Chapter 31: Caring for the Child With a Genitourinary Condition

Chapter 31: Caring for the Child With a Genitourinary Condition

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. An infant appears dehydrated. Laboratory results indicate a serum sodium of 143 mEq/L. Which fluid would the nurse use for IV replacement?

ANS:  B

This child has an isotonic dehydration, in which fluids and solutes are lost in balanced proportions, as evidenced by the normal serum sodium level. The child needs an isotonic IV solution, which would be 0.9% normal saline. The 0.45% normal saline (“half normal saline”) is hypotonic, as is D5W, with or without potassium. The 3% normal saline is hypertonic.

Cognitive Level: Analysis/Analyzing

Content Area: Pediatrics/Maternity

Patient Needs: Physiological Integrity: Pharmacological and Parenteral Therapies

Integrated Process: Nursing Process: Implementation

Difficulty: Difficult

PTS:   1

2. A school-age female child has a urinary tract infection (UTI). The culture has come back positive for Escherichia coli. Which teaching measure is most important for the nurse to include in the teaching plan?

ANS:  D

All items are appropriate to teach when a child has a UTI. However, E. coli infection stems from contamination with fecal material. The female child should be taught to wipe from front to back to prevent this cross-contamination.

Cognitive Level: Application/Applying

Content Area: Pediatrics/Maternity

Patient Needs: Health Promotion and Maintenance

Integrated Process: Teaching/Learning

Difficulty: Moderate

PTS:   1

3. An infant has poor feeding, fever, and malodorous urine. The parents do not want the nurse to catheterize the child. Which response by the nurse is the most appropriate?

ANS:  B

Parents can be understandably distraught at the thought of their baby having an invasive procedure. The nurse should ensure that the parents understand why the catheterized urine sample or a suprapubic aspirated urine sample is the best choice for obtaining the most accurate urinalysis results. If the parents still refuse, the nurse should document their refusal, inform the provider, and apply a collection bag. The nurse should also treat the baby’s fever with acetaminophen, but this option is not directly related to the question.

Cognitive Level: Application/Applying

Content Area: Pediatrics/Maternity

Patient Needs: Physiological Integrity: Reduction of Risk Potential

Integrated Process: Nursing Process: Implementation

Difficulty: Moderate

PTS:   1

4. An acutely ill child is admitted for a suspected severe urinary tract infection (UTI). Which is the priority action by the nurse?

ANS:  B

Antibiotics need to be started as soon as possible, but it is imperative to obtain a urine sample for a culture and sensitivity to guide medication choices first. While awaiting the results, the nurse will administer a broad-spectrum antibiotic. The child does need an IV, but there is no indication that the child needs aggressive fluid resuscitation. Teaching is always an important task, but does not take priority over obtaining the sample for urinalysis.

Cognitive Level: Analysis/Analyzing

Content Area: Pediatrics/Maternity

Patient Needs: Safe and Effective Care Environment: Management of Care

Integrated Process: Nursing Process: Implementation

Difficulty: Moderate

PTS:   1

5. The parents of a child diagnosed with vesicoureteral reflux (VUR) want to know why their child’s kidneys appear large on an abdominal x-ray. Which response by the nurse is the most appropriate?

ANS:  A

In VUR, urine backflows into the kidneys, causing hydronephrosis, or distention of the kidneys. The other answers are incorrect.

Cognitive Level: Comprehension/Understanding

Content Area: Pediatrics/Maternity

Patient Needs: Physiological Integrity: Physiological Adaptation

Integrated Process: Teaching/Learning

Difficulty: Moderate

PTS:     1