RENAL DISORDER

Tea-colored urine…….The nurse is caring for a child admitted with acute

glomerulonephritis. Which clinical manifestation would likely have been noted in the child
with this diagnosis?

Demonstrate love and acceptance at home……….A parent is asking how she can help
her son deal with the peer ridicule at school in regards to enuresis. What is the best
response by the nurse?

The child has a greater risk for trauma to the kidney………The location of the kidneys in
the child in relationship to the location of the kidneys in the adult makes which fact a greater
likelihood in the child?

This will determine if there is an acid-base problem……..The nurse is working with a

child with impaired urinary elimination. What is the purpose of monitoring the electrolytes
and arterial blood gases (ABGs)?

urinalysis……….Which of these laboratory results would be most important for the nurse to
assess in a child who has a diagnosis of urinary tract infection?

The child does not have intravenous access……….A pediatric client is scheduled for an
intravenous pyelogram (IVP) of the kidney this afternoon. Which of these actions by the
nurse would require immediate attention?

Parents/family use positive coping mechanisms in response to the child and the
voiding disorder…….The nurse determines that interventions for a voiding disorder have
been effective when the family of a child with enuresis demonstrates evidence of which of
the following?

Checking with the parents for any allergies……A nurse is caring for a 7-year-old girl
scheduled for an intravenous pyelogram (IVP). Which action would be the priority before the
test?

The most common age for UTIs in children is 2 to 6 years of age………The nurse is
discussing urinary tract infections (UTI's) in children with a group of peers. Which fact is the
most accurate regarding urinary tract infection seen in children?

Oliguria and jaundice………A teacher sends a child to see the school nurse for irritability
and bruising. Which symptom would be indicative of hemolytic uremic syndrome?

Weighing on the same scale each day……..In caring for a child with nephrotic syndrome,
which interventions will be included in the child's plan of care?
recent illness such as strep throat……..A child diagnosed with acute glomerulonephritis
will most likely have a history of:

obtaining a clean catch voided urine………The first method of choice for obtaining a urine
specimen from a 3-year-old child with a possible urinary tract infection is:

6 to 7 years of age……The nurse is teaching an in-service program to a group of nurses on

the topic of children diagnosed with acute glomerulonephritis. In which age range is the peak
incidence of this disorder noted?
Sodium bicarbonate tablets……The nurse is caring for a 10-year-old boy with end-stage
renal disease (ESRD) with metabolic acidosis. What would the nurse expect to administer if
ordered?

Escherichia coli…….A nurse is preparing a presentation for a local parent group about
urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into
the presentation as the most common cause?

1200 mL……..The nurse is monitoring the fluid balance of a 9-year-old child. When
evaluating urine output for the day, which output would the nurse identify as being within
normal limits?

"This surgery will cure my child's condition."..........The nurse is educating the mother of
a child who will receive a kidney transplant. Which statement made by the mother indicates
further teaching is needed?

acute glomerulonephritis………A client has just been admitted to the unit with a history of
recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would
suspect which condition?

A fever is commonly noted with a UTI.

Change diapers promptly, especially after bowel movements.
Female urethras are shorter and straighter than males………The nurse is caring for a 7-
month-old female infant diagnosed with a urinary tract infection (UTI). The parents are upset
as this is the infant's second UTI with a fever. Which instruction is most helpful? Select all
that apply.

intestinal bacteria……Most urinary tract infections seen in children are caused by

Risk for infection……When providing care to a child with vesicoureteral reflux (VUR),
which nursing diagnosis would be the priority?

Signs of infection………..A 6-year-old child has undergone a renal transplant and is

receiving cyclosporine. The nurse instructs the parents to be especially alert for which
complication?

Abdominal pain
Hypertension
Crackles………..The nurse is assessing a child with acute poststreptococcal
glomerulonephritis. Which client symptoms would the nurse anticipate during assessment?
Select all that apply.

Sexual activity………A 16-year-old girl has had several cases of cystitis in the past year.
Which of the following should the nurse suspect as the cause, based on this finding?

Abdominal pain……….A 3-year-old child is exhibiting irritability, fever, and decreased

appetite. A recent history of which of the following would make the nurse suspicious of a
urinary tract infection (UTI)?

Wipe from front to back.

Encourage fluids throughout the day.
Finish all antibiotic prescribed……….Which instruction should a nurse give to a client who
has a history of urinary tract infection to prevent recurrence?
Oliguria………The nurse is reviewing lab work prior to shift handoff on a client with a
subnormal urine output. Which is the nurse most correct to report?

Periorbital edema………The nurse is triaging clients as they come in to an express care

facility. Which assessment finding is clinically significant for early nephrotic syndrome?

Abdominal palpation……….The nurse is caring for a pediatric client who is scheduled for
the surgical removal of a Wilms tumor. Which is contraindicated in the client's care?

The child can live a more normal lifestyle………….The nurse knows this is a description
of peritoneal dialysis when compared to hemodialysis:

acute glomerulonephritis………….The caregiver of a child with a history of ear infections

calls the nurse and reports that her son has just told her his urine "looks funny." He also has
a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days
ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to
have the child seen by the care provider because the nurse suspects the child may have:

The child recently had an ear infection……….The nurse is collecting data for a child
diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's
history?

Blood pressure 136/84……….The nurse is collecting data on a 6-year-old child admitted

with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's
diagnosis?

"The child may look chubby, but he is really malnourished.""............The nurse is

teaching an in-service program on children diagnosed with nephrotic syndrome. Which
statement made by the nurse accurately reflects information on the disease process?

Creatinine clearance rate………A child is being evaluated for renal and urinary tract
disease. What would the nurse expect to be ordered to evaluate the child's glomerular
filtration rate?

Hypospadias………The nurse is assessing a male neonate and notes that the urethral
opening is on the ventral aspect of the penis. Which finding is documented?

Report any abnormally colored urine to the child's primary care

provider……………….The mother of 6-month-old girl is concerned about her daughter
getting a urinary tract infection. What should the nurse mention to the mother to help prevent
this condition?

An 18-year-old female who is sexually active……….Which child has the highest risk of
urinary tract infection?

Onset of a streptococcus infection last week………The nurse is caring for a client newly
diagnosed with acute glomerulonephritis? When receiving the pediatric client's history, which
is anticipated?

The VCUG will rule out VUR………..A voiding cystourethrogram (VCUG) is ordered on a
child. What education should be provided to the parents?

Demonstrate love and acceptance at home……….A parent is asking how she can help
her son deal with the peer ridicule at school in regards to enuresis. What is the best
response by the nurse?
Bloody urine………The nurse is collecting data on a child recently diagnosed with acute
glomerulonephritis. Which of the following clinical manifestations was likely noted in this
child?

The child has a greater risk for trauma to the kidney…………The location of the kidneys
in the child in relationship to the location of the kidneys in the adult makes which fact a
greater likelihood in the child?

The nurse administers diuretics.

The nurse administers antihypertensives.
The nurse weighs the child every day using the same scale.
The nurse dipsticks the child's urine to test for protein……….When caring for a child
who has a diagnosis of acute glomerulohephritis, which nursing interventions would most
likely be included in the child's plan of care? Select all that apply.

"Let's meet with the dietitian and plan some meals."..........The nurse is preparing a 7-
year-old girl for discharge after treatment for nephrotic syndrome. Which instructions would
the nurse include in the discharge teaching plan for the parents?

Applying a barrier/healing cream or paste on skin…………The nurse is caring for an

infant with bladder exstrophy. As part of the infant's preoperative plan of care, the nurse
monitors for abdominal skin excoriation. Which action would be most appropriate for
promoting healing and preventing further skin breakdown?

False……….Peritoneal dialysis is so effective that 3 hours of peritoneal dialysis

accomplishes as much as 12 hours of hemodialysis.

The client remains continent throughout the night………..Which goal of therapy would
be appropriate for a nurse to establish with a client's family and a client who has a diagnosis
of enuresis?

Acute glomerulonephritis……..The nurse is collecting data on a school-aged child with the

following symptoms:

Abrupt beginning to urinary symptoms

Gross hematuria
VS -99 (F), 39.2 (C), 92, 22, 142/92
Mild edema………….Which disease condition does the nurse anticipate?

Failure to thrive………An infant is diagnosed with a urinary tract infection. What

corroborating finding would the nurse expect on assessment?

Eyes……….The nurse is caring for a child with nephrotic syndrome. The child is noted to
have edema. The edema would most likely be seen where on this child?

Take the child's blood pressure and report the findings to the nurse while the nurse is
still on the phone…………The caregiver of a child being treated at home for acute
glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The
child is resting comfortably but the caregiver would like to know what to do. The nurse would
instruct the caregiver to take which action?

15 mL……..If the newborn is following a normal development process, the child will most
likely void when which amount of urine is in the bladder?
Eyes…….A symptom often seen in acute glomerulonephritis is edema. The most common
site the edema is first noted is in which area of the body?

Measure the abdominal girth daily…………The nurse is caring for an 8-year-old child
hospitalized with nephrotic syndrome. Which nursing intervention would be appropriate for
this child?

Administer the IV fluid slowly……….A 10-year-old girl is experiencing acute renal failure
due to dehydration. The nurse is preparing to administer IV fluid. Which of the following
interventions should the nurse take in caring for this child?

"Children are not expected to stay dry through the night until the age of 5."...............A
concerned mother brings her 3-year-old to the primary care office because of nighttime
voiding. Which response made by the nurse is best?

Check the catheter for patency…………..The nurse is caring for a post-surgical child with
a new suprapubic catheter. The child begins to moan in pain suddenly. Which nursing
intervention is the priority?

Weight, daily……….A child is hospitalized with nephrotic syndrome. Which measurement is

best for the nurse to determine the child's edema?

Take the child's blood pressure and report the findings to the nurse while the nurse is
still on the phone………….The caregiver of a child being treated at home for acute
glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The
child is resting comfortably but the caregiver would like to know what to do. The nurse would
instruct the caregiver to take which action?

Pulse rate and rhythm…………The nurse is providing care to a child with acute renal
failure. What assessment would be a priority for the nurse to determine if this child is
developing hyperkalemia?

Encourage the child to take all the antibiotics if diagnosed with strep throat………..A
school nurse is trying to prevent post streptococcal glomerulonephritis in children. What
would be the best way to prevent this?

Blood pressure 136/84………….The nurse is collecting data on a 6-year-old child admitted

with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's
diagnosis?

Checking with the parents for any allergies………A nurse is caring for a 7-year-old girl
scheduled for an intravenous pyelogram (IVP). Which action would be the priority before the
test?

Tea-colored urine…………..The nurse is caring for a child admitted with acute

glomerulonephritis. Which clinical manifestation would likely have been noted in the child
with this diagnosis?

Parents/family use positive coping mechanisms in response to the child and the
voiding disorder…………….The nurse determines that interventions for a voiding disorder
have been effective when the family of a child with enuresis demonstrates evidence of which
of the following?
Banana splits……….A child who has been diagnosed with minimal change nephrotic
syndrome (MCNS) is being discharged after a 3-week hospitalization. Her edema has been
greatly reduced and her appetite is beginning to return. Her caregivers have promised to
have a family party to celebrate her return. The child has requested the following foods for
the party. Which of these foods would the nurse suggest is appropriate for this child's diet?

"A girl's urethra is much shorter and straighter than a boy's, so it can be
contaminated fairly easily………….The nurse is reinforcing teaching with the caregiver of
5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why
her daughter has had three urinary tract infections but her son has had none. She reports
that their diets and fluid intake is similar. Which statement would be accurate for the nurse to
tell this mother?

Sexual activity……….A 16-year-old girl has had several cases of cystitis in the past year.
Which of the following should the nurse suspect as the cause, based on this finding?

Sodium bicarbonate tablets………. The nurse is caring for a 10-year-old boy with end-
stage kidney disease (ESKD) with metabolic acidosis. What would the nurse expect to
administer if ordered?

Acute glomerulonephritis……….A client has just been admitted to the unit with a history of
recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse would
suspect which condition?

Intestinal bacteria…….. Most urinary tract infections seen in children are caused by:
a) Wipe from front to back
c) Finish all antibiotics prescribed
d) Encourage fluids throughout the day………..Which instructions should a nurse give to
a client who has a history of urinary tract infections to prevent recurrence? Select all that
apply.

Measure the abdominal girth daily…………..The nurse is caring for an 8-year-old child
hospitalized with nephrotic syndrome. Which nursing intervention would be appropriate for
this child?

Oliguria……The nurse is reviewing lab work prior to shift handoff on a client with a
subnormal urine output. Which is the nurse most correct to report?

Urinalysis…….Which laboratory test result would be most important for the nurse to assess
in a child who is suspected of having a urinary tract infection?

The child has been sexually abused, maybe on the fishing trip……. A caregiver brings
her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after
being completely toilet trained even at night for over 2 years. The caregiver further reports
that the child has wet the bed every night since returning home from a 1-week fishing trip.
The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and
will not make eye contact. Further evaluation needs to be done to rule out what possible
explanation for the bedwetting?

Oliguria and jaundice……..A teacher sends a child to see the school nurse for irritability
and bruising. Which symptom would be indicative of hemolytic uremic
syndrome?
Placing the infant in a side-lying position…… When developing the preoperative plan of
care for an infant with bladder exstrophy, which intervention would the nurse least likely
include?

Sudden onset of severe scrotal pain with significant hemorrhagic swelling………The

nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which
assessment finding would indicate testicular torsion?

Acute glomerulonephritis……..The caregiver of a child with a history of ear infections calls

the nurse and reports that her son has just told her his urine "looks funny." He also has a
headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days
ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to
have the child seen by the care provider because the nurse suspects the child may have:

Onset of a streptococcus infection last week…………The nurse is caring for a client

newly diagnosed with acute glomerulonephritis. When receiving the pediatric client's history,
which is anticipated?

1200 mL…….The nurse is monitoring the fluid balance of a 9-year-old child. When
evaluating urine output for the day, which output would the nurse identify as being within
normal limits?

b) A fever is commonly noted with a UTI

d) Change diapers promptly, especially after bowel movements
e) Female urethras are shorter and straighter than males…….The nurse is caring for a
7-month-old female infant diagnosed with a urinary tract infection (UTI). The parents are
upset as this is the infant's second UTI with a fever. Which instruction is most helpful? Select
all that apply.

Demonstrate love and acceptance at home……….A parent is asking how to help the child
deal with the peer ridicule at school in regards to enuresis. What is the best response by the
nurse?

Creatinine clearance rate……… A child is being evaluated for renal and urinary tract
disease. What would the nurse expect to be ordered to evaluate the child's glomerular
filtration rate?

"The kidneys help control blood pressure, so our child's blood pressure needs to be
checked often"......... A nurse is conducting a discussion group with parents of children who
have genitourinary disorders. As part of the discussion, the nurse reviews the major
functions of the kidneys. The nurse determines that the teaching was successful based on
which statement by the group?

The child has a greater risk for trauma to the kidney………The location of the kidneys in
the child in relationship to the location of the kidneys in the adult makes which fact a greater
likelihood in the child?

a) Small bladder capacity

b) Lack of awareness
c) Urinary tract infection…….Which cause of pediatric enuresis must be ruled out before
psychological causes are investigated? Select all that apply.
To dilute the urine and flush the bladder………The nurse is caring for a child diagnosed
with a urinary tract infection. The caregiver asks the nurse why it is so important for the child
to have so much fluid. What is the most important reason the child needs increased fluids?

"Let's meet with the dietitian and plan some meals".......The nurse is preparing a 7-year-
old girl for discharge after treatment for nephrotic syndrome. Which instructions would the
nurse include in the discharge teaching plan for the parents?

The most common age for UTIs in children is 2 to 6 years of age……. The nurse is
discussing urinary tract infections (UTI's) in children with a group of peers. Which fact is the
most accurate regarding urinary tract infection seen in children?

Abdominal pain……A 3-year-old child is exhibiting irritability, fever, and decreased

appetite. A recent history of which of the following would make the nurse suspicious of a
urinary tract infection (UTI)?

"Children are not expected to stay dry through the night until the age of
5"....................A concerned mother brings her 3-year-old to the primary care office because
of nighttime voiding. Which response made by the nurse is best?

Bloody urine……… The nurse is collecting data on a child recently diagnosed with acute
glomerulonephritis. Which clinical manifestation was likely noted in this child?

"Has your child complained of pain?"......The nurse is collecting data on a 2-year-old

child admitted with a diagnosis of urinary tract infection. When interviewing the caregivers,
which question would be most important for the nurse to ask?

Acute Glomerulonephritis
A client is admitted with oliguria, edema, hypertension & circulatory congestion, hematuria,
and proteinuria. What are these findings indicative of?

Acute poststreptococcal glomerulonephritis (APSGN)

an antibody-antigen disease that occurs as a result of certain strains of the Group A
β-hemolytic streptococcal infection and is most commonly seen in children between the ages
of 5 and 8 years
a risk factor for Acute Glomerulonephritis

expected (history) finding of Acute Glomerulonephritis

recent upper respiratory infection or streptococcal infection

5 and 10
Acute glomerulonephritis is most common in children between the ages of ________years,
the age group most susceptible to streptococcal infections.

encephalopathy…….If blood pressure reaches 160/100 mm Hg as part of the acute

process of APG, _____________may occur, with symptoms of headache, irritability,
seizures, vomiting, coma or lethargy, and perhaps transitory paralysis.

Obtaining a clean catch voided urine………The first method of choice for obtaining a
urine specimen from a 3-year-old child with a possible urinary tract infection is which of the
following?

Teach her to wipe her perineum front to back after voiding……To prevent further urinary
tract infections in a preschooler, what measures would you teach her mother?
The child's risk for renal scarring is increased with pyelonephritis…….The mother of a
child diagnosed with pyelonephritis asks if the kidneys were damaged because of this. What
is the best response by the nurse?
Thick, white cheese-like discharge……..An adolescent comes to the clinic reporting vaginal
discharge. When assessing the vaginal discharge, which of the following would lead the
nurse to suspect that the adolescent has candidiasis?

Bladder capacity reaches adult capacity by age 1 year……..A group of nursing students
are reviewing the variations in the genitourinary system in children as compared with adults.
The students demonstrate understanding of this information when they identify which of the
following?

Smoky colored urine……The nurse is caring for a child admitted with acute
glomerulonephritis. Which of the following clinical manifestations would likely have been
noted in the child with this diagnosis?

