3. What is an initial sign of nephrosis that the nurse might note in a child?
a. Raspberry-like rash
b. Periorbital edema
c. Temperature elevation
d. Abdominal pain
ANS: B The edema of nephrotic syndrome is generalized and not readily noticed, even by the parents,
but an early sign that can be assessed is periorbital edema. DIF: Cognitive Level: Knowledge REF: Page
692 TOP: Nephrotic Syndrome KEY: Nursing Process Step: Data Collection MSC: NCLEX: Health
Promotion and Maintenance: Prevention and Early Detection of Disease
4. What is it important to assess in a child receiving prednisone to treat nephrotic syndrome?
a. Infection
b. Urinary retention
c. Easy bruising
d. Hypoglycemia
ANS: A Prednisone depresses the immune response and increases susceptibility to infection. Because
steroids mask signs of infection, the child must be assessed for more subtle symptoms of illness.
6. A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed.
What is the most appropriate nursing intervention for this child?
a. Providing activities for the child on restricted activity
b. Feeding the child a protein-restricted diet
c. Carefully handling edematous extremities
d. Observing the child for evidence of hypotension
ANS: A Although children may feel well, activity is limited until hematuria resolves.
8. The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to
get immunizations to enter kindergarten. What does the nurse clarify about receiving immunizations
while on prednisone? a. Can interfere with the treatment for nephrosis b. Require that the child have
antibiotic coverage c. Can be given in smaller, divided doses d. Should be delayed ANS: D No
vaccinations or immunizations should be administered while the disease is active and during
immunosuppressive therapy.
9. Diuresis has not occurred on a child with nephrotic syndrome after a month on corticosteroids. What
protocol can the nurse encourage to bring about diuresis? a. Ibuprofen, an anti-inflammatory agent b.
Furosemide (Lasix), a diuretic c. Ciprofloxacin (Cipro), an antibiotic d. Cyclophosphamide (Cytoxan), an
antisuppressant ANS: D A potent antisuppressant such as Cytoxan can bring about diuresis when
corticosteroids have proven ineffective.
10. What foods does the nurse recommend the child with acute glomerulonephritis avoid to prevent
hyperkalemia? a. Dairy products b. Whole-grain cereals c. Organ meats d. Bananas ANS: D Bananas are
very high in potassium and should be avoided.
13. A parent tells the nurse that her child is scheduled for an x-ray of the bladder and urethra that is
done while the child is urinating. What is this test known as? a. Cystometrogram b. Cystoscopy c.
Voiding cystourethrogram d. Intravenous pyelogram ANS: C An x-ray examination of the bladder and
urethra before and during micturition is called a voiding cystourethrogram
15. What is an appropriate intervention for the edematous child with reduced mobility related to
nephrotic syndrome? a. Reach the child to minimize body movements. b. Change the childs position
frequently. c. Keep the head of the childs bed flat. d. Keep edematous areas moist and covered. ANS: B
The child should be turned frequently to prevent respiratory tract infection and to prevent pressure on
delicate skin.
16. Which statement made by a parent of a child with nephrotic syndrome indicates an understanding
of discharge teaching? a. I will make sure he gets his measles vaccine as soon as he gets home. b. He can
stop taking his medication next week. c. I should check his urine for protein when he goes to the
bathroom. d. He should eat a low-protein diet for the next few weeks. ANS: C The parents should be
instructed to keep a daily record of the childs urinary proteins
17. A 5-year-old boy is admitted to the hospital with acute glomerulonephritis. In taking the childs
history, what does the nurse recognize as the probable cause? a. Recovery from German measles 2
months ago b. Dysuria since the previous night c. A history of allergy d. A sore throat 2 weeks ago ANS: D
Acute glomerulonephritis develops from 1 to 3 weeks after a streptococcal infection, which causes an
allergictype response that alters the effectiveness of the glomeruli.
20. What will the nurse caution the parents of a child who has had a nephrectomy that he will have to
avoid? a. Contact sports b. Horseback riding c. Alcohol d. Diuretic medications ANS: A Children who have
only one kidney should avoid contact sports to prevent injury to that remaining organ.
26. The nurse caring for a child with nephrotic syndrome is alert to which classic symptoms of this
disorder? (Select all that apply.) a. Proteinuria b. Grossly bloody urine c. Hyperalbuminemia d. Fatigue e.
Generalized edema
24. A 7-year-old child has a BUN of 25 mg/dL. What is the nurse aware this lab value might indicate?
(Select all that apply.) a. Dehydration b. Renal disease c. Need for steroid therapy d. Diabetes Test Bank Introduction to Maternity and Pediatric Nursing 8e (by Leifer) 272 NURSINGTB.COM INTRODUCTION TO
MATERNITY AND PEDIATRIC NURSING 8TH EDITION LEIFER TEST BANK Downloaded by:
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by Zaqua Ervin (zaquaervin222@gmail.com) lOMoARcPSD|12030340 Stuvia.com - The Marketplace to
Buy and Sell your Study Material NURSINGTB.COM e. Pituitary malfunction ANS: A, B, C Increased BUN
can indicate dehydration, renal disease, and/or need for steroid therapy
26. The nurse caring for a child with nephrotic syndrome is alert to which classic symptoms of this
disorder? (Select all that apply.) a. Proteinuria b. Grossly bloody urine c. Hyperalbuminemia d. Fatigue e.
