has to know." d) "You will grow out of this eventually; you just need to be patient."
"There are several things we can do to help you achieve this goal."
The nurse is caring for an infant with grade II vesicoureteral reflux (VUR). The mother is very fearful that her child will have progressive renal damage. Which response by the nurse would be most appropriate? a) "Your son will most likely need surgical intervention." b) "You can expect recurrent urinary tract infections along with progressive renal damage." c) "This problem must be carefully managed to avoid permanent damage." d) "This condition usually resolves spontaneously with no symptoms."
"This condition usually resolves spontaneously with no symptoms."
The nurse is performing education for the parents of an infant with bladder exstrophy. Which statement by the parents would indicate and understanding of the child's future care? 1. "Care will be no different than that of any other infant." 2. "My infant will only need this one surgery." 3. "My child will wear diapers all his life." 4. "We will need to care for the urinary diversion."
"We will need to care for the urinary diversion."
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 response would be most appropriate for the nurse to make to this child? a) "But it's a good thing, having a period is a part of growing up." b) "Are you afraid of getting pregnant?" c) "What have you heard about it that makes you worried?" d) "Do you think it will hurt?"
"What have you heard about it that makes you worried?"
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) A contributing factor in dysmenorrhea is the increased secretion of prostaglandins. b) Genetic abnormalities are the most common cause of dysmenorrhea. c) Common symptoms of dysmenorrhea are weight gain and mood swings. d) Dysmenorrhea can result from diaphragms or tampons being left in place too long.
A contributing factor in dysmenorrhea is the increased secretion of prostaglandins.
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: a) A medication given to treat dysmenorrhea b) A symptom of premenstrual syndrome c) A dull, aching abdominal pain at ovulation d) The beginning of menstruation
A dull, aching abdominal pain at ovulation
The nurse is caring for an infant boy with grade IV vesicoureteral reflux. Which finding would lead the nurse to suspect that hydronephrosis is present? a) Abdominal mass b) Enlarged inguinal glands c) Purulent drainage from the penis d) Swollen testes
Abdominal mass
The nurse is caring for an infant boy with grade IV vesicoureteral reflux. Which finding would lead the nurse to suspect that hydronephrosis is present? a) Swollen testes b) Enlarged inguinal glands c) Purulent drainage from the penis d) Abdominal mass
Abdominal mass
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) Absence of a thrill b) Dialysate without fibrin or cloudiness c) Presence of a thrill d) Presence of a bruit
Absence of a thrill
The nurse is administering cyclophosphamide as ordered for a 12-year-old boy with nephrotic syndrome. Which instruction is most accurate regarding administration? a) Administer in the evening on an empty stomach b) Encourage fluids, adequate food intake, and voiding before and after administration c) Provide adequate hydration and encourage voiding d) Administer in the morning, encourage fluids and voiding during and after administration
Administer in the morning, encourage fluids and voiding during and after administration
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) Provide a diet high in protein and sodium b) Make sure the IV fluid contains potassium c) Increase oral intake of fluid d) Administer the IV fluid slowly
Administer the IV fluid slowly
Urinary tract infections are usually successfully treated by what means? a) Administering antibiotics b) Administering diuretics c) Performing bladder irrigations d) Increasing fluids, such as cranberry juice
Administering antibiotics
A 13-year-old girl tells the nurse during a gynecological visit that a friend of hers developed toxic shock syndrome from tampon use. The client says that tampons work well for her, but she wonders whether they are safe. Which of the following recommendations should the nurse give this client to help prevent toxic shock syndrome? a) Use feminine hygiene sprays in conjunction with tampons b) Use the highest absorbency tampon possible c) Alternate use of tampons with sanitary pads d) Insert two tampons at a time
Alternate use of tampons with sanitary pads
The nurse is caring for a child admitted with nephrotic syndrome. Which clinical manifestations would likely have been noted in the child with this diagnosis? a) Oliguria b) Pyelonephritis c) Ascites d) Amenorrhea
Ascites
A group of nursing students are reviewing the variations in the genitourinary system in children as compared with adults. The students demonstrate understanding of this information when they state: a) A child's kidneys are surrounded by more fat padding than an adult's kidneys. b) Glomerular filtration rate is faster in infants than in adults. c) Bladder capacity reaches adult capacity by age 1 year. d) The renal system usually reaches functional maturity by age 5 years.