"There are nutritional and medical things she can do to lessen the symptoms; I'll give
both of you information about some strategies and we'll track her for a few
months.".............A single male caregiver of a 14-year-old girl accompanies his daughter to
her pre-high school physical. In the course of discussion about how his daughter is
developing, he remarks, "She's terrific most of the time. Of course when she gets her period,
she's miserable and mean, but I tell her that's just what it's like to be a woman." Of the
following statements, which would be the most appropriate response by the nurse?

Fowler's……The child with nephrotic syndrome who has ascites and difficulty breathing is
probably most comfortable sleeping in which position?

Infection-control precautions that may cause him to be lonely………..A child in kidney

failure has had a kidney transplantation. You would prepare the child for which of the
following to occur postoperatively?

Endometriosis…….A 15-year-old girl has been experiencing dysmenorrhea for the past
year. Over the past 6 months, she has been taking ibuprofen and oral contraceptives, with
no improvement. What underlying condition should be assessed for in this client at this
point?

Recent illness such as strep throat……..A child diagnosed acute glomerulonephritis will
most likely have a history of which of the following?

Creatinine clearance…..A child needs to collect urine for 24 hours and the nurse explains
that this test assesses glomerular filtration rate and how the kidneys are functioning. Which
of the following would be indicative of this type of test?

Take over-the-counter ibuprofen for its prostaglandin action……..A 16-year-old tells

you she has terrible dysmenorrhea. Which of the following actions would be the best health
teaching measure regarding this?

Explain that breakthrough bleeding is normal during the first 3 or 4 months of oral
contraceptive use but that it should go away after tha………..A 16-year-old girl visits her
gynecologist with a complaint of metrorrhagia, or bleeding between menstrual periods, since
her last visit, 3 months ago. On consulting the patient's chart, the nurse learns that she was
prescribed an oral contraceptive at her last visit. Which of the following interventions should
the nurse implement in this situation?
Encourage the child to take all the antibiotics if diagnosed with strep throat…….A
school nurse is trying to prevent poststreptococcal glomerulonephritis in children. Which of
the following would be the best way to prevent this?

Cryptorchidism…..The condition in which one or both of the testes does not descend in the
male infant is referred to as which of the following?

There is a chance the testicles will descend on their own…..A parent asks if their
newborn's undescended testicles will need surgery to repair. What is the best response by
the nurse?

Take the child to a private room and interview her regarding her sexual history and
partners…………An adolescent girl and her caregiver present at the pediatrician's office.
The adolescent complains of severe abdominal pain. A diagnosis of pelvic inflammatory
disease is made. The nurse notes in the child's chart that this is the third time she has been
treated for PID. The most appropriate action by the nurse would be to

a condom should be used during intercourse……You are counseling a couple about

sexually transmitted diseases. The male partner has genital herpes. To prevent spread of
the infection to the female partner, you advise the couple that

This occurs when there is backflow of urine into the bladder and sometimes
kidneys…………A nurse is providing education to parents of a child diagnosed with
vesicoureteral reflux (VUR). Which of the following would be included in the education?

The foreskin is needed for repair………A newborn is diagnosed with hypospadias and the
parents want him to be circumcised. What would be the best response by the nurse?

Dark brown urine……Encouraging fluid intake after dinner…….A nurse is developing a

teaching plan for the parents of an 8 year old experiencing nocturnal enuresis. The nurse
determines that additional teaching is needed when the parents identify which of the
following as an appropriate measure?
You obtain a history from the mother of a child with glomerulonephritis about how he
became ill. Which of the following would you expect her to tell you she noticed?

"Emotional stress can be a cause of this disorder."........The nurse is doing a

presentation for a group of nursing students about the topic of menstrual disorders. After
discussing the disorder secondary amenorrhea the students make the following statements.
Which statement made by the nursing students is the most accurate regarding the cause of
secondary amenorrhea?

Pulse rate 135 bpm…….The nurse is collecting data on a 6-year-old child admitted with a
possible urinary tract infection. Which of the following vital signs might indicate the possibility
of an infection?

The boy has only begun wetting the bed and his pants recently, 1 year after being
successfully potty-trained………..A 5-year-old boy occasionally wets his bed at night and
his pants during the day. Which of the following findings would indicate an organic as
opposed to a functional cause of this enuresis?

some discomfort at the surgery site……..A 3-year-old is scheduled for a surgery to

correct undescended testes. An important postoperative consideration you would want to
prepare his parents for is
Weigh the child twice a day on the same scale…………The nurse is working with a child
with altered genitourinary status. Which of the following interventions would be included in
the plan of care with excess fluid volume?

The child can live a more normal lifestyle………The nurse knows which of the following is
a description of peritoneal dialysis when compared to hemodialysis?

Weighing on the same scale each day……….In caring for a child with nephrotic
syndrome, which of the following interventions will be included in the child's plan of care?

Intestinal bacteria……..Most urinary tract infections seen in children are caused by which
of the following?

Encourage high fluid intake………A nurse is performing postoperative care on a child with
a ureteral stent. Which of the following interventions will help manage bladder spasms?

Testis cannot be "milked" down inguinal canal……..The nurse is caring for a 5-month-
old boy with an undescended left testis. Which of the following would the nurse identify as
indicative of true cryptorchidism?

This may indicate a urinary tract infection……..A child is having their urine checked for a
routine well visit. When analyzing the results, what would positive leukocytes indicate?

A dull, aching abdominal pain at ovulation………A group of nursing students is

discussing terminology related to the genitourinary system during a post-conference setting.
One of the students asks what mittelschmerz is or what it means. A classmate of this student
correctly answers that mittelschmerz is which of the following?

The child has been sexually abused, maybe on the fishing trip……….A caregiver brings
her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after
being completely toilet trained even at night for over 2 years. The caregiver further reports
that the child has wet the bed every night since returning home from a one week fishing trip.
The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and
will not make eye contact. Further evaluation needs to be done to rule out which of the
following?

White cottage cheese-like discharge……..The nurse is caring for a 2-year-old girl with
suspected vulvovaginitis. The nurse suspects the cause as Candida albicans based on
which finding?

Alternate use of tampons with sanitary pads…….A 13-year-old girl tells the nurse during
a gynecological visit that a friend of hers developed toxic shock syndrome from tampon use.
The client says that tampons work well for her, but she wonders whether they are safe.
Which of the following recommendations should the nurse give this client to help prevent
toxic shock syndrome?

Sexual activity………A 16-year-old girl has had several cases of cystitis in the past year.
Which of the following should the nurse suspect as the cause, based on this finding?

Smoky colored urine……The nurse is caring for a child admitted with acute
glomerulonephritis. Which of the following clinical manifestations would likely have been
noted in the child with this diagnosis?

Pyelonephritis……..The nurse is teaching a group of nursing students about genitourinary

conditions. The nurse tells these students about a condition that occurs when there is an
inflammation of the kidney and renal pelvis. The condition the nurse is referring to is which of
the following?

The child recently had an ear infection……….The nurse is collecting data for a child
diagnosed with acute glomerulonephritis. Which of the following would the nurse likely find in
this child's history?

"A girl's urethra is much shorter and straighter than a boy's, so it can be
contaminated fairly easily."..............The nurse is reinforcing teaching with the caregiver of
5-year-old twins regarding urinary tract infections (UTI's). The caregiver is puzzled about
why her daughter has had three urinary tract infections but her son has had none. She
reports that their diets and fluid intake is similar. Which of the following statements would be
accurate for the nurse to tell this mother?

DNA analysis……..A child is born with ambiguous genitalia. Which of the following
assessments establishes whether the child is genetically male or female?

Increased white blood cell count of dialysate outflow………A nurse is assessing a child
that may have peritonitis. Which of the following would be signs of this problem?

Eyes…….The nurse is caring for a child with nephrotic syndrome. The child is noted to have
edema. The edema would most likely be seen where on this child?

void during the procedure………A 4-year-old girl with a urinary tract infection is scheduled
to have a voiding cystourethrogram. When preparing her for this procedure, you would want
to prepare her to

Creatinine clearance rate………A child is being evaluated for renal and urinary tract
disease. Which of the following would the nurse expect to be ordered to evaluate the child's
glomerular filtration rate?

Risk for infection related to immunocompromised state……….Which of the following

nursing diagnoses would be the priority when caring for a child in renal failure following a
kidney transplant?

Risk for infection……..When providing care to a child with vesicoureteral reflux (VUR),
which nursing diagnosis would be the priority?

Demonstrate love and acceptance at home……A parent is asking how she can help her
son deal with the peer ridicule at school in regards to enuresis. What is the best response by
the nurse?

Measure the abdominal girth daily……..The nurse is caring for an 8-year-old hospitalized
child with nephrotic syndrome. Which of the following nursing interventions would be
appropriate for this child?

Eyes…..A symptom often seen in acute glomerulonephritis is edema. The most common
site the edema is first noted is in which area of the body?

False…..The human papillomavirus (HPV) is commonly passed on from a pregnant woman

to her fetus.

Take the child's blood pressure and report the findings to the nurse while the nurse is
still on the phone…………The caregiver of a child being treated at home for acute
glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The
child is resting comfortably but the caregiver would like to know what to do. The nurse would
instruct the caregiver to do which of the following actions?

Blood Pressure 136/84…….The nurse is collecting data on a 6-year-old child admitted with
acute glomerulonephritis. Which of the following vital signs would the nurse anticipate with
this child's diagnosis?

"The doctor is hoping that the hormone will cause your son's undropped testes to
move into their proper place.".......The caregiver of a 1-year-old son calls the nurse, upset
that his wife has just told him that their son is being given a hormone. His wife says that the
pediatrician called it human chorionic gonadotropic hormone but that is all she understood.
The nurse most accurately clarifies the caregiver's question by making which of the following
statements regarding the son's treatment?

"Let's meet with the dietitian and plan some meals."........The nurse is preparing a 7-
year-old girl for discharge after treatment for nephrotic syndrome. Which instructions would
the nurse include in the discharge teaching plan for the parents?

Holding urine while at school……….A nurse is performing an assessment on a child.

Which of the following would be indicative of a potential for a urinary tract infection?

Sudden onset of severe scrotal pain with significant hemorrhagic swelling……..The

nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which
assessment finding would indicate testicular torsion?

A contributing factor in dysmenorrhea is the increased secretion of

prostaglandins………….The nurse is conducting a presentation for a group of nurses who
work with adolescents. The group of nurses discusses dysmenorrhea. Which of the following
statements is most accurate related to dysmenorrhea?

Hypospadias…….The nurse is assessing a male neonate and notes that the urethral
opening is on the ventral aspect of the penis. The nurse documents this finding as which of
the following?

Urine culture……..A 12-year-old girl reports pain and a burning sensation on urination. The
nurse suspects a urinary tract infection. Which of the following diagnostic tests would be
most appropriate for confirming this condition?

• Intermittent hematuria
• Abdominal mass………When assessing a child with hydronephrosis, which of the
following would the nurse expect to find? Select all that apply.

False…….Peritoneal dialysis is so effective that 3 hours of peritoneal dialysis accomplishes

as much as 12 hours of hemodialysis.

Administer the IV fluid slowly……..A 10-year-old girl is experiencing acute renal failure
due to dehydration. The nurse is preparing to administer IV fluid. Which of the following
interventions should the nurse take in caring for this child?

Show her a speculum prior to the exam……..Which measure would help an adolescent
relax best during a pelvic examination?

Acute glomerulonephritis……The caregiver of a child with a history of ear infections calls

the nurse and reports that her son has just told her his urine "looks funny." He also
complains of a headache, and his mother reports that his eyes are puffy. Although he had a
fever 2 days ago, his temperature is now down to 100 degrees Fahrenheit. The nurse
encourages the mother to have the child seen by the care provider because the nurse
suspects the child may have

• "After reaching the age of normal puberty, your daughter will maintain normal
growth, development and appearance."
• "Medication is available that can halt sexual maturation at this point."..........A mother
is distraught that her 7-year-old daughter has begun puberty early. She worries about both
the physical and social implications of this change for her daughter. Which of the following
should the nurse say to the mother to address these concerns? (Select all that apply.)

Anasarca……The nurse is assessing a child diagnosed with nephritic syndrome and

observes generalized edema. The nurse documents this as which of the following?

Yes
Rationale: Output of infant and child is 0.5-2mL/kg/hr…….The nurse is caring for a 2-
year old child with a RENAL DISORDER. The child's hourly urinary output is 13 mL and the
child weighs 13 kg. Is this patient adequate? Yes or No?

What is the BLADDER capacity of newborns?

30 mL

What is the BLADDER capacity of a 1-YEAR old?

270 mL

What is the OUTPUT of an INFANT and CHILD per hour?

0.5-2mL/kg

How much do 1-YEAR olds VOID per DAY?

400-500 mL/DAY

How much do ADOLESCENTS VOID per DAY?

800-1400 mL/DAY

How often do INFANTS and TODDLERS VOID?

UP to 10 times per DAY

Which medication is APPROPRIATE to give a CHILD with RENAL INSUFFICIENCY?

Furosemide

What is DESMOPRESSIN used for?

Enuresis

The nurse is caring for a child with NEPHROTIC SYNDROME. What assessment is
appropriate?
Urine dipstick for PROTEINURIA

What is the most common type of NEPHROTIC SYNDROME in children?

MINIMAL CHANGE nephrotic syndrome (MCNS) AKA IDIOPATHIC nephrotic
syndrome

**Often occurs BY 6 YEARS OF AGE

How does NEPHROTIC SYNDROME occur in children?

Too much ALBUMIN (PROTEIN) is RELEASED which implies one or both kidneys are
DAMAGED

What is another sign of NEPHROTIC SYNDROME in CHILDREN?

FOAMY URINE

What should be ASSESSED for in patients with MINIMAL CHANGE NEPHROTIC

SYNDROME? (2)
(1) PROTEINURIA via urine DIPSTICK

(2) SERUM PROTEIN and ALBUMIN (low because it is being excreted)

What is being MONITORED in patients with MINIMAL CHANGE NEPHROTIC

SYNDROME? (2)
(1) BLOOD PRESSURE

(2) INTAKE and OUTTAKE/ WEIGHT

(3) HYPOKALEMIA

What are the INTERVENTIONS for patients with MINIMAL CHANGE NEPHROTIC
SYNDROME?
Medical:
CORTICOSTEROIDS

Fluid/Electrolyte Balance:
IV Albumin, DIURETICS

What condition does NEPHROTIC SYNDROME CORRELATE with?

HYPOCALCEMIA caused by low albumin

The patient's bone density LOWERS

The nurse is caring for a child with a RENAL DISORDER, is a LIVER PANEL indicated?
NO, A LIVER PANEL is NOT INDICATED

The nurse is caring for a child with a RENAL DISORDER, is a CBC indicated?
YES, because it can cause ANEMIA, INFECTION, or THROMBOCYTOPENIA

The nurse is caring for a child with a RENAL DISORDER, is a CREATININE TEST
indicated?
YES, it diagnoses IMPAIRED RENAL function

The nurse is caring for a child with a RENAL DISORDER, is a HgA1C indicated?
NO, an HgA1C test is NOT INDICATED
The nurse is caring for a child with a RENAL DISORDER, is a POTASSIUM TEST
indicated?
YES, there can be POTASSIUM IMBALANCE in patients with renal disorders

The nurse is caring for a child with a RENAL DISORDER, is an ALBUMIN TEST indicated?
YES, it is LOW in renal failure and CONTRIBUTES TO EDEMA

The nurse is caring for a child with a RENAL DISORDER, is a CALCIUM TEST indicated?
YES, it correlates with LOW ALBUMIN which is a sign of NEPHROTIC SYNDROME

The nurse is caring for a newborn with BLADDER EXSTROPHY. What is an appropriate
nursing intervention?

C. SPONGE BATHE THE NEWBORN

How does the nurse care for a patient with BLADDER EXSTROPHY?
Keep the bladder MOIST and COVER in a sterile plastic bag

How do nurses prevent SKIN BREAKDOWN in newborns with BLADDER EXSTROPHY

Apply BARRIER CREAMS

How often should the nurse CHANGE SOILED DIAPERS in newborns with BLADDER
EXSTROPHY
The nurse should CHANGE THE DIAPERS IMMEDIATELY

The nurse is teaching a caregiver how to catheterize a URINARY STOMA. What should the
nurse include in the teaching?

A. Do not force the catheter if you feel RESISTANCE

How is a URINARY STOMA cleaned?

It is cleaned with WIPE or MILD SOAP and WATER

How are CATHETERS inserted in URINARY STOMAS?

If slight resistance is felt, TWIST the catheter or aim the catheter DOWNWARD. NEVER
FORCE

A newborn with hypospadias can be circumcised before hypospadias

repair. True or False?
FALSE, wait for the repair.

What should the nurse ASSESS for in patients with HYPO or EPI SPADIAS?
Undescended testes or CRYPTORCHIDISM
The nurse is caring for an 8-year-old child at a well-visit who reports NOCTURNAL
ENURESIS. What is the nurse's best action.

B. Ask about the type, amount, and frequency of fluid intake

Should the patient with NOCTURNAL ENURESIS increase fluids?

YES, DURING THE DAY

Should the patient with NOCTURNAL ENURESIS limit fluids after dinner?
YES, try NOT to drink after dinner

Should the patient with NOCTURNAL ENURESIS VOID before BED?

YES, it empties out the bladder and lowers the chances of voiding at night

When should patients with NOCTURNAL ENURESIS be awaken to void before sleeping?
11PM

How should patients with NOCTURNAL ENURESIS be supported?

Give the patients REWARDS for dry nights but never PUNISHMENTS; tell them MANY
PEOPLE HAVE THIS CONDITION

A nurse is caring for a child with ACUTE POSTSTREPTOCOCCAL

GLUMERULONEPHRITIS (APSGN). What is the priority nursing action?

A. Monitor urine output and color

What are three CLINICAL MANIFESTATIONS of ACUTE PS GLOMUROLONEPHRITIS?

