Peds Chapter 43

21. A child returns from surgery in which a stoma was created in the abdominal wall to the bladder. The nurse identifies this as a: A. vesicostomy. B. ureteral stent. C. continent urinary diversion. D. bladder augmentation.

A

28. The nurse is administering an IV infusion of albumin to a child with nephrotic syndrome. What is the primary concern for the nurse when administering this medication to the child? A. Fluid overload B. Electrolyte imbalance C. Increased blood pressure D. Urine output

A

1. The nurse is caring for a child who is experiencing an acute renal transplant rejection and is to receive muromonab-CD3. What would the nurse most likely expect to assess after the first dose is administered? A. Fever with chills, chest tightness B. Cough, hyperkalemia C. Photosensitivity, gastrointestinal (GI) upset D. Urinary retention, decreased appetite

A

30. An infant has undergone a hypospadias repair. What intervention will the nurse teach the parents to keep the site clean and to reduce swelling? A. "It is important to use double diapering to keep stool off the site." B. "The compression dressing should be changed if it becomes soiled." C. "Keep the penis taped to the abdomen so stool cannot get to surgical site." D. "You can use a gauze dressing to cover the urethral stent."

A

5. The nurse is caring for a 4-year-old girl with vulvovaginitis. After instructing the girl's mother on how to help prevent subsequent episodes, which statement by the mother indicates a need for additional teaching? A. "She tells me she wipes from front to back." B. "I will make sure she changes her underwear every day." C. "She should avoid bubble baths." D. "I will help supervise her wiping after bowel movements."

A

6. A nurse is caring for a 7-year-old girl scheduled for an intravenous pyelogram (IVP). Which action would be the priority before the test? A. Checking with the parents for any allergies B. Ensuring adequate hydration C. Giving the girl an enema D. Screening her for pregnancy

A

8. 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

10. The nurse is preparing a teaching plan for the parents of a child with a urinary tract infection (UTI). In educating the parents, the nurse would recommend that the child avoid: A. a liberal fluid intake. B. caffeine. C. cranberry juice. D. cotton underwear.

B

12. 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

13. After teaching the parents of a child with a hydrocele about this condition, which statement indicates that the teaching was successful? A. "If this gets worse and we don't treat it, our son could become infertile." B. "This condition should gradually go away on its own." C. "The surgeon is going to operate on him immediately." D. "It's going to be difficult putting ice packs on his scrotum."

B

17. 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? A. Klebsiella B. Escherichia coli C. Staphylococcus aureus D. Pseudomonas

B

2. The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color? A. Cloudy yellow B. Cola colored C. Pale to almost clear urine D. Light orange to moderately yellow colored

B

20. 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. "Girls have a smaller bladder size than boys do." B. "A girl's urethra is closer to the rectal opening." C. "A girl's urethra is longer than a boy's urethra." D. "Her kidneys are less well protected."

B

22. The nurse is preparing an 8-year-old girl for a cystoscopy. Which instruction would be most appropriate to give to the child? A. "You need to make sure that you don't go to the bathroom before the test." B. "You might feel some burning when you go to the bathroom afterward." C. "I'm going to have to put a tube into your bladder to empty it." D. "I have to put a thick tight rubber band around your arm to get a blood specimen."

B

27. The nurse is taking a health history of a child with suspected acute poststreptococcal glomerulonephritis. Which response by the client's parent will the nurse highlight for the primary health care provider as an indicator for this condition? A. "My child's has recently reported urinary frequency." B. "My child just got over a head cold with laryngitis." C. "My child's urine is pale yellow in color." D. "My child's eyes appear sunken to me."

B

3. 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?A. "I will need a urine sample." B. "Let your mom help you tinkle in this cup." C. "Please tinkle in this cup right now." D. "Please void in this cup instead of the toilet."

