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Chapter 44: The Child with a Genitourinary Alteration
MULTIPLE CHOICE
1. Which statement by a school-age girl indicates the need for further teaching about the prevention of urinary
tract infections (UTIs)?
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
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UTI.
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.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1125
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
2. The nurse assessing a child with acute poststreptococcal glomerulonephritis should be alert for which
finding?
a.
Increased urine output
b.
Hypotension
c.
Tea-colored urine
d.
Weight gain
ANS: C
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761
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.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1128
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic 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 nurses response is based on the knowledge that the
presence of casts in the urine indicates
a.
Glomerular injury
b.
Glomerular healing
c.
Recent streptococcal infection
d.
Excessive amounts of protein in the urine
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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.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1132
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
4. Which clinical finding warrants further intervention for the child with acute poststreptococcal
glomerulonephritis?
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a.
Weight loss to within 1 lb of the preillness weight
b.
Urine output of 1 mL/kg/hr
c.
A positive antistreptolysin O (ASO) titer
d.
Inspiratory crackles
762
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
A positive ASO titer indicates the presence of antibodies to streptococcal bacteria; it is used
to aid in diagnosis of acute poststreptococcal glomerulonephritis. This is an expected finding
if the child has this acute illness.
D
Children with excess fluid volume may have pulmonary edema. Inspiratory crackles indicate
fluid in the lungs. PulmonaryNURSINGTB.COM
edema can be a life-threatening complication.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1130
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
5. Which diagnostic finding is present when a child has primary nephrotic syndrome?
a.
Hyperalbuminemia
b.
Positive ASO titer
c.
Leukocytosis
d.
Proteinuria
ANS: D
Feedback
A
Hypoalbuminemia is present because of loss of albumin through the defective glomerulus
and the livers inability to synthesize proteins to balance the loss.
B
ASO titer is negative in a child with primary nephrotic syndrome.
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C
Leukocytosis is not a diagnostic finding in primary nephrotic syndrome.
D
Large amounts of protein are lost through the urine as a result of an increased permeability of
the glomerular basement membrane.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1132
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
6. Which finding indicates that a child receiving prednisone for primary nephrotic syndrome is in remission?
a.
Urine is negative for casts for 5 days.
b.
Urine is up to a trace for protein for 5 to 7 days.
c.
Urine is positive for glucose for 1 week.
d.
Urine is up to a trace for blood for 1 week.
ANS: B
Feedback
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A
The absence of casts in the urine gives no indication about the childs response to treatment.
The child with primary nephrotic syndrome is considered to be in remission when the urine is
negative for protein for 5 to 7 consecutive days.
B
The child receiving steroids for the treatment of primary nephrotic syndrome is considered in
remission when the urine is up to trace for protein for 5 to 7 days.
C
Remission is achieved when the urine is negative for protein for 5 to 7 consecutive days. It is
not unusual for glucose to test positive if the child is taking prednisone.
D
The presence or absence of hematuria is not used to determine remission in primary nephrotic
syndrome.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1133
OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity
7. Which statement by a parent of a child with nephrotic syndrome indicates an understanding of a no-addedsalt diet?
a.
I can give my child sweet pickles.
b.
My child can put ketchup on his hotdog.
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c.
I can let my child have potato chips.
d.
I do not put any salt in foods when I am cooking.
764
ANS: D
Feedback
A
All types of pickles are high in sodium and should not be served to the child on a no-addedsalt diet.
B
The child should not be allowed to eat hotdogs; they are considered a cured or processed
meat and are high in sodium.
C
Potato chips are a high-sodium food and should not be included in the childs diet when
sodium intake is restricted.
D
A no-added-salt diet means that no salt should be added to foods, either when cooking or
before eating.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1134
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OBJ: Nursing Process: Evaluation MSC: Client
Needs: Health Promotion and Maintenance
8. What is an appropriate intervention for a child with nephrotic syndrome who is edematous?
a.
Teach the child to minimize body movements.
b.
Change the childs position every 2 hours.
c.
Avoid the use of skin lotions.
d.
Bathe every other day.
ANS: B
Feedback
A
The child with edema is at risk for impaired skin integrity. It is important for the child to
change position frequently to prevent skin breakdown.
B
Frequent position changes decrease pressure on body parts and help relieve edema in
dependent areas.
C
Applying lotion to the skin helps to increase circulation.
