Wong’s Essentials of Pediatric Nursing, 10th Edition
Wong’s Essentials of Pediatric Nursing, 10th Edition
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Chapter 26: The Child with Genitourinary Dysfunction
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Computed tomography uses external radiation to visualize the renal system. |
| b. | Visualization of the renal system is accomplished without exposure to radiation or radioactive isotopes. |
| c. | Contrast medium and x-rays allow for visualization of the renal system. |
| d. | External radiation for x-ray films is used to visualize the renal system, before, during, and after voiding. |
ANS: A
A renal ultrasound transmits ultrasonic waves through the renal parenchyma, allowing for visualization of the renal system without exposure to external beam radiation or radioactive isotopes. Computed tomography uses external radiation and sometimes contrast media to visualize the renal system. An intravenous pyelogram uses contrast medium and external radiation for x-ray films. The voiding cystourethrogram visualizes the renal system with injection of a contrast media into the bladder through the urethral opening and use of x-ray before, during, and after voiding.
DIF: Cognitive Level: Understand REF: p. 848
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
| a. | pH |
| b. | Osmolality |
| c. | Creatinine |
| d. | Protein level |
ANS: C
The most useful clinical indication of glomerular filtration is the clearance of creatinine. It is a substance that is freely filtered by the glomerulus and secreted by the renal tubule cells. The pH and osmolality are not estimates of glomerular filtration. Although protein in the urine demonstrates abnormal glomerular permeability, it is not a measure of filtration rate.
DIF: Cognitive Level: Understand REF: p. 850
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
| a. | Fever with a positive blood culture |
| b. | Proteinuria and edema |
| c. | Oliguria and hypertension |
| d. | Anemia and thrombocytopenia |
ANS: A
Symptoms of urosepsis include a febrile UTI coexisting with systemic signs of bacterial illness; blood culture reveals presence of urinary pathogen. Proteinuria and edema are symptoms of minimal change nephrotic syndrome (MCNS). Oliguria and hypertension are symptoms of acute glomerulonephritis (AGN). Anemia and thrombocytopenia are symptoms of hemolytic uremic syndrome (HUS).
DIF: Cognitive Level: Analyze REF: p. 846
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Physiologic Integrity: Physiologic Adaptation
| a. | Increased fluid intake |
| b. | Short urethra in young girls |
| c. | Prostatic secretions in males |
| d. | Frequent emptying of the bladder |
ANS: B
The short urethra in females provides a ready pathway for invasion of organisms. Increased fluid intake and frequent emptying of the bladder offer protective measures against urinary tract infections. Prostatic secretions have antibacterial properties that inhibit bacteria.
DIF: Cognitive Level: Understand REF: p. 846
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
| a. | Wear cotton underpants. |
| b. | Limit bathing as much as possible. |
| c. | Increase fluids; decrease salt intake. |
| d. | Cleanse perineum with water after voiding. |
ANS: A
Cotton underpants are preferable to nylon underpants. No evidence exists that limiting bathing, increasing fluids/decreasing salt intake, or cleansing the perineum with water after voiding decrease urinary tract infections in young girls.
DIF: Cognitive Level: Apply REF: p. 851
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential
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