(1) HYPERTENSION

(2) PROTEINURIA

(3) MACROSCOPIC HEMATURIA; urine appearing DARK RED/BROWN

What should nurses teach patients and their families about APSGN? (4)
(1) Monitor URINE OUTPUT and COLOR

(2) Take BLOOD PRESSURE

(3) RESTRICT DIETS and FLUIDS as PRESCRIBED

(4) RESTRICT ACTIVITIES

A nurse is caring for an infant with END STAGE RENAL DISEASE. Are SODIUM
BICARBONATE tablets alright to administer?
YES, it corrects METABOLIC ACIDOSIS
A nurse is caring for an infant with END STAGE RENAL DISEASE. Is it okay to use
DIALYSIS?
YES, corrects UREMIA and removes TOXIN

A nurse is caring for an infant with END STAGE RENAL DISEASE. Is it okay to use
POTASSIUM SUPPLEMENTS?
NO, usually they have HYPERKALEMIA

A nurse is caring for an infant with END STAGE RENAL DISEASE. Is it okay to RESTRICT
FLUIDS?
YES, patient might have FLUID OVERLOAD

A nurse is caring for an infant with END STAGE RENAL DISEASE. Is it okay to have DIET
"CHEAT DAYS"
Yes, but only with HEMODIALYSIS

A nurse is caring for an infant with END STAGE RENAL DISEASE. Is it okay to put an IV in
an ARM with FISTULA?
NO, it can CAUSE CLOTS and have problems with the fistula.

What is the common METABOLIC IMBALANCE with END-STAGE RENAL DISEASE

(ESRD) and CHRONIC RENAL FAILURE?
METABOLIC ACIDOSIS

What neurological problems do people with END-STAGE RENAL DISEASE have?

HEADACHE or COMA and LETHARGY caused by METABOLIC ACIDOSIS/UREMIA

What is INCREASED in END-STAGE RENAL DISEASE?

POTASSIUM, BUN, and CREATININE

What are the INTERVENTIONS for END-STAGE RENAL DISEASE? (4)

(1) DIALYSIS

(2) POTASSIUM RESTRICTIONS

(3) FLUID RESTRICTIONS

(4) Administer ERYTHROPOIETIN, GROWTH HORMONE, and SUPPLMENETS

Can PARITONEAL DIALYSIS be done at home?

YES, parents and caregivers can be trained

How long does PERITONEAL DIALYSIS last?

4-8 hours in INCREMENTS

How often is HEMODIALYSIS performed?

3-6 HOURS for 2-4 PER WEEK

What should not be performed on EXTREMITIES with an ARTERIOVENOUS FISTULA or

GRAFT?
DO NOT take BLOOD PRESSURE, PERFORM VENIPUNCTURES, OR USE A
TOURNIQUET

Malformed or low-set ears……..Urinary tract anomalies are frequently associated with

what irregularities in fetal development?

pH 4.0…..What urine test result is considered abnormal?

Renal ultrasonography…….What diagnostic test allows visualization of renal parenchyma

and renal pelvis without exposure to external-beam radiation or radioactive isotopes?

Cystitis……What name is given to inflammation of the bladder?

Urinary stasis…..The nurse is teaching a client to prevent future urinary tract infections
(UTIs). What factor is most important to emphasize as the potential cause?

Urinary tract infection (UTI).....A girl, age 5 1/2 years, has been sent to the school nurse
for urinary incontinence three times in the past 2 days. The nurse should recommend to her
parent that the first action is to have the child evaluated for what condition?

Ensure clear liquid intake of 2 L/day……What recommendation should the nurse make to
prevent urinary tract infections (UTIs) in young girls?

Have siblings examined for VUR………In teaching the parent of a newly diagnosed 2-
year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should
include which information?

Immune complex formation and glomerular deposition…….What pathologic process is

believed to be responsible for the development of postinfectious glomerulonephritis?

Reduction of edema……..The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of
hospitalization for acute glomerulonephritis. What is the most likely cause of this weight
loss?

Daily weight…….What measure of fluid balance status is most useful in a child with acute
glomerulonephritis?

Acute hypertension is a concern that requires monitoring………The parent of a child

hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are
being taken so often. What knowledge should influence the nurse's reply?

Reduced serum albumin…..What laboratory finding, in conjunction with the presenting

symptoms, indicates minimal change nephrotic syndrome?

Minimize excretion of urinary protein………What is the primary objective of care for the
child with minimal change nephrotic syndrome (MCNS)?
 Minimize risk of infection……..A hospitalized child with minimal change nephrotic
syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this
child?

Restricting fluids……The nurse is teaching a child experiencing severe edema associated

with minimal change nephrotic syndrome about his diet. The nurse should discuss what
dietary need?

Response to steroid therapy…….A child is admitted for minimal change nephrotic

syndrome (MCNS). The nurse recognizes that the child's prognosis is related to what factor?

The amount of hematuria is not a reliable indicator of the seriousness of renal

injury……..A 12-year-old child is injured in a bicycle accident. When considering the
possibility of renal trauma, the nurse should consider what factor?

Severe dehydration………What condition is the most common cause of acute renal failure
in children?

Mannitol (Osmitrol) or furosemide (Lasix) (or both).......A child is admitted in acute renal
failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the
administration of what medication?

Water and sodium retention……….What major complication is associated with a child with
chronic renal failure?

Low in phosphorus……What diet is most appropriate for the child with chronic renal failure
(CRF)?

Multiple stresses are placed on children with ESRD and their families because
children's lives are maintained by drugs and artificial means………..What nursing
consideration is most important when caring for a child with end-stage renal disease
(ESRD)?

Resentment of the control and enforced dependence imposed by dialysis……The

nurse is caring for an adolescent who has just started dialysis. The child always seems
angry, hostile, or depressed. The nurse should recognize that this is most likely related to
what underlying cause?

It is the preferred means of renal replacement therapy in children……….What

statement is descriptive of renal transplantation in children?

"I should not add additional salt to any of my child's meals.".......The nurse is
conducting discharge teaching with the parent of a 7-year-old child with minimal change
nephrotic syndrome (MCNS). What statement by the parent indicates a correct
understanding of the teaching?

Phimosis…….What is the narrowing of preputial opening of foreskin called?

Treatment is necessary to maintain the ability to be fertile when

older……….Identification and treatment of cryptorchid testes should be done by age 2
years. What is an important consideration?
Promote development of normal body image…………Congenital defects of the
genitourinary tract, such as hypospadias, are usually repaired as early as possible to
accomplish what?

Additional surgery may be necessary to achieve continence……..The parents of a 2-

year-old boy who had a repair of exstrophy of the bladder at birth ask when they can begin
toilet training their son. The nurse replies based on what knowledge?

Posturination dribbling……..An infant has been diagnosed with bladder obstruction. What
do symptoms of this disorder include?

Explain the disorder so they can explain it to others……….The parents of a child born
with ambiguous genitalia tell the nurse that family and friends are asking what caused the
baby to be this way. Tests are being done to assist in gender assignment. What should the
nurse's intervention include?

Gender assignment involves collaboration between the parents and a

multidisciplinary team……….Parents of a newborn with ambiguous genitalia want to know
how long they will have to wait to know whether they have a boy or a girl. The nurse answers
the parents based on what knowledge?

. "Prevent damage to the undescended testicle.".........Surgery is performed on a child to

correct cryptorchidism. The parents understand the reason for the surgery if they tell the
nurse this was done to do what?

Elevate the scrotum with a rolled washcloth……..What is an appropriate nursing

intervention for a child with minimal change nephrotic syndrome (MCNS) who has scrotal
edema?

Massive proteinuria, hypoalbuminemia, and edema……What do the clinical

manifestations of minimal change nephrotic syndrome include?

Diuresis occurs as urinary protein excretion diminishes……..For minimal change

nephrotic syndrome (MCNS), prednisone is effective when what occurs?

"We understand our child will not be able to attend school, so we will arrange for
home schooling."..........A nurse is evaluating the effectiveness of teaching regarding care
of a child with minimal change nephrotic syndrome (MCNS) that is in remission after
administration of prednisone. The nurse realizes further teaching is required if the parents
state what?

Urine output will increase………..A parent asks the nurse what would be the first indication
that acute glomerulonephritis was improving. What would be the nurse's best response?

Obtain the child's blood pressure and notify the health care provider…….A child with
acute glomerulonephritis is in the playroom and experiences blurred vision and a headache.
What action should the nurse take?

5 to 7 years……The nurse is preparing to admit a child to the hospital with a diagnosis of

acute poststreptococcal glomerulonephritis. The nurse understands that the peak age at
onset for this disease is what?

2 to 3 years……The nurse is preparing to admit a child to the hospital with a diagnosis of

minimal change nephrotic syndrome. The nurse understands that the peak age at onset for
this disease is what?
b. Anorexia
c. Hypertension
d. Purpura………The nurse is admitting a 9-year-old child with hemolytic uremic syndrome.
What clinical manifestations should the nurse expect to observe? (Select all that apply.)

a. Encourage fluids.
b. Monitor urinary output.
e.Monitor serum peak and trough levels……………The nurse is caring for a child with a
urinary tract infection who is on intravenous gentamicin (Garamycin). What interventions
should the nurse plan for this child with regard to this medication? (Select all that apply.)

a. Rash
b. Urticaria
e.Photosensitivity………..The nurse is caring for a child with a urinary tract infection who
is on trimethoprim-sulfamethoxazole (Bactrim). What side effects of this medication should
the nurse teach to the parents and the child? (Select all that apply.)

a. Hyponatremia
b. Hyperkalemia
d.Decreased plasma creatinine level
The nurse is caring for a child with acute renal failure. What laboratory findings should the
nurse expect to find? (Select all that apply.)

c. Frequent urination
d. Poor urinary stream
e. Failure to gain weight……..What signs and symptoms are indicative of a urinary tract
disorder in the neonatal period (birth to 1 month)? (Select all that apply.)

a. Pallor
b. Poor feeding
d. Excessive thirst
e. Frequent urination………What signs and symptoms are indicative of a urinary tract
disorder in the infancy period (1-24 months)? (Select all that apply.)

a. Fatigue
d. Growth failure
e. Blood in the urine………What signs and symptoms are indicative of a urinary tract
disorder in the childhood period (2 to 14 years)? (Select all that apply.)

d. Moderate sodium restriction

e. Limit foods high in potassium….What dietary instructions should the nurse give to
parents of a child in the oliguria phase of acute glomerulonephritis with edema and
hypertension? (Select all that apply.)

d. No salt added at the table

e. Restriction of foods high in sodium…….What dietary instructions should the nurse give
to parents of a child with minimal change nephrotic syndrome with massive edema? (Select
all that apply.)

b. Fluid restriction
d. Sodium restriction
e. Potassium restriction…….What dietary instructions should the nurse give to parents of a
child undergoing chronic hemodialysis? (Select all that apply.)
b. Calcium gluconate
c. Sodium bicarbonate
d. Glucose 50% and insulin………A child is hospitalized in acute renal failure and has a
serum potassium greater than 7 mEq/L. What temporary measures that will produce a rapid
but transient effect to reduce the potassium should the nurse expect to be prescribed?
(Select all that apply.)

b. There are fewer complications with a fistula.

c. There is less restriction of activity with a fistula.
d. It produces dilation and thickening of the superficial vessels……….Parents of a child
who will need hemodialysis ask the nurse, "What are the advantages of a fistula over a graft
or external access device for hemodialysis?" What response should the nurse give? (Select
all that apply.)

a. Fever
c. Diminished urinary output
e. Swelling and tenderness of graft area
What are signs and symptoms of a possible kidney transplant rejection in a child? (Select all
that apply.)

c. urinalysis………The nurse is caring for a 10 year old girl presenting with fever, dysuria,
flank pain, urgency, and hematuria. The nurse would expect to help obtain which of the
following tests first to reveal preliminary information about the urinary system?

the boy has a recent history of an upper respiratory infection………The nurse is caring
for a 12 year old boy diagnosed with acute glomerulonephritis. When reviewing the boy's
health history which of the following will likely be noted?

weight the old dialysate……..The nurse is caring for a child who is undergoing peritoneal
dialysis. Immediately after draining the dialysate, what is the immediate action the nurse
should take?

she can eat whatever she wants on dialysis days…….A nurse is caring for a 12 year old
girl recently diagnosed with end stage renal disease. The nurse is discussing dietary
restrictions with the girl's mother. Which of the following responses indicates a need for
further teaching?

administer in the morning, encourage fluids and voiding during and after
administration………The nurse is administering cyclophasophamide as ordered for a 12
year old boy with nephrotic syndrome. Which of the following instructions is most accurate
regarding administration of this cytotoxic drug?

. there are several things w can do to help you achieve this goal……..A nurse is caring
for a 10 year old boy with nocturnal enuresis with no physiologic cause. He says he is
embarrassed and wishes he could stop the bedwetting immediately. How should the nurse
respond?

hemolytic anemia, thrombocytopenia, and acute renal failure……..The nurse is

assessing an infant with suspected hemolytic uremic syndrome. Which of the following
characteristics of this condition would the nurse expect to assess, including information from
the chart review

withhold his routine medication until after dialysis is completed……..A nurse is caring
for a 13 year old boy with end stage renal disease who is preparing to have his hemodialysis
treatment in the dialysis unit. Which of the following is the appropriate nursing action?

I cannot have sex again until my partner is treated………The nurse is conducting a

follow-up visit for a 13 year old girl who has been treated for pelvic inflammatory disease.
Which of the following remarks indicates a need for further teaching?

absence of a thrill……….The nurse is caring for a child who receives dialysis via an AV
fistula. which of the following findings indicates an immediate need to notify the physician.

hypertension……….The nurse is caring for a child diagnosed with hydronephrosis. Which

of the following manifestations is consistent with complications of the disorder?

a. intravenous pyelogram (IVP)

c. Voiding cystourethrogram (VCUG)
e.renal ultrasound
The nurse is caring for a child who has been admitted to the acute care facility with
manifestations consistent with hydronephrosis. Which of the following diagnostic tests can
the nurse anticipate will be performed to confirm diagnosis? Select all that apply

our son's condition may resolve on its own………The nurse is caring for the parents of a
newborn who has an undescended testicle. Which of the following comments by the parents
indicates understanding of the condition?

scrotal elevation……..The nurse is caring for a child with epididymitis. When planning care
which of the following interventions may be included?

report redness or swellling on the penile shaft………The nurse is planning the discharge
instructions for the parents of a 1 month old child who has had a circumcision completed.
Which of the following should be included in the education provided?

1.Headache
3.Red-brown urine
4.Periorbital edema
The nurse is assigned to care for a child who is suspected of having glomerulonephritis. The
nurse reviews the child's record and notes that which findings are associated with the
diagnosis of glomerulonephritis? Select all that apply.

2.Avoid tub baths until the stent has been removed……….An 18-month-old child is being
discharged after surgical repair of hypospadias. Which postoperative nursing care measure
should the nurse stress to the parents as they prepare to take this child home?

4.Prevent tension on the suture……….The nurse is assigned to care for a 2-year-old child
who has been admitted to the hospital for surgical correction of cryptorchidism. What is the
highest priority in the postoperative plan of care for this child?

1.Promoting bed rest ………The nurse is assisting in developing a plan of care for a 10-
year-old child diagnosed with acute glomerulonephritis. Following review of the plan of care,
the nurse determines that which intervention is the priority for the child?
1.Wound care ……..The nurse is assisting in planning discharge instructions to the mother
of a child following orchiopexy, which was performed on an outpatient basis. Which is the
priority in the plan of care?

2. Bladder function…….The nurse is reviewing the record of a child scheduled for a

primary health care provider's visit. Before data collection, the nurse notes documentation
that the child has enuresis. Based on this diagnosis, the nurse plans to focus on which factor
when collecting data?

2.Generalized edema ……….The nurse is assisting with gathering admission assessment

data on a 2-year-old child who has been diagnosed with nephrotic syndrome. The nurse
collects data knowing that which is a common characteristic associated with nephrotic
syndrome?
1.Provide adequate nutrition.

2.Restrict fluids, as prescribed.

3.Institute measures to prevent infection.

5.Administer blood products to treat severe anemia.

6.Anticipate the child will have central nervous system involvement………………..The

nurse is planning care for a child with hemolytic-uremic syndrome (HUS). The child has been
anuric and will be receiving peritoneal dialysis treatment. The nurse should plan to include
which interventions in the care of the child? Select all that apply.

2.Control hypertension. ………The nurse caring for a child with nephrotic syndrome
reviews the medication record. The nurse notes that prazosin hydrochloride is prescribed for
the child. The nurse determines that this medication has been prescribed to achieve which
result?

3."I take away privileges such as TV time when the bed is wet in the morning."...........A
parent with a 6-year-old child diagnosed with enuresis discusses with the nurse the
measures that are being taken to help her child. Which statement by the parent indicates a
need for further teaching?

1.Proteinuria ……..The nurse is reviewing the record of a child admitted to the hospital with
nephrotic syndrome. Which finding should the nurse expect to note documented in the
record?

3.Preventing infection at the surgical site………..The child with cryptorchidism is being

discharged after orchiopexy, which was performed on an outpatient basis. The nurse should
reinforce instructions to the parents about which priority care measure?

3.Furosemide……..The nurse is administering medications to a 6-year-old child with

nephrotic syndrome. To reduce proteinuria, the nurse would expect which medication to be
prescribed?

3."I'll let him decide when to return to his play activities.".........The nurse is reinforcing
discharge instructions to the parent of a 2-year-old child who has had an orchiopexy to
correct cryptorchidism. Which statement by the parent indicates a need for further
teaching?
2.Bacteriuria ……….The nurse collects a urine specimen preoperatively from a child with
epispadias who is scheduled for surgical repair. The nurse reviews the child's record for the
laboratory results of the urine test and would most likely expect to note which finding?

3.Skin disruption ………..The nurse assists in preparing a plan of care for the infant with
bladder exstrophy. The nurse identifies which immediate problem as the priority for the
infant?

4."It is an extrusion of the urinary bladder to the outside of the body through a defect
in the lower abdominal wall."..........The parents of a newborn have been told that their
child was born with bladder exstrophy and the parents ask the nurse about this condition.
Which response should the nurse give to the parents about bladder exstrophy?

3."Did your child recently complain of a sore throat?" ……..The nurse is collecting data
on a child recently diagnosed with glomerulonephritis. Which question to the mother should
elicit information about the cause of this disease?

2.Renal anomalies ……….A male child who had surgery to correct hypospadias is seen in
a primary health care provider's office for a well-baby checkup. The nurse provides
instructions to the mother, knowing that which long-term complication is associated with
hypospadias?

1.Ascites

2.Anorexia

4.Proteinuria

6.Periorbital and facial edema………..A child is admitted to the hospital with a probable
diagnosis of nephrotic syndrome. Which findings should the nurse expect to observe?
Select all that apply.