NURSINGTB.COM
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D
765
Bathing daily removes irritating body secretions from the skin.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1135
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
9. What should the nurse include in a teaching plan for the parents of a child with vesicoureteral reflux?
a.
The importance of taking prophylactic antibiotics
b.
Suggestions for how to maintain fluid restrictions
c.
The use of bubble baths as an incentive to increase bath time
d.
The need for the child to hold urine for 6 to 8 hours
ANS: A
Feedback
A
Prophylactic antibiotics are used to prevent urinary infection in a child with vesicoureteral
reflux, although this treatment plan has become controversial.
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B
Fluids are not restricted when a child has vesicoureteral reflux. In fact, fluid intake should be
increased as a measure to prevent UTIs.
C
Bubble baths should be avoided to prevent urethral irritation and possible UTI.
D
To prevent UTIs, the child should be taught to void frequently and never resist the urge to
urinate.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1124
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
10. Which intervention is appropriate when examining a male infant for cryptorchidism?
a.
Cooling the examiners hands
b.
Taking a rectal temperature
c.
Eliciting the cremasteric reflex
d.
Warming the room
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ANS: D
Feedback
A
Examining the infant with cold hands is uncomfortable for the infant and likely to cause the
infants testes to retract into the inguinal canal. It may also cause the infant to be
uncooperative during the examination.
B
A rectal temperature yields no information about cryptorchidism.
C
Testes can retract into the inguinal canal if the infant is upset or cold or if the cremasteric
reflex is elicited. This can lead to an incorrect diagnosis.
D
For the infants comfort, the infant should be examined in a warm room with the examiners
hands warmed. Testes can retract into the inguinal canal if the infant is upset or cold.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1126
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
11. Parents ask the nurse when should our childs hypospadias be corrected? The nurse responds based upon the
knowledge that correction of hypospadias should be accomplished by the time the child is
a.
1 month of age
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b.
6 to 12 months of age
c.
School age
d.
Sexually mature
ANS: B
Feedback
A
Surgery to correct hypospadias is not performed when the infant is this young.
B
The correction of hypospadias should ideally be accomplished by the time the child is 6 to 12
months of age and before toilet training.
C
It is preferable for hypospadias to be surgically corrected before the child enters school so
that the child has normal toileting behaviors in the presence of his peers.
D
Corrective surgery for hypospadias is done long before sexual maturity.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1127
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OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
12. You are the nurse caring for a 4-year-old child who has developed acute renal failure as a result of
hemolytic-uremic syndrome (HUS). Which bacterial infection was most likely the cause of HUS?
a.
Pseudomonas aeruginosa
b.
Escherichia coli
c.
Streptococcus pneumoniae
d.
Staphylococcus aureus
ANS: B
Feedback
A
Pseudomonas aeruginosa is not associated with HUS.
B
Children with HUS become infected by Escherichia coli, which is usually contracted from
eating improperly cooked meat or contaminated dairy products.
C
Streptococcus pneumoniae isNURSINGTB.COM
not associated with HUS.
D
Staphylococcus aureus is not associated with HUS.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1137
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
13. Which dietary modification is appropriate for a child with chronic renal failure?
a.
Decreased protein
b.
Decreased fat
c.
Increased potassium
d.
Increased phosphorus
ANS: A
Feedback
A
Protein intake is restricted because of the kidneys inability to remove waste products.
NURSINGTB.COM
MATERNAL CHILD NURSING 5TH EDITION MCKINNEY TEST BANK
Test Bank - Maternal-Child Nursing (5th Edition by McKinney)
B
A low-fat diet is not relevant to chronic renal failure.
C
Potassium intake may be restricted because of the kidneys inability to remove it.
D
Phosphorus is restricted to help prevent bone disease.
768
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1139
OBJ: Nursing Process: Planning MSC: Client Needs: Health Promotion and Maintenance
14. Which condition is characterized by a history of bloody diarrhea, fever, abdominal pain, and low
hemoglobin and platelet counts?
a.
Acute viral gastroenteritis
b.
Acute glomerulonephritis
c.
Hemolytic-uremic syndrome
d.
Acute nephrotic syndrome
ANS: C
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Feedback
A
Anemia and thrombocytopenia are not associated with acute gastroenteritis.
B
The symptoms described are not suggestive of acute glomerulonephritis.
C
Hemolytic-uremic syndrome is an acute disorder characterized by anemia, thrombocytopenia,
and acute renal failure. Most affected children have a history of gastrointestinal symptoms,
including bloody diarrhea.