Bladder capacity reaches adult capacity by age 1 year.
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) Pulse oximetry 93% on room air b) Respirations 24 per minute c) Pulse rate 112 bpm d) Blood pressure 136/84
Blood pressure 136/84
A 10-year-old in renal failure is on continuous ambulatory peritoneal dialysis (CAPD). What would it be important to teach his parents? a) Slight bleeding from the exchange catheter is to be expected. b) Cramping should not occur with an infusion. c) The return solution will be cloudy because of urea in it. d) Dialysis solution must be infused over a period of 30 minutes.
Cramping should not occur with an infusion.
A child needs to collect urine for 24 hours and the nurse explains that this test assesses glomerular filtration rate and how the kidneys are functioning. What would be indicative of this type of test? a) Urinalysis for casts and bacteria b) Microscopic studies for RBC casts c) Creatinine clearance d) Urine culture and sensitivity
Creatinine clearance
A child is born with ambiguous genitalia. Which of the following assessments establishes whether the child is genetically male or female? a) Pyelography b) Ultrasound c) DNA analysis d) Laparoscopy
DNA analysis
A 5-year-old who had a renal transplant 9 months ago and has no history of chickenpox presents to the pediatric clinic for his vaccinations. Which is the most appropriate set to give? 1. DTap, IPV 2. DTap, IPV, MMR, varicella 3. DTap, IPV, varicella 4. IPV only
DTap, IPV
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? a) Demonstrate how to urinate in the bathroom every time. b) Demonstrate love and acceptance at home. c) Take away a toy every time the child urinates in their pants. d) Discuss how child can continue to go to the bathroom instead of in the underwear.
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? a) Diuresis and pallor b) Loss of weight, oliguria c) Headache, loss of appetite d) Dirty green urine
Dirty green urine Explanation: Acute glomerulonephritis often presents with glomeruli bleeding. Inspect the urine for gross hematuria, which will cause the urine to appear tea colored, cola colored, or even a dirty green color.
A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms? a) Allow tubes to dangle freely to encourage flow. b) Apply antibiotic ointment to tube site. c) Encourage high fluid intake. d) Increase low-fat foods.
Encourage high fluid intake.
A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this? a) Encourage the child to take all the antibiotics if diagnosed with strep throat. b) All children in the child's class should be tested for strep throat if one child has a positive test. c) Prophylactic antibiotics after strep throat are important. d) Tell parents to give ibuprofen if their child has a sore throat.
Encourage the child to take all the antibiotics if diagnosed with strep throat.
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? a) Mittelschmerz b) Endometriosis c) Toxic shock syndrome d) Amenorrhea
Endometriosis
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? a) Eyes b) Sacrum c) Abdomen d) Fingers
Eyes
An infant is diagnosed with a urinary tract infection. What would the nurse expect on assessment? a) Dysuria b) Abdominal pain c) Urgency d) Failure to thrive
Failure to thrive
An infant is diagnosed with a urinary tract infection. What would the nurse expect on assessment? a) Urgency b) Failure to thrive c) Dysuria d) Abdominal pain
Failure to thrive
The nurse is assessing a male neonate and notes that the urethral opening is on the ventral aspect of the penis. The nurse documents this finding as: a) Bladder exstrophy b) Epispadias c) Hypospadias d) Patent urachus
Hypospadias
A nurse is teaching the parents about the kidney transplant their child is going to receive. What would be included in the teaching? a) As long as the medications are used properly, the transplant will not be rejected. b) Immunosuppression is common after a kidney transplant. c) The child can stop medication after three months of therapy. d) Induction therapy medication will prevent infection with the transplant.
Immunosuppression is common after a kidney transplant.