4.Encourage the child to eat in the playroom………….The nurse is assisting with

preparing a plan of care for a 4-year-old child hospitalized with nephrotic syndrome. Which
intervention is most appropriate for this child?

1.Catheterizing the infant using the smallest available straight catheter………A nurse
caring for a 2-month-old febrile infant is asked to collect a urine specimen for a culture and
sensitivity. The nurse collects the specimen by performing which action?

4.Covering the bladder with a nonadhering plastic wrap…….A nursing instructor is

observing a nursing student caring for an infant with a diagnosis of bladder exstrophy. The
nursing student provides appropriate care to the infant by performing which action?

3.Dipstick the urine for protein every 4 hours……….A 2-year-old child is admitted to the
hospital with a diagnosis of nephrotic syndrome. In planning care for this child, which nursing
intervention should be of highest priority

3."I should carry my child by straddling the child on my hip." ……..The nurse has
reinforced discharge instructions to the mother of an 18-month-old child following surgical
repair of hypospadias. Which statement by the mother indicates a need for further teaching?

2.Fears of separation and mutilation are present. ………..A 1-year-old child with
hypospadias is scheduled for surgery to correct this condition. The nurse is asked to assist
in preparing a plan of care for this child. During this developmental time period, which factor
should the nurse take into account?

2.Attaches a urinary collection device to the infant's perineum………A urinalysis has

been prescribed for an infant and the nurse plans to collect the specimen. The nurse
implements which appropriate method to collect the specimen?

4.Computed tomography scan………The nurse is assigned to care for an infant with

cryptorchidism. One testis cannot be palpated. The nurse anticipates that which diagnostic
study will be prescribed to determine where the undescended testis is located in the body?

4.Primary nocturnal enuresis is common, and most children will outgrow bed-wetting
without therapeutic intervention………….A child is seen in the clinic, and the primary
health care provider documents a diagnosis of primary nocturnal enuresis. The mother asks
the nurse about the diagnosis. Which should the nurse relay to the mother about primary
nocturnal enuresis?

3."The fluid retention should be controlled by medication and diet." ………..The nurse
is providing information to the mother of a child with nephrotic syndrome regarding the
edematous appearance of the child. Which statement should the nurse make to the mother?

2.12 to 24 mL/hour ………..An infant, weighing 12 kg, is receiving diuretic therapy, and the
nurse is closely monitoring the intake and output. Which is the amount of hourly urine output
should the nurse expect as adequate?

2."In most cases, medication and diet will control fluid retention." ……….The nurse is
preparing a 2-year-old child with suspected nephrotic syndrome for a renal biopsy to confirm
the diagnosis. The mother asks the nurse, "Will my child ever look thin again?" The nurse
should respond by giving which statement?

1.Encourage limited activity and provide safety measures……The nurse is assisting in

developing a plan of care for a child diagnosed with acute glomerulonephritis. The nurse
should include which intervention in the plan of care?

. A child with this illness can have sudden increases in blood pressure without
warning……..The father of a child with acute glomerulonephritis asks the nurse why blood
pressure readings are being taken so often. The nurse knows that:

2. Decreasing the amount of protein in the urine………Which of the following is the goal
of care for a child with minimal change nephrotic syndrome?

3. Low sodium and low protein…….A child with end-stage renal disease should have a
diet consisting of:

3. Visualize the bladder……..A child is having a cystoscopy procedure to

4. Discussing the placement of a Foley catheter……..A child has been scheduled for a
cystourethrography. The nurse prepares the child by:

4. All of the above should be done…….A child with end-stage renal disease is being
assessed by the nurse. The nurse notes crackles in the patients lungs. The nurse should:

3. Have a lower pulse in the lower extremities……….The nurse is assessing a child with
end-stage renal disease would anticipate the cardiac system to:
2. A urinary tract infection………Vomiting in a child with chronic kidney disease can
indicate:

1. Assess the amount of protein the girl has consumed within the last 24
hours……….A teenage girl has come to the nurses office at school because the last three
times she has urinated, the urine has had a lot of bubbles. The nurse should:

1. Water………A mother has called the triage nurse to find out which fluids she should give
her son that has been vomiting for the last 12 hours. Identify the fluid that would be
appropriate to give the child.

2. 500 ml……A child that weighs 55 pounds requires __________ of fluid per day.

2. Have adequate weight gain……A child with known renal disease will:

3. Concern for a malfunctioning lymphatic system………Ascites in a child with known

renal disease would cause:

1. 909 ml/hour……….A normal urine output for a child that weighs 40 pounds would
be________.
Convert 40 pounds to kilograms = 18.18 kg
18.18 kg x 50 ml/day = 909 ml/day
909ml/24 hours = 37.8 ml/hour

2. Hyponatremia………A child with renal disease is exhibiting muscle cramping. This is

mostly likely caused by:

1. A urinalysis…………A 3 year old exhibits a high fever, flank pain, hematuria, and
vomiting. The nurse should anticipate which order?

4. Urinary tract infections………Kali is a 5 year old patient with a history of spina bifida.
Kali is at increased risk for ________ due to her neurogenic bladder issues.

2. Nitrates are present………A childs urine analysis returns with indications of a urinary
tract infection. Identify the result that would lead to the diagnosis.

3. Structural issues within the urethra……….Vesicoureteral reflux occurs in young girls

because of:

2. Kidney damage………Vesicoureteral reflux is closely related to:

1. 760 mg/dose……….A child weighing 67 pounds has been admitted with a severe urinary
tract infection and is receiving Ceftriaxone 75 mg/kg/day in three doses. The correct amount
per dose would be __________

4. Is appropriate for this infection, and all doses should be taken as prescribed to be
effective………….A doctor has ordered amoxicillin to be given to a child with a known
urinary tract infection. The nurse knows this antibiotic:

2. Urinary tract infections….Identify the number one hospital-acquired infection in children.

4. All of the above should be considered………..A nurse assessing a child for a third
urinary tract infection within the last six months without a known etiology should:
4. All of the above will need to occur……….A child has been diagnosed with
nephrolithiasis. The nurse taking care of the child will need to:

1. Generalized edema…………Acute renal failure in a child will exhibit:

3. Monitoring blood pressure……….The priority nursing assessment in a child with acute

renal failure should be:

3. The balance of how much fluid the child can have per day has to be regulated, and
a whole bottle of Gatorade would be too much…………A child with acute renal failure
wants to drink a bottle of Gatorade because he is thirsty. The nurse must explain that:

2. A 7 year old with group A beta-hemolytic strep throat infection………Which child is

most at risk for nephrotic syndrome?

3. A weight check is needed every three days……..A nurse needs to clarify an order for a
child with Nephrotic syndrome. Identify the incorrect order.

3. Hyperlipidemia, hypoalbuminemia, edema, and proteinuria………A nurse assessing a

child with nephrotic syndrome would anticipate

3. The child will be put on taper with a dose of prednisone, changing after six weeks
to a decreased dosage……….A child is receiving Prednisone to help manage his nephrotic
syndrome. What type of education should the family receive about the administration of
prednisone?

4. All of the above………A child with the diagnosis of acute postinfectious

glomerulonephritis may exhibit:

. Call the doctor with the results to receive further orders since the diagnosis is
confirmed with the laboratory results, along with an update on the
child………..Laboratory tests have returned for a child with questionable acute
postinfectious glomerulonephritis. The labs are: BUN 20, WBC 24 g/dl, ESR 19 mm/hr. The
nurse knows that with results like this, she will need to:

3. Notify the physician immediately, request an order for Lorazepam, and provide
seizure precautions………A child with acute postinfectious glomerulonephritis is exhibiting
a change in the level of consciousness. The nurse should:

4. A positive Chvosteks sign………A nurse is instructing the parents on signs and

symptoms of hyperkalemia. Her instructions should include all of the following except:

3. A cystoscopy procedure…….A nurse is assessing a child with Henoch Schonlein

purpura. Which of the following orders should be clarified with the doctor?

2. The rash is temporary and will go away by itself……….A mother of a child with
Henoch Schonlein purpura asks the nurse how long it will be before the rash disappears.
Identify the best response by the nurse.

1. Peanut butter on wheat toast……..The dietician is speaking to the nurse about a patient
with hemolytic uremic syndrome. Identify the types of food that should be provided for the
patient.
1. Seizures and hematuria…….A child has arrived to the emergency room after a motor
vehicle accident. The nurse is assessing for any renal injuries. Identify the signs that would
indicate such an injury.

2. Hyperkalemia……..A child with a known diagnosis of acute renal failure is assessed. The
nurse knows that the most immediate threat to this childs life is:

2. A pediatric urologist consultation………A nurse is assessing a 27-week, premature

neonate. The nurse notes that the premies testicles are not descended. The nurse should
anticipate which order?

3. Cover the area with film wrap………..A newborn has been brought to the neonatal
intensive care unit because of bladder exstrophy. The nurse should immediately:

2. The fistula contains a vein and artery, which allows the blood access so the
hemodialysis can be performed………..A 14-year-old girl is preparing to have
hemodialysis performed due to end-stage renal disease. The patient asks what a fistula
provides during the procedure. Identify the correct reason for the use of the fistula.

1. Taking all of the medication until gone.

2. Scheduling a follow-up urinalysis.
3. Encouraging increased liquid intake.
4. Promoting regular voiding times………..A nurse is preparing discharge planning papers
for a child with a urinary tract infection. The instructions should include: (Select all that
apply.)

2. Hemodialysis.
3. Blood transfusions.
4. Antiepileptic medications.
5. Antihypertensive medications…………Hemolytic uremic syndrome can lead to the need
for: (Select all that apply.)

1. The urethral meatus is located in the midpenile area, not the head.
2. The circumcision could damage the urethral meatus………...The mother of a baby
boy with hypospadias asks the nurse about why her newborn son should not be circumcised
like her other son. The nurse recognizes that this procedure should not occur because:
(Select all that apply.)]

There is a chance the testicles will descend on their own………..A parent asks if her
newborn's undescended testicles will need surgery to repair. What is the best response by
the nurse?

testicular torsion……….A client has been admitted to the emergency department with
nausea, vomiting, and severe scrotal pain. These findings indicate what condition?

“A girl's urethra is much shorter and straighter than a boy's, so it can be

contaminated fairly easily.”............The nurse is reinforcing teaching with the caregiver of
5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about why
her daughter has had three urinary tract infections but her son has had none. She reports
that their diets and fluid intake is similar. Which statement would be accurate for the nurse to
tell this mother?

Blood pressure 136/84……….The nurse is collecting data on a 6-year-old child admitted

with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's
diagnosis?
thick, white discharge……….A nurse should recognize that which symptom would be
most consistent with a diagnosis of candidiasis?

The nurse suspects the client has a sexually transmitted infection as evidenced by
yellow, green odorous drainage…………. a 15-year-old female adolescent visits the
school nurse. The client appears anxious and states they have been dating a couple of
different friends. The client states that they went to a party the other night and does not
remember the entire night. The client states "I woke up and some of my clothes were
missing. Now I have been experiencing some pain when I pee and there is yellow, green
drainage that smells awful."

Complete the following sentence(s) by choosing from the lists of options.

The nurse suspects the client has ______________ as evidence by

___________________.

The client remains continent throughout the night………….Which goal of therapy would
be appropriate for a nurse to establish with a client's family and a client who has a diagnosis
of enuresis?

Acute glomerulonephritis…………An 8-year-old boy and his father visit the pediatrician's
office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis
shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep
throat a little over a week ago. Which condition should the nurse suspect?

The foreskin is needed for repair………….A newborn is diagnosed with hypospadias and
the parents want the newborn to be circumcised. What would be the best response by the
nurse?

weight, daily…….A child is hospitalized with nephrotic syndrome. Which measurement is

best for the nurse to determine the child's edema?

intestinal bacteria…………Most urinary tract infections seen in children are caused by:

Sodium bicarbonate tablets………..The nurse is caring for a 10-year-old boy with end-
stage kidney disease (ESKD) with metabolic acidosis. What would the nurse expect to
administer if ordered?

Tea-colored urine……….The nurse is caring for a child admitted with acute

glomerulonephritis. Which clinical manifestation would likely have been noted in the child
with this diagnosis?.....

hemolytic anemia, thrombocytopenia, and acute renal failure……..The nurse is

assessing an infant with suspected hemolytic uremic syndrome. Which characteristics of this
condition should the nurse expect to assess or glean from chart review?

"There are several things we can do to help you achieve this goal.".........The nurse is
caring for a 10-year-old child experiencing nocturnal enuresis with no physiologic cause. The
child states, "I am embarrassed and I wish I could stop this right now!" How will the nurse
respond?

"Precocious puberty is early sexual development."..........A parent asks the nurse, "What
is precocious puberty?" The nurse's response should be based on which statement?
Cystoscopy………A 7-year-old boy has experienced repeated urinary tract infections
(UTIs). His older sister also experienced repeated UTIs and was diagnosed with
vesicoureteral reflux, a condition that tends to appear in families. Therefore, the nurse
suspects this same condition in this client. Which diagnostic tests would confirm this
suspicion?

The child does not have intravenous access………A pediatric client is scheduled for an
intravenous pyelogram (IVP) of the kidney this afternoon. Which situation would require
immediate attention by the nurse?

leukocyte count……….The nurse is concerned about the pediatric client’s immune system
after taking corticosteroids. Which laboratory study is the nurse most correct to assess?

The child can live a more normal lifestyle………..The nurse knows that which statement
is a description of peritoneal dialysis when compared to hemodialysis:

"The doctor is hoping that the hormone will cause your son's undropped testes to
move into their proper place."...........The caregiver of a 1-year-old boy calls the nurse,
upset that his wife has just told him that their son is being given a hormone. His wife says
that the pediatrician called it human chorionic gonadotropic hormone but that is all she
understood. The nurse most accurately clarifies the caregiver's question by making which
statement regarding the son's treatment?

Monitor output………..A nurse is performing postoperative care on a child with a ureteral

stent. Which intervention will help manage tube patency?

Encourage high fluid intake……….A nurse is performing postoperative care on a child with
a ureteral stent. Which intervention will help manage bladder spasms?

Sudden onset of severe scrotal pain with significant hemorrhagic

swelling…………..The nurse is taking a health history of a 12-year-old boy presenting with
scrotal pain. Which assessment finding would indicate testicular torsion?

Generalized Edema, Weight Gain, Headache……….The nurse is caring for a child

diagnosed with acute post-streptococcal glomerulonephritis. When assessing the child, what
findings does the nurse anticipate? Select all that apply.

Creatinine clearance rate………A child is being evaluated for renal and urinary tract
disease. What would the nurse expect to be ordered to evaluate the child's glomerular
filtration rate?

hypertension………The nurse is caring for a child diagnosed with hydronephrosis. Which

manifestation is consistent with complications of the disorder?

acute glomerulonephritis………..The caregiver of a child with a history of ear infections

calls the nurse and reports that her son has just told her his urine "looks funny." He also has
a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days
ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to
have the child seen by the care provider because the nurse suspects the child may have:

hypertension………The nurse is caring for a child diagnosed with hydronephrosis. Which

manifestation is consistent with complications of the disorder?
"I will always use a condom with any further sexual encounters."........The nurse is
discharging a client diagnosed with bacterial vaginosis. Which statement would indicate to
the nurse that the client has a correct understanding of the discharge instructions?

The VCUG will rule out vesicoureteral reflux………A voiding cystourethrogram (VCUG) is
prescribed for a child. What education should be provided to the parents?

Demonstrate love and acceptance at home……..A parent is asking how to help the child
deal with the peer ridicule at school in regards to enuresis. What is the best response by the
nurse?

Take the child's blood pressure and report the findings to the nurse while the nurse is
still on the phone………..The caregiver of a child being treated at home for acute
glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The
child is resting comfortably but the caregiver would like to know what to do. The nurse would
instruct the caregiver to take which action?

Risk for infection……..When providing care to a child with vesicoureteral reflux (VUR),
which nursing diagnosis would be the priority?

Eyes………The nurse is caring for a child with nephrotic syndrome. The child is noted to
have edema. The edema would most likely be seen where on this child?

"Let's meet with the dietitian and plan some meals."........The nurse is preparing a 7-
year-old girl for discharge after treatment for nephrotic syndrome. Which instructions would
the nurse include in the discharge teaching plan for the parents?

The child recently had an ear infection……..The nurse is collecting data for a child
diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's
history?

Muscle weakness…….When examining the musculoskeletal system of the child, which

would be indicative of a potential kidney problem?

Weigh the old dialysate………The nurse is caring for a child who is undergoing peritoneal
dialysis. Immediately after draining the dialysate, which action should the nurse should take
immediately?

metronidazole……….A nurse is caring for a client who has been diagnosed with bacterial
vaginosis. What medication should the nurse anticipate as part of the treatment plan?

Urinalysis……….The nurse is caring for a 10-year-old girl presenting with fever, dysuria,
flank pain, urgency, and hematuria. The nurse would expect to help obtain which test first?

gonorrhea……..A nurse caring for a client diagnosed with Chlamydia trachomatis can
expect which subsequent tests?

The use of cleansing towelettes may have caused the vulvovaginitis………A nurse is
discussing with a family the various causes of their child's vulvovaginitis. What would be
included in the education?

thick, white discharge……..A nurse should recognize that which symptom would be most
consistent with a diagnosis of candidiasis?
1. Increased Urinary Frequency
2. Dysuria (painful urination)
3. Costovertebral Pain
4. Temperature, 101.2 F. 38.4 C.
5. Urinalysis, positive for leukocytes; white blood cell (WBC) count

NextGen: Click to highlight the findings that will require follow-up.

The nurse is caring for a 6-year-old male child who was brought to the pediatrician's office
by the parent for a fever for the past few days.

Metronidazole………An adolescent is diagnosed with a trichomonal infection. Which

medication would the nurse include when teaching the adolescent about treatment for this
infection?

metronidazole…………A nurse is caring for a client who has been diagnosed with bacterial
vaginosis. What medication should the nurse anticipate as part of the treatment plan?

Proteinuria, hypoalbuminemia, and hypercholesterolemia…….A child is getting a

diagnostic work-up for nephrotic syndrome. Which lab results would the nurse expect to
see?