Generalized edema ANS: A, B, D, E All options listed are those of nephrotic syndrome with the exception
of hyperalbuminemia. The nephrotic child has hypoalbuminemia, as most of the protein has been spilled
in the urine.
28. What special considerations are related to long-term prednisone therapy in preschoolers? (Select all
that apply.) a. Delayed immunization b. Hypertension c. Enlargement of the sex organs d. Alteration in
nutrition e. Increased risk for infection ANS: A, E Delayed immunization and greater risk for infection are
concerns relative to long-term prednisone therapy
9. A child has a fever and arthralgia. The primary care pediatric nurse practitioner learns that the child
had a sore throat 3 weeks prior and auscultates a murmur in the clinic. Which test will the nurse
practitioner order? A. AntiDNase B test B. ASO titer Correct Downloaded by Zaqua Ervin
(zaquaervin222@gmail.com) lOMoARcPSD|12030340 PPP. Rapid strep test QQQ. Throat culture
11. A child is diagnosed with nephrotic syndrome, and the pediatric nurse practitioner provides primary
care in consultation with a pediatric nephrologist. The child was treated with steroids and responded
well to this treatment. What will the nurse practitioner tell the child’s parents about this disease?
GGGG. “Future episodes are likely to have worse outcomes.” HHHH. “Steroids will be used when
relapses occur.” Correct IIII. “This represents a cure from this disease.” JJJJ. “Your child will need to take
steroids indefinitely.”
12. A child who has nephrotic syndrome is on a steroids and a saltrestricted diet for a relapse of
symptoms. A dipstick urinalysis shows 1+ protein, down from 3+ at the beginning of the episode. In
consultation with the child’s nephrologist, what is the correct course of treatment considering this
finding? QQQ. Begin a taper of the steroid medication while continuing salt restrictions. RRR. Continue
with steroids and salt restrictions until the urine is negative for protein. Correct SSS. Discontinue the
steroids and salt restrictions now that improvement has occurred. TTT. Relax salt restrictions and
continue administration of steroids until proteinuria is gone. 13. A child who had GABHS 2 weeks prior is
in the clinic with periorbital edema, dyspnea, and elevated blood pressure. A urinalysis reveals
teacolored urine with hematuria and mild proteinuria. What will the primary care pediatric nurse
practitioner do to manage this condition? SSS. Prescribe a 10to 14day course of highdose amoxicillin.
TTT. Prescribe highdose steroids in consultation with a nephrologist. UUU. Reassure the parents that this
condition will resolve spontaneously. VVV. Refer the child to a pediatric nephrologist for hospitalization.
Correct
11. An 8-year-old child is hospitalized with infectious polyneuritis (Guillain-Barr syndrome [GBS]). When
explaining this disease process to the parents, what should the nurse consider? a. Paralysis is
progressive with little hope for recovery. b. Disease is inherited as an autosomal, sex-linked, recessive
gene. c. Disease results from an apparently toxic reaction to certain medications. d. Muscle strength
slowly returns, and most children recover. ANS: D Recovery usually begins within 2 to 3 weeks, and most
patients regain full muscle strength. The paralysis is progressive with proximal muscle weakness
occurring before distal weakness. The recovery of muscle strength occurs in the reverse order of onset
of paralysis. Most individuals regain full muscle strength. Better outcomes are associated with younger
ages. GBS is an WWW.NURSYLAB.COM Downloaded by Zaqua Ervin (zaquaervin222@gmail.com)
lOMoARcPSD|12030340 immune-mediated disease often associated with a number of viral or bacterial
infections or the administration of vaccines. DIF: Cognitive Level: Applying REF: dl. 1644 TOP: Integrated
Process: Teaching/Learning MSC: Client Needs: Physiological Integrity 12. A 12-year-old child with
Guillain-Barr syndrome (GBS) is admitted to the pediatric intensive care unit. She tells you that
yesterday her legs were weak and that this morning she was unable to walk. After the nurse determines
the current level of paralysis, which should the next priority assessment be? a. Swallowing ability b.
Parental involvement c. Level of consciousness d. Antecedent viral infections ANS: A Assessment of
swallowing is essential. Both pharyngeal involvement and respiratory function are usually involved at
the same time. The child may require ventilatory support. The inability to swallow also contributes to
aspiration pneumonia. Parental involvement is important after the physiologic assessment is complete.
The child is answering questions and describing the onset of the illness, which demonstrates she is alert
and oriented. Information regarding antecedent viral infections can be obtained after the child is
assessed and stabilized.