A nurse is assessing a child that may have peritonitis. Which of the following would be signs of this problem? a) Diarrhea b) Increased white blood cell count of dialysate outflow c) Increased red blood cell count of dialysate outflow d) Syncope
Increased white blood cell count of dialysate outflow
A child in kidney failure has had a kidney transplantation. You would prepare the child for which of the following to occur postoperatively? a) Infection-control precautions that may cause him to be lonely b) A transient rash from T-cell suppression c) Full-body irradiation that will leave him nauseated d) Burning on urination from high uric acid content
Infection-control precautions that may cause him to be lonely
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? a) Suggesting that sexual partners use antibiotic ointment b) Using a vaginal douche routinely c) Using oral contraceptives as prescribed d) Insisting that sexual partners use condoms
Insisting that sexual partners use condoms
Most urinary tract infections seen in children are caused by: a) Dietary insufficiencies b) Hereditary causes c) Intestinal bacteria d) Fungal infections
Intestinal bacteria
The nurse is caring for an 8-year-old hospitalized child with nephrotic syndrome. Which nursing intervention would be appropriate for this child? a) Administer antipyretics as needed. b) Measure the abdominal girth daily. c) Weigh the child once a week. d) Test the urine for ketones twice a day.
Measure the abdominal girth daily.
An adolescent is diagnosed with a trichomonal infection. Which medication would the nurse include when teaching the adolescent about treatment for this infection? a) Miconazole b) Acyclovir c) Ceftriaxone d) Metronidazole e) Doxycycline
Metronidazole
When examining the musculoskeletal system of the child, which would be indicative of a potential kidney problem? a) Hypertonia b) Walking with a limp c) Muscle weakness d) A clunk felt in abduction of the hip
Muscle weakness
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? a) Age b) Number of sexual partners c) Race d) Age at first menses
Number of sexual partners
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: a) Ascites b) Amenorrhea c) Oliguria d) Pyelonephritis
Oliguria
A nurse notices clear fluid draining from the base of the umbilical cord stump of a newborn boy while changing his diaper. Which of the following conditions does this finding most likely indicate? a) Vesicoureteral reflux b) Exstrophy of the bladder c) Patent urachus d) Hypospadias
Patent urachus Explanation: When the bladder first forms in utero, it is joined to the umbilicus by a narrow tube, the urachus. If this fails to close during embryologic development, a fistula is left between the bladder and umbilicus (patent urachus).
A child diagnosed with acute glomerulonephritis will most likely have a history of: a) Hemorrhage or history of bruising easily b) Sibling diagnosed with the same disease c) Recent illness such as strep throat d) Hearing loss with impaired speech development
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? 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.
Report any abnormally colored urine to the child's primary care provider.
The nurse is planning the discharge instructions for the parents of a 1-month-old infant who has had a circumcision completed. Which information should be included in the education provided? a) Reduce the child's fluid intake to reduce voiding during the first 24 hours b) Use petroleum jelly on the head of the penis for the first 2 weeks after the procedure c) Report any bleeding to the physician d) Report redness or swelling on the penile shaft
Report redness or swelling on the penile shaft
When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority? a) Imbalanced nutrition less than body requirements b) Excess fluid volume c) Risk for infection d) Activity intolerance
Risk for infection
Which nursing diagnosis would be the priority when caring for a child in renal failure following a kidney transplant? a) Constipation related to effects of administered drugs b) Deficient fluid volume related to fluid intake restrictions postoperatively c) Risk for infection related to immunocompromised state d) Pain related to tissue rejection
Risk for infection related to immunocompromised state
The nurse is caring for a child with epididymitis. When planning care, which intervention may be included? a) Scrotal elevation b) Corticosteroid therapy c) Catheterization d) Warm compresses
Scrotal elevation
Which measure would help an adolescent relax best during a pelvic examination? a) Help her hold her breath during the exam. b) Advise her to keep one hand on her abdomen. c) Show her a speculum prior to the exam. d) Assure her that no part of the exam will hurt.
Show her a speculum prior to the exam.
The nurse recognizes that what would be a likely physiologic cause for a child to have enuresis? a) Sexual abuse b) Regression to get attention c) Stress and stressful situations d) Sleeping too soundly
Sleeping too soundly
The nurse is caring for a 10-year-old boy with end-stage renal disease (ESRD) with metabolic acidosis. What would the nurse expect to administer if ordered? a) Sodium bicarbonate tablets b) Ferrous sulfate c) Vitamin D d) Erythropoietin
Sodium bicarbonate tablets
The nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which assessment finding would indicate testicular torsion? a) Sudden onset of severe scrotal pain with significant hemorrhagic swelling b) Hardened and tender epididymitis with edema and erythema of scrotum c) Enlarged inguinal glands and fever d) Fever, scrotal swelling, and urethral discharge
Sudden onset of severe scrotal pain with significant hemorrhagic swelling
A 16-year-old tells you she has terrible dysmenorrhea. Which action would be the best health teaching measure regarding this? a) Take over-the-counter ibuprofen for its prostaglandin action. b) Use ice to help in reducing inflammation and pain. c) Drink a minimum of fluid if having pain. d) Take acetaminophen beginning with the first day of a menstrual flow.