Severe cramping and pain should not occur with an infusion………A 10-year-old child
in renal failure is on continuous cycling peritoneal dialysis (CCPD). What would be important
to teach the parents?
Withhold his routine medication until after dialysis is completed……..A nurse is caring for a
13-year-old boy with end-stage kidney disease who is preparing to have his hemodialysis
treatment in the dialysis unit. Which nursing action is appropriate?

Test her urine for glucose to rule out diabetes mellitus…..A 14-year-old girl visits her
gynecologist and is found to have vaginal candidiasis. She is obese, claims to not be
sexually active, and is not on oral contraceptive pills. Which intervention should be
considered for this client?

"Our son's condition may resolve on its own."........The nurse is caring for the parents of
a newborn who has an undescended testicle. Which comment by the parents indicates
understanding of the condition?

Peritoneal dialysis………..The nurse is educating the parents of a child requiring renal

replacement therapy The parents express concern because they live in a remote, rural area
with no access to pediatric specialty dialysis units. Which would the nurse recommend to the
parents?

1. History of repeated urinary tract infections.

2. Abdominal mass on palpation.
3. Crying on voiding.
A nurse is reviewing the medical record of an infant with hydronephrosis. Which finding(s)
will the nurse anticipate in the history and physical examination? Select all that apply.

heart rate and blood pressure………..The nurse is assessing a hospitalized child

diagnosed with nephrotic syndrome. What set of assessments is most important for the
nurse to complete to help identify hypoalbuminemia in this child?

wipe from front to back after urinating or defecating……..An adolescent asks the nurse
how to best prevent vulvovaginitis. The nurse's best answer would be to:
scrotal elevation……….The nurse is caring for a child with epididymitis. When planning
care, which intervention may be included?

Monitor output……..A nurse is performing postoperative care on a child with a ureteral

stent. Which intervention will help manage tube patency?

1. temperature >100.8°F (38.7°C)

2. weight gain
3. increased blood urea nitrogen level……..The nurse is caring for a client who had a
kidney transplant 4 months ago. What symptom would be indicative of an acute transplant
rejection? Select all that apply

7-year-old male with a recent history of an upper respiratory infection………Which

child is at risk for acute glomerulonephritis?

1st. Imbalanced nutrition

2nd. Altered skin integrity
3rd. Altered comfort
4th. Anxiety
Which nursing diagnosis would the nurse select as the priority when caring for a client with
nephrotic syndrome?

Sleeping too soundly……..The nurse recognizes that what would be a likely physiologic
cause for a child to have enuresis?

1. intravenous pyelogram (IVP)

2. voiding cystourethrogram (VCUG)
3. renal ultrasound
The nurse is caring for a child who has been admitted to the acute care facility with
manifestations consistent with hydronephrosis. Which tests will confirm the diagnosis?
Select all that apply.

1. The child may be dehydrated.

2. The child's diet contains high levels of protein.
3. There may be an infectious process in the child.
The nurse is reviewing the blood urea nitrogen (BUN) results of an assigned client. The test
is elevated. What factors may be associated with this result? Select all that apply.

Have the child sit in a sitz bath of warm water to void………A child, diagnosed with a
urinary tract infection, is afraid to void because it hurts. What action should the nurse
recommend to the parent to help relieve this fear?

1. Collect a "clean catch" voided urine.

2. Observe the child for signs of any reactions to the antibiotics.
In caring for a child with a urinary tract infection, the nurse would perform all of the following
nursing interventions. Which two interventions would the nurse identify as the priority?

1. urinary tract infection

2. small bladder capacity
3. lack of awareness……….Which cause of pediatric enuresis must be ruled out before
psychological causes are investigated? Select all that apply.

1. hematuria
2. flank pain
3. urinary frequency
4. history of repeated urinary tract infections………The nurse is reviewing the health
history of a client suspected of having vesicoureteral reflux. What findings in the health
history are consistent with this disorder? Select all that apply.

Positive culture for group A streptococcus……….The nurse is caring for a 6-year-old

child with acute glomerulonephritis. When reviewing the client's laboratory results, which
result is most important to review with the health care provider?

1. intermittent hematuria
2. abdominal mass………When assessing a child with hydronephrosis, what would the
nurse expect to find? Select all that apply.

1. furosemide
2. dialysis
3. serum electrolyte levels
4. urinalysis
5. labetalol………..The nurse is caring for a 6-year-old client diagnosed with acute renal
failure. During assessment, the nurse notes: temperature 99.0°F (37.2°C), urine output less
than 0.4 mL/kg/hr, blood pressure 130/88 mm Hg, periorbital edema, and respirations 28
breaths/minute. Which prescriptions will the nurse anticipate from the primary health care
provider? Select all that apply.

obtaining a clean catch voided urine………The first method of choice for obtaining a urine
specimen from a 3-year-old child with a possible urinary tract infection is:

1. genital inflammation
2. white-gray vaginal discharge
3. petechiae on the upper vagina…….Which symptoms would the nurse expect to find in a
client who has been diagnosed with trichomoniasis? Select all that apply.

1st. Confirm the client's identity.

2nd. Provide education to the client about the prescribed diagnostic test.
3rd. Document the time of the client's next voiding time.
4th. Begin the testing time period.
5th. Collect urine in a chilled container.
6th. End the test at the 24-hour mark………..The health care provider has prescribed a
24-hour urine specimen on a 15-year-old client. Review the steps below and place them in
the correct order. Use all options.

1. 1 to 2 week course of antibiotics

2. keeping the client in semi-Fowler position
3. antihypertensive therapy
4. high-protein dietA nurse is caring for a client with a diagnosis of acute
glomerulonephritis……….. Which intervention would the nurse expect to be included in the
treatment plan? Select all that apply.

Fever with chills, chest tightness………….The nurse is caring for a child who is
experiencing an acute renal transplant rejection and is to receive muromonab-CD3. Which of
the following would the nurse most likely expect to assess after the first dose is
administered?

Cola colored…………..The nurse is visually inspecting a urine specimen from a 12-year-old

boy. The nurse documents gross hematuria with a specimen of which color?

"Let your mom help you tinkle in this cup."........The nurse is caring for a 4-year-old with
a suspected urinary tract infection. Which of the following would be most appropriate when
obtaining a urine specimen from the child?

Using a double-diapering technique………The nurse is providing postsurgical care for an

infant who has undergone a hypospadias repair. Which action by the nurse would be most
important to help keep the area clean while maintaining proper position of the drainage
tubing?

"He just got over a head cold with laryngitis."........The nurse is taking a health history of
a child with suspected acute poststreptococcal glomerulonephritis. Which of the following
responses would alert the nurse to a confirmed risk factor for this condition?

"Let's put you in touch with some other girls who are also having the same body
changes."...........The nurse is caring for a 12-year-old girl with nephrotic syndrome. The girl
confides that she feels like a "freak" compared to her peers because of her weight, edema,
and moon face. Which response by the nurse would be most appropriate?

Informing the child she should feel no discomfort……..An 8-year-old girl is scheduled for
a renal ultrasound. Which of the following would the nurse include in the plan of care when
preparing the child for this test?

Caffeine……….The nurse is preparing a teaching plan for the parents of a child with a
urinary tract infection (UTI). Which of the following would the nurse encourage the parents to
avoid?

To stimulate red blood cell growth…………The mother of a child with end-stage renal
disease asks the nurse why her son is getting an injection of erythropoietin. When
responding to the mother, the nurse incorporates understanding of which of the following as
the rationale?

Decreased platelets and leukocytosis………….A child is diagnosed with hemolytic-uremic

syndrome (HUS). Review of the child's laboratory test results would reveal which of the
following?

"This condition should gradually go away on its own."..........After teaching the parents
of a child with a hydrocele about this condition, which statement indicates that the teaching
was successful?

Epispadias………A nurse is conducting a physical examination of an infant and observes

the urethral opening on the dorsal side of the penis. The nurse documents this finding as
which of the following
The condition is a surgical emergency…………A 15-year-old boy comes to the
emergency department accompanied by his parents. The boy reports an abrupt onset of
sudden pain on the right side of his scrotum. When asked to rate his pain on a scale of 1 to
10, with 10 being the most severe, the boy states, "It's a 12." Further assessment reveals a
blue-black swelling on the affected side. The nurse suspects testicular torsion and
immediately notifies the physician based on the understanding of which of the following?

Decreased blood urea nitrogen (BUN)...........The nurse is reviewing the laboratory test
results of a child with nephrotic syndrome. Which of the following would the nurse least likely
expect to find?

Pat the perineal area dry after cleaning………..The nurse is applying a urine bag to a 15-
month-old boy to collect a urine specimen. Which of the following would the nurse do first?

Amoxicillin………A group of students are reviewing information about renal failure in

children. The students demonstrate a need for additional teaching when they identify which
agent as a potential contributor to renal failure?

Escherichia coli……….A nurse is preparing a presentation for a local parent group about
urinary tract infections (UTIs) in children. Which of the following would the nurse incorporate
into the presentation as the most common cause?

"She had surgery to repair a problem with her anus.".........A nurse is interviewing the
parents of a child diagnosed with obstructive uropathy. Which statement by the parents
would the nurse identify as significant?

1. Abdominal pain
2. Hypertension
3. Crackles…………..The nurse is assessing a child with acute poststreptococcal
glomerulonephritis. Which of the following would the nurse expect to assess? Select all
answers that apply.

Assess usual voiding patterns…………A nurse identifies a nursing diagnosis of impaired

urinary elimination related to urinary tract infection. When developing the plan of care, which
of the following would be most important for the nurse to do first?

"A girl's urethra is closer to the rectal opening.".................While presenting a panel

discussion to a group of parents about urinary tract infections in children, one of the parents
asks the nurse, "Why would my daughter be more at risk than my son?" Which response by
the nurse would be most accurate?

Vesicostomy………A child returns from surgery in which a stoma was created in the
abdominal wall to the bladder. The nurse identifies this as which of the following?

"You might feel some burning when you go to the bathroom afterward."...........The
nurse is preparing an 8-year-old girl for a cystoscopy. Which instruction would be most
appropriate to give to the child?

1. Round abdomen
2. Positive bowel sounds
3. Dullness over the spleen………..The nurse is assessing a 5-year-old child's
genitourinary system. Which of the following would the nurse document as a normal finding?
Select all answers that apply.

1. Clean the penis gently with soap and water.

2. If the foreskin is not retractable do not force it.
3. When the foreskin is retracted, gently replace it prior to completing
diapering…………The nurse is providing instruction to the parents of a newborn boy. The
parents have decided not to circumcise the child. What information should be included in the
discussion? Select all answers that apply.

D. Teach her to wipe her perineum front to back after voiding………To prevent further
urinary tract infections in a preschooler, what measures would you teach her mother?

B. Urine culture…………..A female adolescent comes to the clinic for an evaluation.

Assessment reveals a possible urinary tract infection. What would the nurse expect to be
done to confirm this suspicion?

B. dilute the urine and flush the bladder………..The nurse is caring for a child diagnosed
with a urinary tract infection. The caregiver asks the nurse why it is so important for the child
to have so much fluid. The nurse tells the caregiver that the most important reason the child
needs increased fluids is to:

D. This may indicate a urinary tract infection……….A child is having the urine checked
for a routine well visit. When analyzing the results, what would positive leukocytes indicate?

D. pyelonephritis……….The nurse is teaching a group of nursing students about

genitourinary conditions. The nurse tells these students about a condition that occurs when
there is an inflammation of the kidney and renal pelvis. The condition the nurse is referring to
is:

B. Weigh the child daily on the same scale…………The nurse is working with a child with
altered genitourinary status. Which intervention would be included in the plan of care for the
client with excess fluid volume?

A. "A girl's urethra is closer to the rectal opening."........While presenting a panel

discussion to a group of parents about urinary tract infections (UTIs) in children, one of the
parents asks the nurse, "Why would my daughter be more at risk than my son?" Which
response by the nurse would be most accurate?

B. Acute glomerulonephritis……..An 8-year-old boy and his father visit the pediatrician's
office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis
shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep
throat a little over a week ago. Which condition should the nurse suspect?

B. This occurs when there is back flow of urine into the bladder and sometimes the
kidneys………..A nurse is providing education to parents of a child diagnosed with
vesicoureteral reflux (VUR). Which would be included in the parental education?

C. regulate blood pressure……..The nurse is doing an in-service training with a group of

peers on the topic of the genitourinary system. Which function is a major task of the
kidneys?

C. Encourage the child to take all the antibiotics if diagnosed with strep throat………A
school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What
would be the best way to prevent this?

C. acute glomerulonephritis……………A client has just been admitted to the unit with a
history of recent strep infection, hematuria, and proteinuria. Based on these findings, the
nurse would suspect which condition?
C. Positive culture for group A streptococcus……….The nurse is caring for a 6-year-old
child with acute glomerulonephritis. When reviewing the client's laboratory results, which
result is most important to review with the health care provider?

B. Acute glomerulonephritis…………The nurse is collecting data on a school-aged child

with the following symptoms:
Abrupt beginning to urinary symptoms
Gross hematuria
VS: 99 (F), 39.2 (C), 92, 22, 142/92
Mild edema
Which disease condition does the nurse anticipate?

A. The need to avoid high-sodium foods…….The nurse is caring for a child who has just
been diagnosed with nephrotic syndrome. What health education should the nurse provide
to the child and family?

D. Hematuria can remain in the urine for up to one year………A school-aged child
diagnosed with glomerulonephritis is in the physician's office for a 6-month follow-up visit.
Hematuria is found in the urine. The parents are concerned and want to know why the
glomerulonephritis is not gone. What is the best response by the nurse?

B. Delay the circumcision until the hypospadias is surgically repaired.

C. Save the diapers so that output can be measured.
E. Surgical repair is often completed between ages 6 and 12 months………..The nurse
discovers a hypospadias during the physical assessment of a newborn. Which information is
most important? Select all that apply.

B. decreased blood protein level

C. increased blood urea nitrogen level
E. increased blood creatinine ……..Assessment of a school-aged child reveals a sudden
onset of hematuria. The parent states that the child has not felt well but the only recent past
medical history is impetigo. Acute post-streptococcal glomerulonephritis is diagnosed and
laboratory tests are performed. Which result would the nurse identify as supporting this
diagnosis? Select all that apply.

D. Cola colored………The nurse is visually inspecting a urine specimen from a 12-year-old

boy. The nurse documents gross hematuria with a specimen of which color?

C. abdominal pain………A 3-year-old child is exhibiting irritability, fever, and decreased

appetite. A recent history of which of the following would make the nurse suspicious of a
urinary tract infection (UTI)?

A. urinalysis………Which of these laboratory results would be most important for the nurse
to assess in a child who has a diagnosis of urinary tract infection?

A. The nurse administers antihypertensives.

B. The nurse weighs the child every day using the same scale.
D. The nurse administers diuretics.
E. The nurse dipsticks the child's urine to test for protein……….When caring for a child
who has a diagnosis of acute glomerulonephritis, which nursing interventions would most
likely be included in the child's plan of care? Select all that apply.
The father of a child with acute glomerulonephritis asks the nurse why blood pressure
readings are being taken so often. The nurse knows that

A child with this illness can have sudden increases in blood pressure without warning

Which of the following is the goal of care for a child with minimal change nephrotic
syndrome?
Decreasing the amount of protein in the urine

A child with end-stage renal disease should have a diet consisting of

Low sodium and low protein

A child is having a cystoscopy procedure to

Visualize the bladder

A child has been scheduled for a cystourethrography. The nurse prepares the child by
Discussing the placement of a Foley catheter

A child with end-stage renal disease is being assessed by the nurse. The nurse notes
crackles in the patient's lungs. The nurse should
1. Documents the lungs sounds.
2. Assess for shortness of breath and the respiratory rate.
3. Obtain a pulse oximetry reading.
4. All of the above should be done.

The nurse is assessing a child with end-stage renal disease would anticipate the cardiac
system to
Have a lower pulse in the lower extremities

Vomiting in a child with chronic kidney disease can indicate

A urinary tract infection

A teenage girl has come to the nurse's office at school because the last three times she has
urinated, the urine has had a lot of bubbles. The nurse should:
Assess the amount of protein the girl has consumed within the last 24 hours

A mother has called the triage nurse to find out which fluids she should give her son that has
been vomiting for the last 12 hours. Identify the fluid that would be appropriate to give the
child.
Water

A child that weighs 55 pounds requires __________ of fluid per day.

500 ml

A child with known renal disease will:

Have adequate weight gain.

Ascites in a child with known renal disease would cause

Concern for a malfunctioning lymphatic system.

A normal urine output for a child that weighs 40 pounds would be________.
Convert 40 pounds to kilograms = 18.18 kg
18.18 kg x 50 ml/day = 909 ml/day
909ml/24 hours = 37.8 ml/hour
909 ml/hour

A child with renal disease is exhibiting muscle cramping. This is mostly likely caused by
Hyponatremia

A 3 year old exhibits a high fever, flank pain, hematuria, and vomiting. The nurse should
anticipate which order?
A urinalysis

Kali is a 5 year old patient with a history of spina bifida. Kali is at increased risk for ________
due to her neurogenic bladder issues.
Urinary tract infections

A child's urine analysis returns with indications of a urinary tract infection. Identify the result
that would lead to the diagnosis.
Nitrates are present

Vesicoureteral reflux occurs in young girls because of:

Structural issues within the urethra

Vesicoureteral reflux is closely related to

Kidney damage

A child weighing 67 pounds has been admitted with a severe urinary tract infection and is
receiving Ceftriaxone 75 mg/kg/day in three doses. The correct amount per dose would be
__________
760 mg/dose

A doctor has ordered amoxicillin to be given to a child with a known urinary tract infection.
The nurse knows this antibiotic
Is appropriate for this infection, and all doses should be taken as prescribed to be
effective

Identify the number one hospital-acquired infection in children

Urinary tract infections

A nurse assessing a child for a third urinary tract infection within the last six months without
a known etiology should
1. Notify the doctor.
2. Ask if sexual abuse is occurring.
3. Ask the family if all the medication is being taken correctly.
4. All of the above should be considered.

A child has been diagnosed with nephrolithiasis. The nurse taking care of the child will need
to
1. Strain the urine for crystals.
2. Measure accurate urinary output.
3. Provide pain management.
4. All of the above will need to occur.

The priority nursing assessment in a child with acute renal failure should be
Monitoring blood pressure
A child with acute renal failure wants to drink a bottle of Gatorade because he is thirsty. The
nurse must explain that
The balance of how much fluid the child can have per day has to be regulated, and a
whole bottle of Gatorade would be too much.