D
The symptoms described are not suggestive of nephrotic syndrome.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1137
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
15. A child with secondary enuresis who complains of dysuria or urgency should be evaluated for which
condition?
a.
Hypocalciuria
b.
Nephrotic syndrome
NURSINGTB.COM
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Test Bank - Maternal-Child Nursing (5th Edition by McKinney)
c.
Glomerulonephritis
d.
UTI
769
ANS: D
Feedback
A
An excessive loss of calcium in the urine (hypercalciuria) can be associated with complaints
of painful urination, urgency, frequency, and wetting.
B
Nephrotic syndrome is not usually associated with complaints of dysuria or urgency.
C
Glomerulonephritis is not a likely cause of dysuria or urgency.
D
Complaints of dysuria or urgency from a child with secondary enuresis suggest the possibility
of a UTI.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1120
OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity
16. A nurse is teaching a class on acute renal failure. The nurse relates that acute renal failure as a result of
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hemolytic-uremic syndrome (HUS) is classified
as
a.
Intrarenal
b.
Prerenal
c.
Postrenal
d.
Chronic
ANS: A
Feedback
A
Intrarenal acute renal failure is the result of damage to kidney tissue. Possible causes of
intrarenal acute renal failure are HUS, glomerulonephritis, and pyelonephritis.
B
Prerenal acute renal failure is the result of decreased perfusion to the kidney. Possible causes
include dehydration, septic and hemorrhagic shock, and hypotension.
C
Postrenal acute renal failure results from obstruction of urine outflow. Conditions causing
postrenal failure include ureteropelvic obstruction, ureterovesical obstruction, or neurogenic
bladder. Renal failure caused by HUS is of the acute nature.
NURSINGTB.COM
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D
770
Chronic renal failure is an irreversible loss of kidney function, which occurs over months or
years.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1136
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
17. A true statement describing the differences in the pediatric genitourinary system compared with the adult
genitourinary system is that
a.
The young infants kidneys can more effectively concentrate urine than an adults kidneys.
b.
After 6 years of age, kidney function is nearly like that of an adult.
c.
Unlike adults, most children do not regain normal kidney function after acute renal failure.
d.
Young children have shorter urethras, which can predispose them to UTIs.
ANS: D
Feedback
A
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The young infants kidneys cannot
concentrate urine as efficiently as those of older children
and adults because the loops of Henle are not yet long enough to reach the inner medulla,
where concentration and reabsorption occur.
B
By 6 to 12 months of age, kidney function is nearly like that of an adult.
C
Unlike adults, most children with acute renal failure regain normal function.
D
Young children have shorter urethras, which can predispose them to UTIs.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1117
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
18. Which factor predisposes the urinary tract to infection?
a.
Increased fluid intake
b.
Short urethra in young girls
c.
Prostatic secretions in males
d.
Frequent emptying of the bladder
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ANS: B
Feedback
A
This offers protective measures against UTIs.
B
The short urethra in females provides a ready pathway for invasions of organisms.
C
Prostatic secretions have antibacterial properties that inhibit bacteria.
D
This offers protective measures against UTIs.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1122
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
19. Hypospadias refers to
a.
Absence of a urethral opening
b.
Penis shorter than usual for age
c.
Urethral opening along dorsal surface of penis
d.
Urethral opening along ventral surface of penis
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ANS: D
Feedback
A
The urethral opening is present, but not at the glans.
B
Hypospadias refers to the urethral opening, not to the size of the penis.
C
This is known as epispadias.
D
Hypospadias is a congenital condition in which the urethral opening is located anywhere
along the ventral surface of the penis.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1127
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
20. The narrowing of preputial opening of foreskin is called
a.
Chordee
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MATERNAL CHILD NURSING 5TH EDITION MCKINNEY TEST BANK
Test Bank - Maternal-Child Nursing (5th Edition by McKinney)
b.
Phimosis
c.
Epispadias
d.
Hypospadias
772
ANS: B
Feedback
A
Chordee is the ventral curvature of the penis.
B
Phimosis is the narrowing or stenosis of the preputial opening of the foreskin.
C
Epispadias is the meatal opening on the dorsal surface of the penis.
D
Hypospadias is a congenital condition in which the urethral opening is located anywhere
along the ventral surface of the penis.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1129 | Table 44-1
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OBJ: Nursing Process: Assessment MSC: Client
Needs: Physiologic Integrity
21. The nurse closely monitors the temperature of a child with nephrotic syndrome. The purpose of this is to
detect an early sign of which possible complication?
a.