Take over-the-counter ibuprofen for its prostaglandin action.
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 do which action? a) Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone. b) Give the child a diuretic and report back to the nurse in a few hours. c) Weigh the child in the same clothes she had been weighed in the day before and report the two weights to the nurse while the nurse is on the phone. d) Give the child fluids and report back to the nurse in a few hours.
Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.
The nurse is caring for a child admitted with acute glomerulonephritis. Which clinical manifestation would likely have been noted in the child with this diagnosis? a) Jaundiced skin b) Loose, dark stools c) Tea-colored urine d) Strawberry red tongue
Tea-colored urine
A 4-year-old girl presents with recurrent urinary tract infection. A prior workup did not reveal any urinary tract abnormalities. What is the priority nursing action? 1. Obtain a sterile urine sample after completion of antibiotics. 2. Teach appropriate toileting hygiene. 3. Prepare the child for surgery to reimplant the ureters. 4. Adminitser antibiotics intramuscularly
Teach appropriate toileting hygiene.
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? a) Fluid detected in scrotal sac b) Venous varicosity detected along the spermatic cord c) Testis cannot be "milked" down inguinal canal d) Testis can briefly be brought into scrotum
Testis cannot be "milked" down inguinal canal
A 9-year-old boy who is uncircumcised has developed balanoposthitis. There is no sign of phimosis. Which of the following recommendations should the nurse give the boy and his parents to help prevent future occurrences? a) To become circumcised b) To avoid warm baths c) To apply a local antibiotic ointment daily d) To pull back the foreskin and clean the penis thoroughly when showering
To pull back the foreskin and clean the penis thoroughly when showering
Syphilis in a pregnant woman can cause spontaneous miscarriage, preterm labor, stillbirth, or congenital anomalies in the newborn. a) False b) True
True
The nurse is caring for a child admitted with a urinary tract infection. In addition to foul-smelling urine, which clinical manifestation would likely have been noted in the child with this diagnosis? a) Vomiting b) Increased appetite c) Decreased urination d) Weight gain
Vomiting
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? a) Karyotyping to establish the client's gender b) Administer a short course of chorionic gonadotropin hormone for about 5 days c) Orchiopexy to correct the condition d) Wait a year or two to see whether the testes will descend on their own
Wait a year or two to see whether the testes will descend on their own
When the nurse is caring for a child with hyemolytic-uremic syndrome or acute glomerulonephritis and the child is not yet toilet trained, which action by the nurse would best determine fluid retention? 1. Test urine for specific gravity 2. Weigh child daily 3. Weigh the wet diapers 4. Measure abdominal girth daily
Weigh child daily
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? a) Hold all medication until the fluid retention is improving. b) Measure the amount of nitrates present in the urine. c) Avoid administering IVs. d) Weigh the child twice a day on the same scale.
Weigh the child twice a day on the same scale.
You are counseling a couple about sexually transmitted diseases. The male partner has genital herpes. To prevent spread of the infection to the female partner, you advise the couple that a) intercourse should be avoided until a Pap test is negative. b) a condom should be used during intercourse. c) coitus should be delayed until 10 days after penicillin is begun. d) acyclovir should be applied topically prior to intercourse.
a condom should be used during intercourse.
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 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) acute glomerulonephritis. c) lipoid nephrosis (idiopathic nephrotic syndrome). d) rheumatic fever.
acute glomerulonephritis.