Which child is most at risk for nephrotic syndrome?

A 7 year old with group A beta-hemolytic strep throat infection

A nurse needs to clarify an order for a child with Nephrotic syndrome. Identify the incorrect
order.
A weight check is needed every three days.

A nurse assessing a child with nephrotic syndrome would anticipate

Hyperlipidemia, hypoalbuminemia, edema, and proteinuria

A child is receiving Prednisone to help manage his nephrotic syndrome. What type of
education should the family receive about the administration of prednisone?
The child will be put on taper with a dose of prednisone, changing after six weeks to a
decreased dosage.

A child with the diagnosis of acute postinfectious glomerulonephritis may exhibit

1. Anorexia.
2. Abdominal pain.
3. Malaise.
4. All of the above.

Laboratory tests have returned for a child with questionable acute postinfectious
glomerulonephritis. The labs are: BUN 20, WBC 24 g/dl, ESR 19 mm/hr. The nurse knows
that with results like this, she will need to
Call the doctor with the results to receive further orders since the diagnosis is
confirmed with the laboratory results, along with an update on the child.

A child with acute postinfectious glomerulonephritis is exhibiting a change in the level of

consciousness. The nurse should
Notify the physician immediately, request an order for Lorazepam, and provide
seizure precautions.

A nurse is instructing the parents on signs and symptoms of hyperkalemia. Her instructions
should include all of the following except
A positive Chvostek's sign

A nurse is assessing a child with Henoch Schonlein purpura. Which of the following orders
should be clarified with the doctor?
A cystoscopy procedure

A mother of a child with Henoch Schonlein purpura asks the nurse how long it will be before
the rash disappears. Identify the best response by the nurse
"The rash is temporary and will go away by itself."

The dietician is speaking to the nurse about a patient with hemolytic uremic syndrome.
Identify the types of food that should be provided for the patient.
Peanut butter on wheat toast
A child has arrived to the emergency room after a motor vehicle accident. The nurse is
assessing for any renal injuries. Identify the signs that would indicate such an injury.
Seizures and hematuria

A child with a known diagnosis of acute renal failure is assessed. The nurse knows that the
most immediate threat to this child's life is
Hyperkalemia

A nurse is assessing a 27-week, premature neonate. The nurse notes that the premie's
testicles are not descended. The nurse should anticipate which order?
A pediatric urologist consultation

A newborn has been brought to the neonatal intensive care unit because of bladder
exstrophy. The nurse should immediately
Cover the area with film wrap

A 14-year-old girl is preparing to have hemodialysis performed due to end-stage renal

disease. The patient asks what a fistula provides during the procedure. Identify the correct
reason for the use of the fistula.
The fistula contains a vein and artery, which allows the blood access so the
hemodialysis can be performed.

Circumcised males have a higher incidence of urinary tract infections than uncircumcised
males.
True/False
False

A nurse is preparing discharge planning papers for a child with a urinary tract infection. The
instructions should include: (Select all that apply.)
1. Taking all of the medication until gone.
2. Scheduling a follow-up urinalysis.
3. Encouraging increased liquid intake.
4. Promoting regular voiding times.

Hemolytic uremic syndrome can lead to the need for: (Select all that apply.)
2. Hemodialysis.
3. Blood transfusions.
4. Antiepileptic medications.
5. Antihypertensive medications.

The mother of a baby boy with hypospadias asks the nurse about why her newborn son
should not be circumcised like her other son. The nurse recognizes that this procedure
should not occur because: (Select all that apply.)
1. The urethral meatus is located in the midpenile area, not the head.
2. The circumcision could damage the urethral meatus.

Costovertebral angle tenderness and chills…………Which of the following symptoms do

you expect to see in a patient diagnosed with acute pyelonephritis?

. “It burns when I pee.”..........You have a patient that might have a urinary tract infection
(UTI). Which statement by the patient suggests that a UTI is likely?
After painful urination is relieved, stop taking phenazopyridine…………Which
instructions do you include in the teaching care plan for a patient with cystitis receiving
phenazopyridine (Pyridium)?

A 50 y.o. postmenopausal woman………..Which patient is at greatest risk for developing

a urinary tract infection (UTI)?

. Check for kinks in the outflow tubing………..You have a patient that is receiving
peritoneal dialysis. What should you do when you notice the return fluid is slowly draining?

15 minutes……..What is the appropriate infusion time for the dialysate in your 38 y.o.
patient with chronic renal failure undergoing peritoneal dialysis?

Avoid taking blood pressures in the arm with the fistula…………A 30 y.o. female patient
is undergoing hemodialysis with an internal arteriovenous fistula in place. What do you do to
prevent complications associated with this device?

B. Disequilibrium syndrome………..Your patient becomes restless and tells you she has a
headache and feels nauseous during hemodialysis. Which complication do you suspect?

B. Infuse normal saline solution……..Your patient is complaining of muscle cramps while

undergoing hemodialysis. Which intervention is effective in relieving muscle cramps?

Keep fingernails short and clean…….Your patient with chronic renal failure reports
pruritus. Which instruction should you include in this patient’s teaching plan?

. Strain all urine……….Which intervention do you plan to include with a patient who has
renal calculi?

Recent sore throat…….An 18 y.o. student is admitted with dark urine, fever, and flank pain
and is diagnosed with acute glomerulonephritis. Which would most likely be in this student’s
health history?

Narcotic analgesics……..Which drug is indicated for pain related to acute renal calculi?

Invasive procedures………Which of the following causes the majority of UTI’s in

hospitalized patients?

Hematuria and proteinuria………Clinical manifestations of acute glomerulonephritis

include which of the following?
400ml…………You expect a patient in the oliguric phase of renal failure to have a 24 hour
urine output less than:

Elevated BUN level……..The most common early sign of kidney disease is:

Stress……A patient is experiencing which type of incontinence if she experiences leaking

urine when she coughs, sneezes, or lifts heavy objects?

Hemorrhage…..Immediately post-op after a prostatectomy, which complications require

priority assessment of your patient?

Prostate-specific antigen…..The most indicative test for prostate cancer is:

“Even with insulin, kidney damage is still a concern.”.........A 22 y.o. patient with diabetic
nephropathy says, “I have two kidneys and I’m still young. If I stick to my insulin schedule, I
don’t have to worry about kidney damage, right?” Which of the following statements is the
best response?

Drink 8 to 10 eight-oz glasses of water daily……A patient diagnosed with sepsis from a
UTI is being discharged. What do you plan to include in her discharge teaching?

Your urine might turn bright orange.”.......You’re planning your medication teaching for
your patient with a UTI prescribed phenazopyridine (Pyridium). What do you include?

Hypertension, oliguria, and fatigue……Which finding leads you to suspect acute

glomerulonephritis in your 32 y.o. Patient?

Fluid volume excess……What is the priority nursing diagnosis with your patient diagnosed
with end-stage renal disease?

Apply pressure to the needle site upon discontinuing hemodialysis……..A patient with
ESRD has an arteriovenous fistula in the left arm for hemodialysis. Which intervention do
you include in his plan of care?

Fluid volume deficit related to inability to conserve water…….You're 60 y.o. patient with
pyelonephritis and possible septicemia has had five UTIs over the past two years. She is
fatigued from lack of sleep, has lost weight, and urinates frequently even in the night. Her
labs show: sodium, 154 mEq/L; osmolarity 340 mOsm/L; glucose, 127 mg/dl; and potassium,
3.9 mEq/L. Which nursing diagnosis is a priority?
Daily doubling of urine output (4 to 5 L/day).....Which sign indicates the second phase of
acute renal failure?

Taking a blood pressure reading on the affected arm can cause clotting of the
fistula……Your patient had surgery to form an arteriovenous fistula for hemodialysis. Which
information is important for providing care for the patient?

Low-protein diet with a prescribed amount of water…….A patient with diabetes mellitus
and renal failure begins hemodialysis. Which diet is best on days between dialysis
treatments?

Disequilibrium syndrome……After the first hemodialysis treatment, your patient develops

a headache, hypertension, restlessness, mental confusion, nausea, and vomiting. Which
condition is indicated?

Set up specific times to empty the bladder…….Which action is most important during
bladder training in a patient with a neurogenic bladder?

Protein……A patient with diabetes has had many renal calculi over the past 20 years and
now has chronic renal failure. Which substance must be reduced in this patient’s diet?

Palpate the fistula throughout its length to assess for a thrill………What is the best way
to check for patency of the arteriovenous fistula for hemodialysis?

Increased calcium loss from the bones………You have a paraplegic patient with renal
calculi. Which factor contributes to the development of calculi?

Fluid volume excess………What is the most important nursing diagnosis for a patient in
end-stage renal disease?

Check the patient’s latest potassium level……Frequent PVCs are noted on the cardiac
monitor of a patient with end-stage renal disease. The priority intervention is:

A. At increased risk for cancer due to immunosuppression caused by cyclosporine

(Neoral)........A patient who received a kidney transplant returns for a follow-up visit to the
outpatient clinic and reports a lump in her breast. Transplant recipients are:

Remain afebrile and have negative cultures…….You’re developing a care plan with the
nursing diagnosis risk for infection for your patient that received a kidney transplant. A goal
for this patient is to:
Fever, weight gain, and diminished urine output……You suspect kidney transplant
rejection when the patient shows which symptoms?

Oliguria………Your patient returns from the operating room after abdominal aortic
aneurysm repair. Which symptom is a sign of acute renal failure?

Hypervolemia…….Which cause of hypertension is the most common in acute renal failure?

Evaluate the patient’s circulation and vital signs………A patient returns from surgery
with an indwelling urinary catheter in place and empty. Six hours later, the volume is 120ml.
The drainage system has no obstructions. Which intervention has priority?

Delay catheterization and notify the doctor.….You’re preparing for urinary catheterization
of a trauma patient and you observe bleeding at the urethral meatus. Which action has
priority?

Disappearance of protein from the urine……..What change indicates recovery in a

patient with nephrotic syndrome?

With prerenal failure, an IV isotonic saline infusion increases urine output……Which

statement correctly distinguishes renal failure from prerenal failure?

The patient must be hemodynamically stable…….Which criterion is required before a

patient can be considered for continuous peritoneal dialysis?

Exchange potassium for sodium…….Polystyrene sulfonate (Kayexalate) is used in renal

failure to:

Pain radiating to the right upper quadrant……..Your patient has complaints of severe
right-sided flank pain, nausea, vomiting, and restlessness. He appears slightly pale and is
diaphoretic. Vital signs are BP 140/90 mmHg, Pulse 118 beats/min., respirations 33
breaths/minute, and temperature, 98.0F. Which subjective data supports a diagnosis of renal
calculi?

For life…..Immunosuppression following kidney transplantation is continued:

Strain all urine…..A client is complaining of severe flank and abdominal pain. A flat plate of
the abdomen shows urolithiasis. Which of the following interventions is important?
 Monitor the client for signs and symptoms of cystitis………A client is receiving a
radiation implant for the treatment of bladder cancer. Which of the following interventions is
appropriate?

Infection………A client has just received a renal transplant and has started cyclosporine
therapy to prevent graft rejection. Which of the following conditions is a major complication of
this drug therapy?

Elevated BUN and creatinine levels…..A client received a kidney transplant 2 months ago.
He’s admitted to the hospital with the diagnosis of acute rejection. Which of the following
assessment findings would be expected?

Client’s support system and understanding of lifestyle changes……..The client is to

undergo kidney transplantation with a living donor. Which of the following preoperative
assessments is important?

Check for the presence of clots and make sure the catheter is draining properly…….A
client had a transurethral prostatectomy for benign prostatic hypertrophy. He’s currently
being treated with a continuous bladder irrigation and is complaining of an increase in
severity of bladder spasms. Which of the interventions should be done first?

Monitor the client’s electrolyte levels……..A client is admitted with a diagnosis of

hydronephrosis secondary to calculi. The calculi have been removed and post obstructive
diuresis is occurring. Which of the following interventions should be done?

Composition of calculus…….A client has passed a renal calculus. The nurse sends the
specimen to the laboratory so it can be analyzed for which of the following factors?

C. Weight gain, pain at graft site…….Which of the following symptoms indicate acute
rejection of a transplanted kidney?

Increased blood glucose levels and decreased wound healing…….Adverse reactions of

prednisone therapy include which of the following conditions?

Normal to low urine specific gravity…….The nurse suspects that a client with polyuria is
experiencing water diuresis. Which laboratory value suggests water diuresis?

Prostate-specific antigen (PSA)......A client is diagnosed with prostate cancer. Which test
is used to monitor the progression of this disease?
Bladder distention……….A 27-year old client, who became paraplegic after a swimming
accident, is experiencing autonomic dysreflexia. Which condition is the most common cause
of autonomic dysreflexia?

High-purine…..When providing discharge teaching for a client with uric acid calculi, the
nurse should make an instruction to avoid which type of diet?

Struvite……The client with urolithiasis has a history of chronic urinary tract infections. The
nurse concludes that this client most likely has which of the following types of urinary
stones?

C. Nephrostomy tube…..The nurse is receiving in transfer from the postanesthesia care

unit a client who has had percutaneous ultrasonic lithotripsy for calculuses in the renal
pelvis. The nurse anticipates that the client’s care will involve monitoring which of the
following?

Shoulder……The client is admitted to the ER following a MVA. The client was wearing a lap
seat belt when the accident occurred. The client has hematuria and lower abdominal pain.
To determine further whether the pain is due to bladder trauma, the nurse asks the client if
the pain is referred to which of the following areas?

. Tender, indurated, and warm to the touch…….The client complains of fever, perineal
pain, and urinary urgency, frequency, and dysuria. To assess whether the client’s problem is
related to bacterial prostatitis, the nurse would look at the results of the prostate
examination, which should reveal that the prostate gland is:

Decreased force in the stream of urine……The nurse is taking the history of a client who
has had benign prostatic hyperplasia in the past. To determine whether the client currently is
experiencing difficulty, the nurse asks the client about the presence of which of the following
early symptoms?

Decongestants…….The client who has a cold is seen in the emergency room with inability
to void. Because the client has a history of BPH, the nurse determines that the client should
be questioned about the use of which of the following medications?

No special precautions except to wear gloves if in contact with the client’s urine………
The nurse is preparing to care for the client following a renal scan. Which of the following
would the nurse include in the plan of care?

. Avoid green, leafy vegetables such as spinach……….The client passes a urinary stone,
and lab analysis of the stone indicates that it is composed of calcium oxalate. Based on this
analysis, which of the following would the nurse specifically include in the dietary
instructions?
. Frequent dressing changes around the Penrose drain………..The client returns to the
nursing unit following a pyelolithotomy for removal of a kidney stone. A Penrose drain is in
place. Which of the following would the nurse include in the client’s postoperative care?

Administration of diuretics……..The nurse is caring for a client following a kidney

transplant. The client develops oliguria. Which of the following would the nurse anticipate to
be prescribed as the treatment of oliguria?

. Acute rejection……..A week after kidney transplantation the client develops a temperature
of 101, the blood pressure is elevated, and the kidney is tender. The X-ray results show the
transplanted kidney is enlarged. Based on these assessment findings, the nurse would
suspect which of the following?

Bradycardia and confusion…….The client with BPH undergoes a transurethral resection

of the prostate. Postoperatively, the client is receiving continuous bladder irrigations. The
nurse assesses the client for signs of transurethral resection syndrome. Which of the
following assessment data would indicate the onset of this syndrome?

Blood pressure of 100/50 and pulse 130………The client is admitted to the hospital with
BPH, and a transurethral resection of the prostate is performed. Four hours after surgery the
nurse takes the client’s VS and empties the urinary drainage bag. Which of the following
assessment findings would indicate the need to notify the physician?

Painless hematuria………Which of the following symptoms is the most common clinical

finding associated with bladder cancer?

Conveys urine from the ureters to a stoma opening in the abdomen……….A client who
has been diagnosed with bladder cancer is scheduled for an ileal conduit. Preoperatively,
the nurse reinforces the client’s understanding of the surgical procedure by explaining that
an ileal conduit:

Thrombophlebitis……..After surgery for an ileal conduit, the nurse should closely evaluate
the client for the occurrence of which of the following complications related to pelvic surgery?

Encourage a high fluid intake……The nurse is assessing the urine of a client who has had
an ileal conduit and notes that the urine is yellow with a moderate amount of mucus. Based
on the assessment data, which of the following nursing interventions would be most
appropriate at this time?

Separation of the appliance from the skin……When teaching the client to care for an ileal
conduit, the nurse instructs the client to empty the appliance frequently, primarily to prevent
which of the following problems?
Soap……The client with an ileal conduit will be using a reusable appliance at home. The
nurse should teach the client to clean the appliance routinely with what product?

“I can usually keep my ostomy pouch on for 3 to 7 days before changing it.”.......The
nurse is evaluating the discharge teaching for a client who has an ileal conduit. Which of the
following statements indicates that the client has correctly understood the teaching? Select
all that apply.

Disturbed Body Image related to creation of a urinary diversion……..a female client

with a urinary diversion tells the nurse, “This urinary pouch is embarrassing. Everyone will
know that I’m not normal. I don’t see how I can go out in public anymore.” The

1. Anxiety related to the presence of urinary diversion.

appropriate nursing diagnosis for this patient is:

. Urine reflux into the stoma……The nurse teaches the client with a urinary diversion to
attach the appliance to a standard urine collection bag at night. The most important reason
for doing this is to prevent:

Maintain a daily fluid intake of 2,000 to 3,000 ml……The nurse teaches the client with an
ileal conduit measure to prevent a UTI. Which of the following measures would be most
effective?

Strain the urine carefully……..A client who has been diagnosed with calculi reports that
the pain is intermittent and less colicky. Which of the following nursing actions is most
important at this time?

. Ensure that the catheter is draining freely…….A client has a ureteral catheter in place
after renal surgery. A priority nursing action for care of the ureteral catheter would be to:

Encourage the client to ambulate every 2 to 4 hours…..Which of the following

interventions would be most appropriate for preventing the development of a paralytic ileus
in a client who has undergone renal surgery?