B

23. The nurse is assessing a 5-year-old child's genitourinary system. Which findings would the nurse document as normal? Select all that apply. A. Labial fusion B. Round abdomen C. Positive bowel sounds D. Dullness over the spleen E. Undescended testicles

B,C,D

29. A child is hospitalized with acute poststreptococcal glomerulonephritis. What assessments should the nurse include in the plan of care for this child?? Select all that apply. A. Assess level of consciousness B. Assess pain C. Monitor blood pressure D. Auscultate lung sounds E. Inspect the urine

B,C,D,E

11. The mother of a child with end-stage renal disease asks the nurse why her son is getting an injection of erythropoietin. When responding to the mother, the nurse explains that the rationale is: A. to treat low calcium levels. B. to stimulate growth in stature. C. to stimulate red blood cell growth. D. to correct acidosis.

C

14. The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. What would the nurse least likely expect to find? A. Hyperlipidemia B. Hypoalbuminemia C. Decreased blood urea nitrogen (BUN) D. Hypoproteinemia

C

15. The nurse is applying a urine bag to a 15-month-old boy to collect a urine specimen. Which action would the nurse take first? A. Apply benzoin to the scrotal area. B. Tuck the bag downward inside the diaper. C. Pat the perineal area dry after cleaning. D. Apply the narrow portion of the bag on the perineal space.

C

18. A nurse is interviewing the parents of a child diagnosed with obstructive uropathy. Which statement by the parents would the nurse identify as significant? A. "She's been constipated quite a few times." B. "We've noticed that her bed is wet in the morning." C. "She had surgery to repair a problem with her anus." D. "She had a bacterial skin infection about a week ago."

C

19. A nurse identifies a nursing diagnosis of Impaired urinary elimination related to infection in the urinary tract as manifested by dysuria for a preschooler. When developing the plan of care, what would be most important for the nurse to do first? A. Develop a schedule for bladder emptying. B. Encourage fluid intake. C. Assess usual voiding patterns. D. Monitor intake and output.

C

25. The nurse is caring for a client with hemolytic-uremic syndrome (HUS). The cilent is demonstrating oliguria. What does the nurse expect to find when reviewing the client's records? A. A pattern of below-normal blood pressure B. Higher fluid output than fluid intake C. Elevated BUN and creatinine levels D. Increased glomerular filtration rate (GFR)

C

26. A 15-year-old client presents to the emergency room reporting an abrupt onset of severe, sudden pain on the right side of the scrotum while playing football. The nurse notes a blue-black swelling of the affected scrotum. Which action will the nurse complete next? A. Complete a head-to-toe assessment B. Have the client rate the pain C. Notify the primary health care provider D. Monitor the client's urine output

C

7. A 6-year-old child has undergone a renal transplant and is receiving cyclosporine. The nurse instructs the parents to be especially alert for which complication? A) Weight loss B) Hypotension C) Signs of infection D) Hair loss

C

24. The nurse is providing instruction to the parents of a newborn boy. The parents have decided not to circumcise the child. What information should be included in the discussion? Select all answers that apply. A. The foreskin should be pulled back for cleaning at least once per day. B. The foreskin should be pulled back gently with each diaper change. C. Clean the penis gently with soap and water. D. If the foreskin is not retractable do not force it. E. When the foreskin is retracted, gently replace it prior to completing diapering

C,D,E

16. A group of students are reviewing information about renal failure in children. The students demonstrate a need for additional teaching when they identify which agent as a potential contributor to renal failure?A. Vancomycin B. Gentamicin C. Co-trimoxazole D. Amoxicillin

D

4. The nurse is providing postsurgical care for an infant who has undergone a hypospadias repair. Which action by the nurse would be most important to help keep the area clean while maintaining proper position of the drainage tubing? A. Keeping the drainage tube taped in an upright position B. Administering antibiotics as ordered C. Administering analgesics as prescribed D. Using a double-diapering technique

D

9. An 8-year-old girl is scheduled for a renal ultrasound. What would the nurse include in the plan of care when preparing the child for this test? A. Withholding food and fluids after midnight B. Checking the child for allergies to shellfish C. Ensuring the child has a full bladder D. Informing the child she should feel no discomfort

D