A nurse is reviewing the medical record of an infant with hydronephrosis. What would the nurse expect to find in the history and physical examination? Select all that apply. a) Crying on voiding b) History of repeated urinary tract infections c) Hypotension d) Fever e) Abdominal mass on palpation
• History of repeated urinary tract infections • Abdominal mass on palpation • Crying on voiding
When assessing a child with hydronephrosis, what would the nurse expect to find? Select all that apply. a) Proteinuria b) Intermittent hematuria c) Foul-smelling urine d) Abdominal mass e) Flank pain
• Intermittent hematuria • Abdominal mass
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) Practicing bladder-stretching exercises b) Giving desmopressin intranasally c) Engaging the child in stress reduction measures d) Encouraging fluid intake after dinner
Encouraging fluid intake after dinner
A 14-year-old girl visits her gynecologist and is found to have vaginal candidiasis. She is obese, claims to not be sexually active, and is not on an oral contraceptive. Which intervention should be considered for this client? a) Prescription of an antibiotic b) Insertion of antifungal tablets or creams in the morning c) Test her urine for glucose to rule out diabetes mellitus d) Prescription of an oral contraceptive
Test her urine for glucose to rule out diabetes mellitus
A 5-year-old child with acute renal failure develops hyperkalemia. What would the nurse expect to administer? a) Polystyrene sulfonate b) Furosemide c) Labetalol d) Nifedipine
Polystyrene sulfonate Polystyrene sulfonate (Kayexalate) is used to decrease potassium levels. Nifedipine and Labetalol would be used to treat hypertension. Furosemide would be used to promote dieresis with fluid overload.
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? a) "That doesn't make being a woman sound very good. It would probably be easier for her if you could be more supportive." 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) "PMS is a problem for a lot of women, but sometimes it's worse in the beginning. She might outgrow it." d) "That must be hard on you, especially because you are raising her by yourself."
"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."
A child is having their urine checked for a routine well visit. When analyzing the results, what would positive leukocytes indicate? a) This determines the presence of RBCs in the urine. b) This may indicate a urinary tract infection. c) This indicates renal disease. d) This determines the presence of sugar in the urine.
This may indicate a urinary tract infection.
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? a) Renal biopsy b) Urine culture c) Urinalysis d) Radioisotope scanning
Urine culture
A female adolescent comes to the clinic for an evaluation. Assessment reveals a possible urinary tract infection. What would the nurse expect to be done to confirm this suspicion? a) Urine culture b) Kidneys, ureter, and bladder x-ray c) Renal ultrasound d) Intravenous pyelogram
Urine culture
While assessing a child with end-stage renal disease, the nurse notes that the child has fallen into a coma. The nurse interprets this finding as resulting from which complication? a) Hypocalcemia b) Immunosuppression c) Metabolic acidosis d) Uremia
Uremia
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) Nephrosis b) Acute glomerulonephritis c) Kidney agenesis d) Polycystic kidney
Acute 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? a) Computed tomography scan b) Urinalysis c) Creatinine clearance rate d) Kidneys, ureter, and bladder x-ray
Creatinine clearance rate
Peritoneal dialysis is so effective that 3 hours of peritoneal dialysis accomplishes as much as 12 hours of hemodialysis. a) True b) False
False
The human papillomavirus (HPV) is commonly passed on from a pregnant woman to her fetus. a) True b) False
False
The child with nephrotic syndrome who has ascites and difficulty breathing is probably most comfortable sleeping in which position? a) Supine b) Fowler's c) Prone d) Sims' position
Fowler's
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, thrombocytopenia, and acute renal failure b) Hemolytic anemia, acute renal failure, and hypotension c) Dirty green colored urine, elevated erythrocyte sedimentation, and depressed serum complement level d) Thrombocytopenia, hemolytic anemia, and nocturia several times each night
Hemolytic anemia, thrombocytopenia, and acute renal failure
A child is getting a diagnostic work-up for nephrotic syndrome. Which lab results would the nurse expect to see? a) Proteinuria, hypoalbuminemia, and hypercholesterolemia b) Neutropenia, hematuria, and hypocholesterolemia c) Hematuria, proteinuria, and hyperalbuminemia d) Proteinuria, hyperalbuminemia, and hypocholesterolemia
Proteinuria, hypoalbuminemia, and hypercholesterolemia
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) Blood Pressure 100/70 b) Respirations 22 per minute c) Pulse rate 135 bpm d) Pulse oximetry 93% on room air
Pulse rate 135 bpm
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 what possible explanation for the bedwetting? a) The child did not want to go on the fishing trip and is now retaliating against being made to go b) The child has been sexually abused, maybe on the fishing trip c) The child has a urinary tract infection due to not bathing while on the fishing trip d) The child is out of the habit of waking himself up during the night to void
The child has been sexually abused, maybe on the fishing trip
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 has a sibling with the same diagnosis. b) The child is being treated for asthma. c) The child had a congenital heart defect. d) The child recently had an ear infection.