Eliminate pressure at the penoscrotal angle…….The primary reason for taping an

indwelling catheter laterally to the thigh of a male client is to:

Eliminate pressure at the penoscrotal angle………..The primary reason for taping an

indwelling catheter laterally to the thigh of a male client is to:

To produce a secretion that aids in the nourishment and passage of sperm………..The

primary function of the prostate gland is:

. inhaled ipratropium (Atrovent).......The nurse is reviewing a medication history of a client

with BPH. Which medication should be recognized as likely to aggravate BPH?
Respiratory paralysis……..A client is scheduled to undergo a transurethral resection of the
prostate gland (TURP). The procedure is to be done under spinal anesthesia.
Postoperatively, the nurse should be particularly alert for early signs of:

Blood pressure………A client with BPH is being treated with terazosin (Hytrin) 2 mg at
bedtime. The nurse should monitor the client’s:

When the drainage becomes bright red……….A client underwent a TURP, and a large
three-way catheter was inserted into the bladder with continuous bladder irrigation. In which
of the following circumstances would the nurse increase the flow rate of the continuous
bladder irrigation?

Deficient fluid volume……..A priority nursing diagnosis for the client who is being
discharged home 3 days after a TURP would be:

Serum acid phosphatase level……..If a client’s prostate enlargement is caused by a

malignancy, which of the following blood examinations should the nurse anticipate to assess
whether metastasis has occurred?

Increase Blood Glucose Level………….Steroids, if used following kidney transplantation

would cause which of the following side effects?

Elevated BUN and Creatinine…….Mr. Roberto was readmitted to the hospital with acute
graft rejection. Which of the following assessment findings would be expected?

Osmosis and diffusion…….Dialysis allows for the exchange of particles across a

semipermeable membrane by which of the following actions?

Strictly follow the hemodialysis schedule……….A client is diagnosed with chronic renal
failure and told she must start hemodialysis. Client teaching would include which of the
following instructions?

Check the catheter for kinks or obstruction………A client is undergoing peritoneal

dialysis. The dialysate dwell time is completed, and the dwell clamp is opened to allow the
dialysate to drain. The nurse notes that the drainage has stopped and only 500 ml has
drained; the amount the dialysate instilled was 1,500 ml. Which of the following interventions
would be done first?

Administer oxygen………A client receiving hemodialysis treatment arrives at the hospital

with a blood pressure of 200/100, a heart rate of 110, and a respiratory rate of 36. Oxygen
saturation in room air is 89%. He complains of shortness of breath, and +2 pedal edema is
noted. His last hemodialysis treatment was yesterday. Which of the following interventions
should be done first?

Assess the AV fistula for a bruit and thrill…….A client has a history of chronic renal
failure and received hemodialysis treatments three times per week through an arteriovenous
(AV) fistula in the left arm. Which of the following interventions is included in this client’s plan
of care?

Accumulation of waste products…….Which of the following factors causes the nausea

associated with renal failure?

A client with diabetes who has a heart catheterization………Which of the following

clients is at greatest risk for developing acute renal failure?

Diarrhea……In a client with renal failure, which assessment finding may indicate
hypocalcemia?

B. Palpation of a thrill over the fistula……..A nurse is assessing the patency of an

arteriovenous fistula in the left arm of a client who is receiving hemodialysis for the treatment
of chronic renal failure. Which finding indicates that the fistula is patent?

calcium carbonate (Tums)........The client with chronic renal failure is at risk of developing
dementia-related to excessive absorption of aluminum. The nurse teaches that this is the
reason that the client is being prescribed which of the following phosphate binding agents?

Headache, deteriorating level of consciousness, and twitching…….The client newly

diagnosed with chronic renal failure recently has begun hemodialysis. Knowing that the
client is at risk for disequilibrium syndrome, the nurse assesses the client during dialysis for:

VS and weight…….A client with chronic renal failure has completed a hemodialysis
treatment. The nurse would use which of the following standard indicators to evaluate the
client’s status after dialysis?

Pallor, diminished pulse, and pain in the left hand……..The hemodialysis client with a
left-arm fistula is at risk for steal syndrome. The nurse assesses this client for which of the
following clinical manifestations?

. Polyuria……..A client is admitted to the hospital and has a diagnosis of early-stage chronic
renal failure. Which of the following would the nurse expect to note on assessment of the
client?
Continue to monitor vital signs…….The client with chronic renal failure returns to the
nursing unit following a hemodialysis treatment. On assessment the nurse notes that the
client’s temperature is 100.2. Which of the following is the most appropriate nursing action?

Notify the physician……..The nurse is performing an assessment on a client who has

returned from the dialysis unit following hemodialysis. The client is complaining of a
headache and nausea and is extremely restless. Which of the following is the most
appropriate nursing action?

. Lima beans……..The nurse is assisting a client on a low-potassium diet to select food

items from the menu. Which of the following food items, if selected by the client, would
indicate an understanding of this dietary restriction?

Increased osmotic pressure to produce ultrafiltration……..The nurse is reviewing a list

of components contained in the peritoneal dialysis solution with the client. The client asks
the nurse about the purpose of the glucose contained in the solution. The nurse bases the
response knowing that the glucose:

Maintain strict aseptic technique………The nurse is preparing to care for a client receiving
peritoneal dialysis. Which of the following would be included in the nursing plan of care to
prevent the major complication associated with peritoneal dialysis?

Explain that the pain will subside after the first few exchanges…………a client newly
diagnosed with renal failure is receiving peritoneal dialysis. During the infusion of the
dialysate the client complains of abdominal pain. Which action by the nurse is most
appropriate?

Hyperglycemia……..The nurse is instructing a client with diabetes mellitus about peritoneal

dialysis. The nurse tells the client that it is important to maintain the dwell time for the
dialysis at the prescribed time because of the risk of:

Place the client on a cardiac monitor…………..The client with acute renal failure has a
serum potassium level of 5.8 mEq/L. The nurse would plan which of the following as a
priority action?

On return from dialysis………..The client with chronic renal failure who is scheduled for
hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). The nurse
should plan to administer this medication:

Change the dressing……..The client with chronic renal failure has an indwelling catheter
for peritoneal dialysis in the abdomen. The client spills water on the catheter dressing while
bathing. The nurse should immediately:
Discontinue dialysis and notify the physician………The client being hemodialyzed
suddenly becomes short of breath and complains of chest pain. The client is tachycardic,
pale, and anxious. The nurse suspects air embolism. The nurse should:

Intake, output, and weight………The nurse has completed client teaching with the
hemodialysis client about self-monitoring between hemodialysis treatments. The nurse
determines that the client best understands the information given if the client states to record
the daily:

Ensure that small clamps are attached to the AV shunt dressing……..The client with an
arteriovenous shunt in place for hemodialysis is at risk for bleeding. The nurse would do
which of the following as a priority action to prevent this complication from occurring?

Place the client in good body alignment.,....Check the level of the drainage
bag………..Check the peritoneal dialysis system for kinks…………..The nurse is
monitoring a client receiving peritoneal dialysis and the nurse notes that a client’s outflow is
less than the inflow. Which of the following actions will the nurse take. Select all that apply.

Excess fluid volume related to the kidney’s inability to maintain fluid

balance………..The nurse assesses the client who has chronic renal failure and notes the
following: crackles in the lung bases, elevated blood pressure, and weight gain of 2 pounds
in one day. Based on these data, which of the following nursing diagnoses is appropriate?

A. Excess Fluid Volume…..C. Activity Intolerance………The nurse is caring for a

hospitalized client who has chronic renal failure. Which of the following nursing diagnoses
are most appropriate for this client? Select all that apply.

It is a time-consuming method of treatment…….What is the primary disadvantage of

using peritoneal dialysis for long-term management of chronic renal failure

Encourage the removal of serum urea………The dialysis solution is warmed before use in
peritoneal dialysis primarily to:\

Bleeding indicates abdominal blood vessel damage………..During the client’s dialysis,

the nurse observes that the solution draining from the abdomen is consistently blood-tinged.
The client has a permanent peritoneal catheter in place. Which interpretation of this
observation would be correct?

Monitor the client’s blood pressure……….Which of the following nursing interventions

should be included in the client’s care plan during dialysis therapy?
To bind phosphorus in the intestine……..Aluminium hydroxide gel (Amphojel) is
prescribed for the client with chronic renal failure to take at home. What is the purpose of
giving this drug to a client with chronic renal failure?

“I’ll take it with meals and bedtime snacks.”........The nurse teaches the client with
chronic renal failure when to take the aluminum hydroxide gel. Which of the following
statements would indicate that the client understands the teaching?

MOM can cause magnesium toxicity……..The client with chronic renal failure tells the
nurse he takes magnesium hydroxide (milk of magnesia) at home for constipation. The
nurse suggests that the client switch to psyllium hydrophilic mucilloid (Metamucil) because:

Validating frequently the client’s understanding of the material………..In planning

teaching strategies for the client with chronic renal failure, the nurse must keep in mind the
neurologic impact of uremia. Which teaching strategy would be most appropriate?

Low protein, low sodium, low potassium………The nurse helps the client with chronic
renal failure develop a home diet plan with the goal of helping the client maintain adequate
nutritional intake. Which of the following diets would be most appropriate for a client with
chronic renal failure?

Allows the client to be more independent……….A client with chronic renal failure has
asked to be evaluated for a home continuous ambulatory peritoneal dialysis (CAPD)
program. The nurse should explain that the major advantage of this approach is that it:

“Diet restrictions with CAPD are fewer than with standard peritoneal dialysis because
dialysis is constant.”..........The client asks whether her diet would change on CAPD.
Which of the following would be the nurse’s best response?

Cloudy dialysate fluid……….Which of the following is the most significant sign of

peritoneal infection?

Hyperkalemia……..The main indicator of the need for hemodialysis is:

Exsanguination………….To gain access to the vein and artery, an AV shunt was used for
Mr. Roberto. The most serious problem with regards to the AV shunt is:

Use surgical aseptic technique when giving shunt care………When caring for Mr.
Roberto’s AV shunt on his right arm, you should:
Urine output, 20 ml/hour………The nurse is conducting a postoperative assessment of a
client on the first day after renal surgery. Which of the following findings would be most
important for the nurse to report to the physician?

Milk, apples, tomatoes, and corn………Because a client’s renal stone was found to be
composed of uric acid, a low-purine, alkaline ash diet was ordered. Incorporation of which of
the following food items into the home diet would indicate that the client understands the
necessary diet modifications?

Maculopapular rash…………Allopurinol (Zyloprim), 200 mg/day, is prescribed for the client

with renal calculi to take home. The nurse should teach the client about which of the
following side effects of this medication?

Decreased serum uric acid level……….The client has a clinic appointment scheduled 10
days after discharge. Which laboratory finding at that time would indicate that allopurinol
(Zyloprim) has had a therapeutic effect?

Activities that increase abdominal pressure……….When developing a plan of care for

the client with stress incontinence, the nurse should take into consideration that stress
incontinence is best defined as the involuntary loss of urine associated with:

The client’s history of three full-term pregnancies………Which of the following

assessment data would most likely be related to a client’s current complaint of stress
incontinence?

The nurse is developing a teaching plan for a client with stress incontinence. Which
of the following instructions should be included?............The nurse is developing a
teaching plan for a client with stress incontinence. Which of the following instructions should
be included?

Involuntary urination with minimal warning……….A client has urge incontinence. Which
of the following signs and symptoms would the nurse expect to find in this client?

A rounded swelling above the pubis……….A 72-year old male client is brought to the
emergency room by his son. The client is extremely uncomfortable and has been unable to
void for the past 12 hours. He has known for some time that he has an enlarged prostate but
has wanted to avoid surgery. The best method for the nurse to use when assessing for
bladder distention in a male client is to check for:
Possible shock………During a client’s urinary bladder catheterization, the bladder is
emptied gradually. The best rationale for the nurse’s action is that completely emptying an
overdistended bladder at one time tends to cause:

Delay catheterization and notify the doctor…………You're preparing for urinary

catheterization of a trauma patient and you observe bleeding at the urethral meatus. Which
action has priority?

Invasive procedures………Which of the following causes the majority of UTI's in

hospitalized patients?

Protein………A patient with diabetes has had many renal calculi over the past 20 years and
now has chronic renal failure. Which substance must be reduced in this patient's diet?

Remain afebrile and have negative cultures……..You're developing a care plan with the
nursing diagnosis risk for infection for your patient that received a kidney transplant. A goal
for this patient is to:

The patient must be hemodynamically stable……Which criterion is required before a

patient can be considered for continuous peritoneal dialysis?

. Check for kinks in the outflow tubing……..You have a patient that is receiving peritoneal
dialysis. What should you do when you notice the return fluid is slowly draining?

Fever, weight gain, and diminished urine output…………You suspect kidney transplant
rejection when the patient shows which symptoms?

. Hypervolemia……….Which cause of HTN is the most common in acute renal failure?

Elevated BUN level…….The most common early sign of kidney disease is:

Check the patient's latest potassium level…………Frequent PVCs are noted on the
cardiac monitor of a patient with end-stage renal disease. The priority intervention is:

Dark, scanty urine output………Your patient has complaints of severe right-sided flank
pain, N/V, and restlessness. He appears slightly pale and is diaphoretic. VS are BP 140/90
mmHg, P 118 bp, RR 33 breaths/min, and T 98.0F. Which subjective data supports a
diagnosis of renal calculi?

Disappearance of protein from the urine……….What change indicates recovery in a

patient with nephrotic syndrome?
Fluid volume deficit r/t inability to conserve water……….Your 60 y/o patient with
pyelonephritis and possible septicemia has had five UTIs over the past 2 years. She is
fatigued from lack of sleep, has lost weight, and urinates frequently even in the night. Her
labs show: Sodium 154 mEq/L, osmolarity 340 most/L, glucose 127 mg/dl, and potassium
3.9 mEq/L. Which nursing diagnosis is priority?

Hemorrhage……..Immediately post-op after a prostatectomy, which complication requires

priority assessment of your patient?

Narcotic analgesics………Daily doubling of urine output (4 to 5 L/day)........Which sign

indicates the second phase of acute renal failure?

15 min………What is the appropriate infusion time for the dialysate in your 38 y/o patient
with chronic renal failure?

Apply pressure to the needle site upon discontinuing hemodialysis……..A patient with
ESRD has an arteriovenous fistula in the left arm for hemodialysis. Which intervention do
you include in his plan of care?

. Evaluate the patient's circulation and VS………A patient returns from surgery with an
indwelling urinary catheter in place and empty. Six hours later, the volume is 120 mL. The
drainage system has no obstructions. Which intervention has priority?

Infuse normal saline solution……..Your patient is complaining of muscle cramps while

undergoing hemodialysis. Which intervention is effective in relieving muscle cramps?

Recent sore throat………An 18 y/o student is admitted with dark urine, fever, and flank
pain and is diagnosed with acute glomerulonephritis. Which would most likely be in this
student's health history?

Fluid volume excess………What is the priority nursing diagnosis with your patient
diagnosed with ESRD?

. "Even with insulin, kidney damage is still a concern."........A 22 y/o patient with diabetic
nephropathy says, "I have two kidneys and I'm still young. If I stick to my insulin schedule, I
don't have to worry about kidney damage, right?" Which of the following statements is the
best response?

Fluid volume excess……….What is the most important nursing diagnosis for a patient in
ESRD?
"It burns when I pee."........You have a patient that might have a urinary tract infection
(UTI). Which statement by the patient suggests that a UTI is likely?

Taking a BP reading on the affected arm can cause clotting of the fistula……….Your
patient had surgery to form an arteriovenous fistula for hemodialysis. Which information is
important for providing care for the patient?

Oliguria…….Your patient returns from the operating room after abdominal aortic aneurysm
repair. Which symptom is a sign of acute renal failure?

HTN, oliguria, and fatigue……….Which finding leads you to suspect acute

glomerulonephritis in your 32 y/o patient?

Palpate the fistula throughout its length to assess for a thrill…..What is the best way to
check for patency of the arteriovenous fistula for hemodialysis?

. Set up specific times to empty the bladder……..Which action is most important during
bladder training in a patient with a neurogenic bladder?

Hematuria and proteinuria……..Clinical manifestations of acute glomerulonephritis include

which of the following?

Disequilibrium syndrome…….Your patient becomes restless and tells you she has a
headache and feels nauseous during hemodialysis. Which complication do you suspect?

Increased calcium loss from the bones……..You have a paraplegic patient with renal
calculi. Which factor contributes to the development of calculi?

Exchange potassium for sodium…….Polystyrene sulfonate (Kayexalate) is used in renal

failure to:

400 mL……..You expect a patient in the oliguric phase of renal failure to have a 24 hour
urine output less than:

Low-protein diet with a prescribed amount of water…….A patient with DM and renal
failure begins hemodialysis. Which diet is best on days between dialysis treatments?\

Strain all urine……Which intervention do you plan to include with a patient who has renal
calculi?
Avoid taking BPs in the arm with the fistula……A 30 y/o female patient is undergoing
hemodialysis with an internal arteriovenous fistula in place. What do you do to prevent
complications associated with this device?

With prerenal failure, an IV isotonic saline infusion increases urine

output……….Which statement correctly distinguishes renal failure from prerenal failure?

Keep fingernails short and clean……Your patient with chronic renal failure reports
pruritus. Which instruction should you include in this patient's teaching plan?

Demonstrate love and acceptance at home………….A parent is asking how she can help
her son deal with the peer ridicule at school in regards to enuresis. What is the best
response by the nurse?

The child has a greater risk for trauma to the kidney………….The location of the kidneys
in the child in relationship to the location of the kidneys in the adult makes which fact a
greater likelihood in the child?

This will determine if there is an acid-base problem……………The nurse is working with

a child with impaired urinary elimination. What is the purpose of monitoring the electrolytes
and arterial blood gases (ABGs)?

urinalysis…………Which of these laboratory results would be most important for the nurse
to assess in a child who has a diagnosis of urinary tract infection?

The child does not have intravenous access……………..A pediatric client is scheduled
for an intravenous pyelogram (IVP) of the kidney this afternoon. Which of these actions by
the nurse would require immediate attention?

Parents/family use positive coping mechanisms in response to the child and the
voiding disorder……………The nurse determines that interventions for a voiding disorder
have been effective when the family of a child with enuresis demonstrates evidence of which
of the following?The nurse determines that interventions for a voiding disorder have been
effective when the family of a child with enuresis demonstrates evidence of which of the
following?

Checking with the parents for any allergies…………A nurse is caring for a 7-year-old girl
scheduled for an intravenous pyelogram (IVP). Which action would be the priority before the
test?