Infection
b.
Hypertension
c.
Encephalopathy
d.
Edema
ANS: A
Feedback
A
An exacerbation of the disease can occur after an infection.
B
Temperature is not an indication of hypertension or edema.
C
Encephalopathy is not a complication usually associated with nephrosis. The child will most
likely have neurologic signs and symptoms.
NURSINGTB.COM
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D
773
Encephalopathy is not a complication usually associated with nephrosis. The child will most
likely have neurologic signs and symptoms.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1135
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
22. A child is admitted with acute glomerulonephritis. The nurse expects the urinalysis during this acute phase
to show
a.
Bacteriuria and hematuria
b.
Hematuria and proteinuria
c.
Bacteriuria and increased specific gravity
d.
Proteinuria and decreased specific gravity
ANS: B
Feedback
A
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Bacteriuria and changes in specific
gravity are not usually present during the acute phase.
B
Urinalysis during the acute phase characteristically shows hematuria and proteinuria.
C
Bacteriuria and changes in specific gravity are not usually present during the acute phase.
D
Bacteriuria and changes in specific gravity are not usually present during the acute phase.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1129
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
23. The most appropriate nursing diagnosis for the child with acute glomerulonephritis is
a.
Risk for Injury related to malignant process and treatment
b.
Deficient Fluid Volume related to excessive losses
c.
Risk for Imbalanced Fluid Volume related to a decrease in plasma filtration
d.
Excess Fluid Volume related to fluid accumulation in tissues and third spaces
ANS: C
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774
Feedback
A
No malignant process is involved in acute glomerulonephritis.
B
Excess fluid volume is found.
C
Glomerulonephritis has a decreased filtration of plasma. The resulting decrease in plasma
filtration results in an excessive accumulation of water and sodium that expands plasma and
interstitial fluid volumes, leading to circulatory congestion and edema.
D
The fluid accumulation is secondary to the decreased plasma filtration.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1130
OBJ: Nursing Process: Diagnosis MSC: Client Needs: Physiologic Integrity
24. The most common cause of acute renal failure in children is
a.
Pyelonephritis
b.
Tubular destruction
c.
Urinary tract obstruction
d.
Severe dehydration
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ANS: D
Feedback
A
These are not common causes of acute renal failure in children.
B
These are not common causes of acute renal failure in children.
C
Obstructive uropathy may cause acute renal failure, but it is not the most common cause.
D
The most common cause of acute renal failure in children is dehydration or other causes of
poor perfusion that may respond to restoration of fluid volume.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1134
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
25. The primary clinical manifestations of acute renal failure are
a.
Oliguria and hypertension
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MATERNAL CHILD NURSING 5TH EDITION MCKINNEY TEST BANK
Test Bank - Maternal-Child Nursing (5th Edition by McKinney)
b.
Hematuria and pallor
c.
Proteinuria and muscle cramps
d.
Bacteriuria and facial edema
775
ANS: A
Feedback
A
The principal feature of acute renal failure is oliguria.
B
These are not principal features of acute renal failure.
C
These are not principal features of acute renal failure.
D
These are not principal features of acute renal failure.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1136
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
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26. A major complication in a child with chronic renal failure is
a.
Hypokalemia
b.
Metabolic alkalosis
c.
Water and sodium retention
d.
Excessive excretion of blood urea nitrogen
ANS: C
Feedback
A
Hyperkalemia is a complication of chronic renal failure.
B
Metabolic acidosis is a complication of chronic renal failure.
C
Chronic renal failure leads to water and sodium retention, which contributes to edema and
vascular congestion.
NURSINGTB.COM
MATERNAL CHILD NURSING 5TH EDITION MCKINNEY TEST BANK
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D
776
Retention of blood urea nitrogen is a complication of chronic renal failure.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1139
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
27. The diet of a child with chronic renal failure is usually characterized as
a.
High in protein
b.
Low in vitamin D
c.
Low in phosphorus
d.
Supplemented with vitamins A, E, and K
ANS: C
Feedback
A
Protein should be limited in chronic renal failure to decrease intake of phosphorus.
B
Vitamin D therapy is administered
in chronic renal failure to increase calcium absorption.
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C
Dietary phosphorus is controlled to prevent or control the calcium/phosphorus imbalance by
the reduction of protein and milk intake.