The child recently had an ear infection.
The mother of a child diagnosed with pyelonephritis asks if the kidneys were damaged because of this. What is the best response by the nurse? a) The child's risk for renal scarring is increased with pyelonephritis. b) No, if the child is urinating normally, the kidneys were not damaged. c) Yes, all children who get pyelonephritis have renal scarring. d) As long as IV antibiotics are started, there is no risk of renal damage.
The child's risk for renal scarring is increased with pyelonephritis.
A newborn is diagnosed with hypospadias and the parents want him to be circumcised. What would be the best response by the nurse? a) The foreskin is needed for repair. b) The circumcision may predispose the child to renal failure. c) Circumcision is usually performed after 1 year old. d) Circumcision with a hypospadias will cause meatal stenosis.
The foreskin is needed for repair.
The nurse is educating the parents of an infant after a circumcision. The parents demonstrate understanding when they state that they need to report what to the physician? a) Bleeding that stops without pressure b) The infant does not urinate within 6 to 8 hours c) Small spots of blood on diaper d) Appearance of granulation tissue
The infant does not urinate within 6 to 8 hours
A nurse is discussing with a family the various causes of their child's vulvovaginitis. What would be included in the education? a) Fevers often occur with vulvovaginitis. b) The use of cleansing towelettes may have caused the vulvovaginitis. c) Child protective services will be called since this is a sign of abuse. d) Constipation is a common cause of vulvovaginitis.
The use of cleansing towelettes may have caused the vulvovaginitis.
An adolescent comes to the clinic reporting vaginal discharge. When assessing the vaginal discharge, what would lead the nurse to suspect that the adolescent has candidiasis? a) Frothy, gray-green discharge b) Milky, gray, fishy-odor discharge c) Thick, white cheese-like discharge d) Yellow-green discharge
Thick, white cheese-like discharge
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) Start the process over with a fresh bag b) Weigh the old dialysate c) Weigh the new dialysate d) Empty the old dialysate
Weigh the old dialysate
A 3-year-old is scheduled for a surgery to correct undescended testes. An important postoperative consideration the nurse would want to prepare the parents for is: a) a liquid diet for 3 days. b) the need for complete bed rest for 10 days. c) some discomfort at the surgery site. d) the need for maintaining a semi-Fowler position.
some discomfort at the surgery site.
A 4-year-old girl with a urinary tract infection is scheduled to have a voiding cystourethrogram. When preparing her for this procedure, the nurse would want to prepare her to: a) void during the procedure. b) anticipate a headache afterward. c) drink three glasses of water during the procedure. d) have a local anesthetic injected prior to the procedure.
void during the procedure.
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? a) Observe the child for signs of any reactions to the antibiotics. b) Teach girls to wipe from front to back. c) Observe for possible indications of sexual abuse. d) Collect a "clean catch" voided urine. e) Record and report any indications of urinary burning, frequency, or urgency. f) Instruct caregivers to avoid bubble baths, especially in young girls.
• Collect a "clean catch" voided urine. • Observe the child for signs of any reactions to the antibiotics.
A voiding cystourethrogram (VCUG) is ordered on a child. What education should be provided to the parents? a) The VCUG will prevent further complications of UTI. b) The VCUG will rule out kidney stones. c) The VCUG will rule out VUR. d) The VCUG will detect if the infection is gone.
The VCUG will rule out VUR.
The nurse is caring for a 10-year-old girl presenting with fever, dysuria, flank pain, urgency, and hematuria. The nurse would expect to help obtain which test first? a) Total protein, globulin, and albumin b) Urinalysis c) Creatinine clearance d) Urine culture and sensitivity
Urinalysis
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: a) 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) 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) contact the necessary authorities to report a suspected case of sexual abuse.
take the child to a private room and interview her regarding her sexual history and partners.
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. a) Albumin b) Imipramine c) Oxybutynin d) Desmopressin e) Prednisone
• Oxybutynin • Imipramine • Desmopressin