The most common age for UTIs in children is 2 to 6 years of age……….The nurse is
discussing urinary tract infections (UTI's) in children with a group of peers. Which fact is the
most accurate regarding urinary tract infection seen in children?
Oliguria and jaundice……….A teacher sends a child to see the school nurse for irritability
and bruising. Which symptom would be indicative of hemolytic uremic syndrome?

Weighing on the same scale each day……….In caring for a child with nephrotic
syndrome, which interventions will be included in the child's plan of care?

recent illness such as strep throat………..A child diagnosed with acute glomerulonephritis
will most likely have a history of:

obtaining a clean catch voided urine………..The first method of choice for obtaining a
urine specimen from a 3-year-old child with a possible urinary tract infection is:

6 to 7 years of age……..The nurse is teaching an in-service program to a group of nurses

on the topic of children diagnosed with acute glomerulonephritis. In which age range is the
peak incidence of this disorder noted?

Sodium bicarbonate tablets………..The nurse is caring for a 10-year-old boy with end-
stage renal disease (ESRD) with metabolic acidosis. What would the nurse expect to
administer if ordered?

Escherichia coli……………A nurse is preparing a presentation for a local parent group

about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate
into the presentation as the most common cause?

1200 mL………..The nurse is monitoring the fluid balance of a 9-year-old child. When
evaluating urine output for the day, which output would the nurse identify as being within
normal limits?

"This surgery will cure my child's condition."..........The nurse is educating the mother of
a child who will receive a kidney transplant. Which statement made by the mother indicates
further teaching is needed?

acute glomerulonephritis………….A client has just been admitted to the unit with a history
of recent strep infection, hematuria, and proteinuria. Based on these findings, the nurse
would suspect which condition?

A fever is commonly noted with a UTI.

Change diapers promptly, especially after bowel movements.

Female urethras are shorter and straighter than males………..The nurse is caring for a
7-month-old female infant diagnosed with a urinary tract infection (UTI). The parents are
upset as this is the infant's second UTI with a fever. Which instruction is most helpful? Select
all that apply.

intestinal bacteria…………Most urinary tract infections seen in children are caused by:

Risk for infection……….When providing care to a child with vesicoureteral reflux (VUR),
which nursing diagnosis would be the priority?

Signs of infection………… A 6-year-old child has undergone a renal transplant and is

receiving cyclosporine. The nurse instructs the parents to be especially alert for which
complication?

Abdominal pain

Hypertension

Crackles………..The nurse is assessing a child with acute poststreptococcal

glomerulonephritis. Which client symptoms would the nurse anticipate during assessment?
Select all that apply.

Abdominal pain……..A 3-year-old child is exhibiting irritability, fever, and decreased

appetite. A recent history of which of the following would make the nurse suspicious of a
urinary tract infection (UTI)?

Periorbital edema……….The nurse is triaging clients as they come in to an express care

facility. Which assessment finding is clinically significant for early nephrotic syndrome?

Abdominal palpation…………The nurse is caring for a pediatric client who is scheduled for
the surgical removal of a Wilms tumor. Which is contraindicated in the client's care?

The child can live a more normal lifestyle…………The nurse knows this is a description of
peritoneal dialysis when compared to hemodialysis:
acute glomerulonephritis………….The caregiver of a child with a history of ear infections
calls the nurse and reports that her son has just told her his urine "looks funny." He also has
a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days
ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to
have the child seen by the care provider because the nurse suspects the child may have:

The child recently had an ear infection…………..The nurse is collecting data for a child
diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's
history?

"The child may look chubby, but he is really malnourished.""...............The nurse is

teaching an in-service program on children diagnosed with nephrotic syndrome. Which
statement made by the nurse accurately reflects information on the disease process?

Report any abnormally colored urine to the child's primary care

provider……………………..The mother of 6-month-old girl is concerned about her daughter
getting a urinary tract infection. What should the nurse mention to the mother to help prevent
this condition?

An 18-year-old female who is sexually active…….Which child has the highest risk of
urinary tract infection?

Onset of a streptococcus infection last week…………….The nurse is caring for a client

newly diagnosed with acute glomerulonephritis? When receiving the pediatric client's history,
which is anticipated?

Bloody urine………….The nurse is collecting data on a child recently diagnosed with acute
glomerulonephritis. Which of the following clinical manifestations was likely noted in this
child?

The child has a greater risk for trauma to the kidney………The location of the kidneys in
the child in relationship to the location of the kidneys in the adult makes which fact a greater
likelihood in the child?

The nurse administers diuretics.

The nurse administers antihypertensives.

The nurse weighs the child every day using the same scale.
The nurse dipsticks the child's urine to test for protein…………When caring for a child
who has a diagnosis of acute glomerulohephritis, which nursing interventions would most
likely be included in the child's plan of care? Select all that apply.

"Let's meet with the dietitian and plan some meals.".............The nurse is preparing a 7-
year-old girl for discharge after treatment for nephrotic syndrome. Which instructions would
the nurse include in the discharge teaching plan for the parents?

Applying a barrier/healing cream or paste on skin……………The nurse is caring for an

infant with bladder exstrophy. As part of the infant's preoperative plan of care, the nurse
monitors for abdominal skin excoriation. Which action would be most appropriate for
promoting healing and preventing further skin breakdown?

The client remains continent throughout the night…………..Which goal of therapy would
be appropriate for a nurse to establish with a client's family and a client who has a diagnosis
of enuresis?

Acute glomerulonephritis………..The nurse is collecting data on a school-aged child with

the following symptoms:

Failure to thrive…..An infant is diagnosed with a urinary tract infection. What corroborating
finding would the nurse expect on assessment?

Take the child's blood pressure and report the findings to the nurse while the nurse is
still on the phone………….The caregiver of a child being treated at home for acute
glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The
child is resting comfortably but the caregiver would like to know what to do. The nurse would
instruct the caregiver to take which action?

15 mL………..If the newborn is following a normal development process, the child will most
likely void when which amount of urine is in the bladder?

Eyes……….A symptom often seen in acute glomerulonephritis is edema. The most common
site the edema is first noted is in which area of the body?

Measure the abdominal girth daily…………The nurse is caring for an 8-year-old child
hospitalized with nephrotic syndrome. Which nursing intervention would be appropriate for
this child?

Administer the IV fluid slowly………..A 10-year-old girl is experiencing acute renal failure
due to dehydration. The nurse is preparing to administer IV fluid. Which of the following
interventions should the nurse take in caring for this child?
"Children are not expected to stay dry through the night until the age of 5.".........A
concerned mother brings her 3-year-old to the primary care office because of nighttime
voiding. Which response made by the nurse is best?

Check the catheter for patency…………..The nurse is caring for a post-surgical child with
a new suprapubic catheter. The child begins to moan in pain suddenly. Which nursing
intervention is the priority?

Encouraging fluid intake after dinner…….A nurse is developing a teaching plan for the
parents of an 8-year-old experiencing nocturnal enuresis. The nurse determines that
additional teaching is needed when the parents identify what as an appropriate measure?

Thick, white cheese-like discharge…………An adolescent comes to the clinic reporting

vaginal discharge. When assessing the vaginal discharge, what would lead the nurse to
suspect that the adolescent has candidiasis?

trichomoniasis……….A frothy, gray-green vaginal discharge

gardnerella…….A milky, gray discharge with a fishy odor suggests

gonorrhea…………A yellow-green vaginal discharge suggests

"Our son's condition may resolve on its own.".........The nurse is caring for the parents of
a newborn who has an undescended testicle. Which comment by the parents indicates
understanding of the condition?

Take over-the-counter ibuprofen for its prostaglandin action………..A 16-year-old tells

you she has terrible dysmenorrhea. Which action would be the best health teaching measure
regarding this?

"Emotional stress can be a cause of this disorder."............The nurse is doing a

presentation for a group of nursing students about the topic of menstrual disorders. After
discussing the disorder secondary amenorrhea, the students make the following statements.
Which statement made by the nursing students is the most accurate regarding the cause of
secondary amenorrhea?

Cryptorchidism…………The condition in which one or both of the testes does not descend
in the male infant is referred to as:

amenorrhea………..The nurse is discussing genitourinary conditions with a group of 16-

year-old girls. One of the girls says she has heard about girls who have stopped taking birth
control pills and now don't have periods. The condition the girl is referring to is:
Testis cannot be "milked" down inguinal canal………….The nurse is caring for a 5-
month-old boy with an undescended left testis. What would the nurse identify as indicative of
true cryptorchidism?

Encourage the child to take all the antibiotics if diagnosed with strep throat…….A
school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What
would be the best way to prevent this?

A dull, aching abdominal pain at ovulation…………A group of nursing students is

discussing terminology related to the genitourinary system during a post-conference setting.
One of the students asks what mittelschmerz is or what it means. A classmate of this student
correctly answers that mittelschmerz is:

Sodium bicarbonate tablets………..The nurse is caring for a 10-year-old boy with end-
stage renal disease (ESRD) with metabolic acidosis. What would the nurse expect to
administer if ordered?

"A girl's urethra is much shorter and straighter than a boy's, so it can be
contaminated fairly easily."................The nurse is reinforcing teaching with the caregiver
of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver is puzzled about
why her daughter has had three urinary tract infections but her son has had none. She
reports that their diets and fluid intake is similar. Which statement would be accurate for the
nurse to tell this mother?

Creatinine clearance………..A child needs to collect urine for 24 hours and the nurse
explains that this test assesses glomerular filtration rate and how the kidneys are
functioning. What would be indicative of this type of test?

take the child to a private room and interview her regarding her sexual history and
partners…………..An adolescent girl and her caregiver present at the pediatrician's office.
The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease
(PID) is made. The nurse notes in the child's chart that this is the third time she has been
treated for PID. The most appropriate action by the nurse would be to:

some discomfort at the surgery site………….A 3-year-old is scheduled for a surgery to

correct undescended testes. An important postoperative consideration the nurse would want
to prepare the parents for is:

True……… tUrine that stands at room temperature for any length of time changes
composition.

Number of sexual partners……..The nurse is taking a history from an adolescent girl with
suspected pelvic inflammatory disease (PID). What data will be most helpful in determining
this girl's risk factors for PID?
Explain that breakthrough bleeding is normal during the first 3 or 4 months of oral
contraceptive use but that it should go away after that……………A 16-year-old girl visits
her gynecologist with a complaint of metrorrhagia, or bleeding between menstrual periods,
since her last visit 3 months ago. On consulting the client's chart, the nurse learns that she
was prescribed an oral contraceptive at her last visit. Which intervention should the nurse
implement in this situation?

"What have you heard about it that makes you worried?"............A 12-year-old girl who
has not yet reached menarche comes to the pediatrician's office for her annual well-child
check. As the nurse is weighing and measuring her, the child says emphatically that she
does not want to get her period. Which response would be most appropriate for the nurse to
make to this child?

"There are several things we can do to help you achieve this goal."........A nurse is
caring for a 10-year-old boy with nocturnal enuresis with no physiologic cause. He says he is
embarrassed and wishes he could stop immediately. How should the nurse respond?

Report any abnormally colored urine to the child's primary care provider…………The
mother of 6-month-old girl is concerned about her daughter getting a urinary tract infection.
What should the nurse mention to the mother to help prevent this condition?

The infant does not urinate within 6 to 8 hours………….The nurse is educating the
parents of an infant after a circumcision. The parents demonstrate understanding when they
state that they need to report what to the physician?

Metronidazole…………An adolescent is diagnosed with a trichomonal infection. Which

medication would the nurse include when teaching the adolescent about treatment for this
infection?

The child has been sexually abused, maybe on the fishing trip………..A caregiver
brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting
after being completely toilet trained even at night for over 2 years. The caregiver further
reports that the child has wet the bed every night since returning home from a one-week
fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy,
skittish, and will not make eye contact. Further evaluation needs to be done to rule out what
possible explanation for the bedwetting?

There is a chance the testicles will descend on their own………..A parent asks if their
newborn's undescended testicles will need surgery to repair. What is the best response by
the nurse?

Risk for infection related to immunocompromised state……….Which nursing diagnosis

would be the priority when caring for a child in renal failure following a kidney transplant?
"There are nutritional and medical things she can do to lessen the symptoms; I'll give
both of you information about some strategies and we'll track her for a few
months."........A single male caregiver of a 14-year-old girl accompanies his daughter to her
pre-high school physical. In the course of discussion about how his daughter is developing,
he remarks, "She's terrific most of the time. Of course when she gets her period, she's
miserable and mean, but I tell her that's just what it's like to be a woman." What would be the
most appropriate response by the nurse?

Absence of a thrill………..The nurse is caring for a child who receives dialysis via an AV
fistula. Which finding indicates an immediate need to notify the physician?

The use of cleansing towelettes may have caused the vulvovaginitis……….A nurse is
discussing with a family the various causes of their child's vulvovaginitis. What would be
included in the education?

Demonstrate love and acceptance at home………..A parent is asking how she can help
her son deal with the peer ridicule at school in regards to enuresis. What is the best
response by the nurse?

Hypospadias……..The nurse is assessing a male neonate and notes that the urethral
opening is on the ventral aspect of the penis. The nurse documents this finding as:

Bladder exstrophy……….______________ ___________ involves the bladder lying open

and exposed on the abdomen.

Patent urachus………._________ ____________ refers to a fistula between the bladder

and umbilicus.

Epispadias…………..the urethral opening is on the dorsal surface of the penis

Hypertension……….The nurse is caring for a child diagnosed with hydronephrosis. Which

manifestation is consistent with complications of the disorder?

"The doctor is hoping that the hormone will cause your son's undropped testes to
move into their proper place."...........The caregiver of a 1-year-old son calls the nurse,
upset that his wife has just told him that their son is being given a hormone. His wife says
that the pediatrician called it human chorionic gonadotropic hormone but that is all she
understood. The nurse most accurately clarifies the caregiver's question by making which
statement regarding the son's treatment?

Weigh the old dialysate……The nurse is caring for a child who is undergoing
peritoneal dialysis. Immediately after draining the dialysate, which action should the
nurse should take immediately?
"What do you like to do on the weekend?"........The nurse is conducting a routine
wellness examination of a 13-year-old girl. Which question would be best to use
when beginning to discuss her sexual behavior?

take the child to a private room and interview her regarding her sexual history
and partners………….. adolescent girl and her caregiver present at the
pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of
pelvic inflammatory disease (PID) is made. The nurse notes in the child's chart that
this is the third time she has been treated for PID. The most appropriate action by
the nurse would be to:

"A girl's urethra is much shorter and straighter than a boy's, so it can be
contaminated fairly easily…………The nurse is reinforcing teaching with the
caregiver of 5-year-old twins regarding urinary tract infections (UTIs). The caregiver
is puzzled about why her daughter has had three urinary tract infections but her son
has had none. She reports that their diets and fluid intake is similar. Which statement
would be accurate for the nurse to tell this mother?

void during the procedure………….A 4-year-old girl with a urinary tract infection is
scheduled to have a voiding cystourethrogram. When preparing her for this
procedure, the nurse would want to prepare her to:

Sodium bicarbonate tablets………….The nurse is caring for a 10-year-old boy with end-
stage renal disease (ESRD) with metabolic acidosis. What would the nurse expect to
administer if ordered?

some discomfort at the surgery site……..A 3-year-old is scheduled for a surgery to

correct undescended testes. An important postoperative consideration the nurse would want
to prepare the parents for is:

Dirty green urine……….The nurse obtains a history from the mother of a child with
glomerulonephritis about how he became ill. What would the nurse expect her to tell you she
noticed?

Withhold his routine medication until after dialysis is completed……….A nurse is

caring for a 13-year-old boy with end-stage renal disease who is preparing to have his
hemodialysis treatment in the dialysis unit. Which nursing action is appropriate?

Urine culture………..A 12-year-old girl reports pain and a burning sensation on urination.
The nurse suspects a urinary tract infection. Which diagnostic test would be most
appropriate for confirming this condition?
The child can live a more normal lifestyle………..The nurse knows this is a description of
peritoneal dialysis when compared to hemodialysis:

. Pyuria……..A 6-month-old girl is suspected to have a urinary tract infection. The nurse
expects which of the following lab results?

Dysuria………7-year-old Damon has cystitis; which of the following would Nurse Elena
expect when assessing the child

Circumcision…………Niklaus was born with hypospadias; which of the following should be

avoided when a child has such condition?

Infection………Stefan was diagnosed with secondary vesicoureteral reflux; such condition

usually results from which of the following?

Preschoolers……..Preferred nurses at the Nurseslabs Medical Center are about to perform

a procedure related to a genitourinary (GU) problem to a group of pediatric patients. Which
of the following groups would find it especially extra stressful?

Drinking acidic juices………Patient S is a sexually active adolescent; which of the

following instructions would be included in the preventive teaching plan about urinary tract
infections?

irritability

fever

vomiting

poor feeding

seizures

high pitched cry

nuchal rigidity

bulging fontanelle……..What clinical behaviors are expected in an infant with meningitis?

less than 1 out of 1,000 live births……..How often does myelomeningocele occur?

To reduce the risk of infection…………Daya's child is scheduled for surgery due to

myelomeningocele; the primary reason for surgical repair is which of the following?

Increase intrathoracic pressure……….Tiffany is diagnosed with increased intracranial

pressure (ICP); which of the following if stated by her parents would indicate a need for
Nurse Charlie to reexplain the purpose for elevating the head of the bed at a 10 to 20-
degree angle?

Cognitive delays………After explaining to the parents about their child's unique

psychological needs related to a seizure disorder and possible stressors, which of the
following interests uttered by them would indicate further teaching?

Sac formation containing meninges and spinal fluid………Spina bifida is one of the
possible neural tube defects that can occur during early embryological development. Which
of the following definitions most accurately describes meningocele?

Assessing for signs and symptoms of increased intracranial pressure (ICP).......Janae

has a seizure disorder; which of the following would be the lowest priority when caring for
her?

Increased risk of infections………..Angie is an adolescent who has seizure disorder;

which of the following would not be a focus of a teaching program?

Difficulty running in the preschooler………..Mr. and Mrs. Andrews' child was diagnosed
with Duchenne's muscular dystrophy; which of the following usually is the first indication of
the condition?

Perform neurovascular checks………A spica cast was put on Baby Betty after an
unfortunate incident to immobilize her hips and thighs; which of the following is the priority
nursing action immediately after application?

Cerebral palsy…….Which of the following is the most common permanent disability in

childhood?