D
Supplementation of vitamins A, E, and K is not part of dietary management in chronic renal
disease.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1139
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
28. Which statement is descriptive of renal transplantation in children?
a.
It is an acceptable means of treatment after age 10 years.
b.
It is preferred means of renal replacement therapy in children.
c.
Children can receive kidneys only from other children.
d.
The decision for transplantation is difficult, since a relatively normal lifestyle is not possible.
ANS: B
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Feedback
A
It can be done in children as young as age 6 months.
B
Renal transplant offers the opportunity for a relatively normal life and is the preferred means
of renal replacement therapy in end-stage renal disease.
C
Both children and adults can serve as donors for renal transplant purposes.
D
Renal transplantation affords the child a more normal lifestyle than dependence on dialysis.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1139
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
MULTIPLE RESPONSE
1. A child with secondary enuresis who complains of dysuria or urgency should be evaluated for what
condition? Select all that apply.
a.
Hypocalciuria
b.
Nephrotic syndrome
c.
Glomerulonephritis
d.
UTI
e.
Diabetes mellitus
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ANS: D, E
Feedback
Correct
Complaints of dysuria or urgency from a child with secondary enuresis
suggest the possibility of a UTI. If accompanied by excessive thirst and
weight loss, these symptoms may indicate the onset of diabetes mellitus.
Incorrect
An excessive loss of calcium in the urine (hypercalciuria) can be associated
with complaints of painful urination, urgency, frequency, and
wetting.Nephrotic syndrome is not usually associated with complaints of
dysuria or urgency. Glomerulonephritis is not a likely cause of dysuria or
urgency.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1120
OBJ: Nursing Process: Evaluation MSC: Client Needs: Physiologic Integrity
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2. A nurse is planning care for a child admitted with nephrotic syndrome. Which interventions should be
included in the plan of care? Select all that apply.
a.
Administration of antihypertensive medications
b.
Daily weights
c.
Salt-restricted diet
d.
Frequent position changes
e.
Teaching parents to expect tea-colored urine
ANS: B, C, D
Feedback
Correct
A child with nephrotic syndrome will need to be monitored closely for fluid
excess so daily weights are important. The diet is salt restricted to prevent
further retention of fluid. Because of the fluid excess, frequent position
changes are required to prevent skin breakdown.
Incorrect
Nephrotic syndrome
does not require antihypertensive medications. These
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are administered for acute glomerulonephritis. Tea-colored urine is expected
with acute glomerulonephritis, but not nephrotic syndrome. The urine in
nephrotic syndrome is frothy indicating protein is being lost in the urine.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1135
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
3. A nurse is assessing an infant for urinary tract infection (UTI). Which assessment findings should the nurse
expect? Select all that apply.
a.
Change in urine odor or color
b.
Enuresis
c.
Fever or hypothermia
d.
Voiding urgency
e.
Poor weight gain
ANS: A, C, E
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MATERNAL CHILD NURSING 5TH EDITION MCKINNEY TEST BANK
Test Bank - Maternal-Child Nursing (5th Edition by McKinney)
779
Feedback
Correct
The signs of a UTI in an infant include fever or hypothermia, irritability,
dysuria as evidenced by crying when voiding, change in urine odor or color,
poor weight gain, and feeding difficulties.
Incorrect
Enuresis and voiding urgency should be assessed in an older child.
PTS: 1 DIF: Cognitive Level: Analysis REF: p. 1122 | Box 44-1
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
COMPLETION
1. The extrusion of the bladder to the outside of the body through a developmental defect in the abdominal wall
is known as bladder _________.
ANS:
exstrophy
The exposed bladder is covered with nonadherent plastic wrap until surgery can be done. Surgical management
is completed in several stages and includes closing the abdominal defect and reconstructing the bladder and
genitalia to allow the child to achieve urinary incontinence.
PTS: 1 DIF: Cognitive Level: Comprehension REF: p. 1129 | Table 44-1
OBJ: Nursing Process: Assessment MSC: Client
Needs: Physiologic Integrity
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TRUE/FALSE
1. The care of the child with chronic renal failure is complex and requires a multidisciplinary team approach.
Most of these children will ultimately require dialysis. Is this statement true or false?
ANS: T
This statement is correct. Children and their families will be most successful with dialysis treatment if the
method chosen fits their lifestyle. The goal is to optimize physical, social, and emotional development while
addressing the complex physical requirements related to chronic renal failure.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1140
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
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