Chapter 25: The Child with Renal Dysfunction

Chapter 25: The Child with Renal Dysfunction

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Urinary tract anomalies are frequently associated with what irregularities in fetal development?

ANS:  C

Although unexplained, there is a frequent association between malformed or low-set ears and urinary tract anomalies. During the newborn examination, the nurse should have a high suspicion about urinary tract structure and function if ear anomalies are present. Children who have myelomeningocele may have impaired urinary tract function secondary to the neural defect. When other congenital defects are present, there is an increased likelihood of other issues with other body systems. Cardiac and extremity defects do not have a strong association with renal anomalies.

DIF:    Cognitive Level: Understanding       REF:   p. 1000

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

2. What urine test result is considered abnormal?

ANS:  A

The expected pH ranges from 4.8 to 7.8. A pH of 4.0 can be indicative of urinary tract infection or metabolic alkalosis or acidosis. Less than 1 or 2 white blood cells per milliliter is the expected range. The absence of protein is expected. The presence of protein can be indicative of glomerular disease. A specific gravity of 1.020 is within the anticipated range of 1.001 to 1.030. Specific gravity reflects level of hydration in addition to renal disorders and hormonal control such as antidiuretic hormone.

DIF:    Cognitive Level: Analyzing             REF:   p. 1002

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

3. What diagnostic test allows visualization of renal parenchyma and renal pelvis without exposure to external-beam radiation or radioactive isotopes?

ANS:  A

The transmission of ultrasonic waves through the renal parenchyma allows visualization of the renal parenchyma and renal pelvis without exposure to external-beam radiation or radioactive isotopes. Computed tomography uses external radiation, and sometimes contrast media are used. Intravenous pyelography uses contrast medium and external radiation for radiography. Contrast medium is injected into the bladder through the urethral opening. External radiation for radiography is used before, during, and after voiding in voiding cystourethrography.

DIF:    Cognitive Level: Understanding       REF:   p. 1011

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

4. What name is given to inflammation of the bladder?

ANS:  A

Cystitis is an inflammation of the bladder. Urethritis is an inflammation of the urethra. Urosepsis is a febrile urinary tract infection with systemic signs of bacterial infection. Bacteriuria is the presence of bacteria in the urine.

DIF:    Cognitive Level: Understanding       REF:   p. 1004

TOP:   Nursing Process: Assessment           MSC:  Client Needs: Physiological Integrity

5. The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause?

ANS:  C

Urinary stasis is the single most important host factor that influences the development of UTIs. Urine is usually sterile but at body temperature provides an excellent growth medium for bacteria. Poor hygiene can be a contributing cause, especially in females because their short urethras predispose them to UTIs. Urinary stasis then provides a growth medium for the bacteria. Intermittent constipation contributes to urinary stasis. A full rectum displaces the bladder and posterior urethra in the fixed and limited space of the bony pelvis, causing obstruction, incomplete micturition, and urinary stasis. Congenital anomalies can contribute to UTIs, but urinary stasis is the primary factor in many cases.

DIF:    Cognitive Level: Applying               REF:   p. 1005

TOP:   Integrated Process: Teaching/Learning

MSC:   Client Needs: Physiological Integrity