Chapter 31 Child Health Nursing Partnering With Children & Families, 3rd Edition

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Chapter 31

Question 1

Type: MCSA

A child has been admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS). The clinical manifestations will include which of the following?

1. Massive proteinuria, hypoalbuminemia, and edema
2. Hematuria, bacteriuria, and weight gain
3. Urine-specific gravity decreased and urinary output increased
4. Gross hematuria, albuminuria, and fever

Correct Answer: 1

Rationale 1: Nephrotic syndrome is an alteration in kidney function secondary to increased glomerular basement membrane permeability to plasma protein. It is characterized by massive proteinuria, hypoalbuminemia, and edema.

Rationale 2: Bacteriuria and fever are associated with a urinary tract infection. Because of the edema, a weight gain, not a weight loss, would be seen.

Rationale 3: In MCNS, the urine output decreases and the specific gravity of urine increases.

Rationale 4: Gross hematuria and hypertension are associated with glomerulonephritis.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 31-1

 

Question 2

Type: MCSA

A child with nephritic syndrome is severely edematous. The primary health care provider has placed the child on bed rest. An important nursing intervention for this child would be to:

1. Monitor BP every 30 minutes.
2. Reposition the child every two hours.
3. Limit visitors.
4. Encourage fluids.

Correct Answer: 2

Rationale 1: Vital signs are taken every four hours.

Rationale 2: A child with severe edema, on bed rest, is at risk for altered skin integrity. To prevent skin breakdown, the child should be repositioned every two hours.

Rationale 3: The child needs social interaction, so visitors should not be limited.

Rationale 4: Fluids need to be monitored; they should not be encouraged.

Global Rationale:

 

Cognitive Level: Applying

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 31-1

 

Question 3

Type: MCSA

A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show which of the following?

1. Bacteriuria and increased specific gravity
2. Hematuria and proteinuria
3. Proteinuria and decreased specific gravity
4. Bacteriuria and hematuria

Correct Answer: 2

Rationale 1: Glomerulonephritis is an inflammation of the glomeruli of the kidneys. Bacteriuria is not present. But because the urine is concentrated, the specific gravity is increased.

Rationale 2: Glomerulonephritis is an inflammation of the glomeruli of the kidneys. The clinical manifestation of glomerulonephritis is grossly bloody hematuria with mild to moderate proteinuria, and because the urine is concentrated, the specific gravity is increased.

Rationale 3: Glomerulonephritis is an inflammation of the glomeruli of the kidneys. Because the urine is concentrated, the specific gravity is increased.

Rationale 4: Glomerulonephritis is an inflammation of the glomeruli of the kidneys. Bacteriuria is not present.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 31-1

 

Question 4

Type: MCSA

A four-year-old has acute glomerulonephritis (AGN) and is admitted to the hospital. The priority nursing diagnosis for this child would be:

1. Risk for injury related to hypertension.
2. Altered growth and development related to a chronic disease.
3. Risk for infection related to hypertension.
4. Fluid volume excess related to decreased plasma filtration.

Correct Answer: 1

Rationale 1: The child with AGN has marked hypertension, which can lead to cardiac failure and cerebral injuries.

Rationale 2: Growth and development are not normally affected because this is an acute process, not a chronic one.

Rationale 3: While a risk for infection might be present, it is not related to the hypertension.

Rationale 4: Although fluid retention occurs, this is not the priority diagnosis.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need:

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 31-1