Chapter 20: The Child with a Genitourinary Alteration

Chapter 20: The Child with a Genitourinary Alteration

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. Which of the following statements made by a school-age girl indicates the need for further teaching about the prevention of urinary tract infections?

a.	“I always wear cotton underwear.”
b.	“I really enjoy taking a bubble bath.”
c.	“I go to the bathroom every 3 to 4 hours.”
d.	“I drink four to six glasses of fluid every day.”

 

 

ANS:   B

 

	Feedback
A	It is desirable to wear cotton rather than nylon underwear. Nylon tends to hold in moisture and promote bacterial growth, whereas cotton absorbs moisture.
B	Bubble baths should be avoided because they tend to cause urethral irritation, which leads to urinary tract infection.
C	Children should be encouraged to urinate at least four times a day.
D	An adequate fluid intake prevents the buildup of bacteria in the bladder.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 579

OBJ:    Nursing Process Step: Assessment

MSC:   NCLEX: Health Promotion and Maintenance

 

2. The nurse assessing a child with acute poststreptococcal glomerulonephritis would be alert for which of the following findings?

a.	Increased urine output
b.	Hypotension
c.	Tea-colored urine
d.	Weight gain

 

 

ANS:   C

 

	Feedback
A	In acute poststreptococcal glomerulonephritis the urine output may be decreased.
B	In acute poststreptococcal glomerulonephritis blood pressure may be increased.
C	Acute poststreptococcal glomerulonephritis is characterized by hematuria, proteinuria, edema, and renal insufficiency. Tea-colored urine is an indication of hematuria.
D	Edema may be noted around the eyelids and ankles in patients with acute poststreptococcal glomerulonephritis; however, weight gain is associated with nephrotic syndrome.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 582

OBJ:    Nursing Process Step: Assessment    MSC:   NCLEX: Physiological Integrity

 

3. The mother of a child who was recently diagnosed with acute glomerulonephritis asks the nurse why the physician keeps talking about “casts” in the urine. The nurse’s response is based on the knowledge that the presence of casts in the urine indicates which of the following?

a.	Glomerular injury
b.	Glomerular healing
c.	Recent streptococcal infection
d.	Excessive amounts of protein in the urine

 

 

ANS:   A

 

	Feedback
A	The presence of red blood cell casts in the urine indicates glomerular injury.
B	Casts in the urine are abnormal findings and are indicative of glomerular injury, not glomerular healing.
C	A urinalysis positive for casts does not confirm a recent streptococcal infection.
D	Casts in the urine are unrelated to proteinuria.

 

 

DIF:    Cognitive Level: Knowledge             REF:    Text Reference: pg 582

OBJ:    Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity

 

4. What is a clinical finding that warrants further intervention for the child with acute poststreptococcal glomerulonephritis?

a.	Weight loss to within 1 pound of the preillness weight
b.	Urine output of 1 milliliter per kilogram per hour
c.	A normal blood pressure
d.	Inspiratory crackles

 

 

ANS:   D

 

	Feedback
A	This is an indication that the child is responding to treatment.
B	This is an acceptable urine output and indicates that the child is responding to treatment.
C	This is an indication that the child is responding to treatment.
D	Children with excess fluid volume may have pulmonary edema. Inspiratory crackles indicate fluid in the lungs. Pulmonary edema can be a life-threatening complication.

 

 

DIF:    Cognitive Level: Application             REF:    Text Reference: pg 582

OBJ:    Nursing Process Step: Planning         MSC:   NCLEX: Physiological Integrity