Question 1

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?

Accepted Answer

A)  Physiologic manifestations of renal disease 
B)  The fact that adolescents have few coping mechanisms 
C)  Neurologic manifestations that occur with dialysis 
D)  Resentment of the control and enforced dependence imposed by dialysis

Question 2

What do the clinical manifestations of minimal change nephrotic syndrome include?

Accepted Answer

A)  Hematuria, bacteriuria, and weight gain 
B)  Gross hematuria, albuminuria, and fever 
C)  Hypertension, weight loss, and proteinuria 
D)  Massive proteinuria, hypoalbuminemia, and edema

Question 3

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?

Accepted Answer

A)  2 to 3 years 
B)  4 to 5 years 
C)  6 to 7 years 
D)  8 to 9 years

Question 4

Identification and treatment of cryptorchid testes should be done by age 2 years. What is an important consideration?

Accepted Answer

A)  Medical therapy is not effective after this age. 
B)  Treatment is necessary to maintain the ability to be fertile when older. 
C)  The younger child can tolerate the extensive surgery needed. 
D)  Sexual reassignment may be necessary if treatment is not successful.

Question 5

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.)

Accepted Answer

A)  High fat 
B)  Low protein 
C)  Encouragement of fluids 
D)  Moderate sodium restriction 
E)  Limit foods high in potassium

Question 6

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.)

Accepted Answer

A)  Dialysis 
B)  Calcium gluconate 
C)  Sodium bicarbonate 
D)  Glucose 50% and insulin 
E)  Sodium polystyrene sulfonate (Kayexalate)

Question 7

What signs and symptoms are indicative of a urinary tract disorder in the neonatal period (birth to 1 month)? (Select all that apply.)

Accepted Answer

A)  Edema 
B)  Bradypnea 
C)  Frequent urination 
D)  Poor urinary stream 
E)  Failure to gain weight

Question 8

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?

Accepted Answer

A)  School phobia 
B)  Glomerulonephritis 
C)  Urinary tract infection (UTI) 
D)  Attention deficit hyperactivity disorder (ADH
D)

Question 9

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?

Accepted Answer

A)  Explain the disorder so they can explain it to others. 
B)  Help parents understand that this is a minor problem. 
C)  Suggest that parents avoid family and friends until the gender is assigned. 
D)  Encourage parents not to worry while the tests are being done.

Question 10

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.)

Accepted Answer

A)  Hematuria 
B)  Anorexia 
C)  Hypertension 
D)  Purpura 
E)  Proteinuria
F) Periorbital edema

Question 11

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?

Accepted Answer

A)  "Prevent damage to the undescended testicle." 
B)  "Prevent urinary tract infections." 
C)  "Prevent prostate cancer." 
D)  "Prevent an inguinal hernia."

Question 12

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

Accepted Answer

A)  Poor hygiene 
B)  Constipation 
C)  Urinary stasis 
D)  Congenital anomalies

Question 13

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.)

Accepted Answer

A)  It is ready to be used immediately. 
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. 
E)  The fistula does not require a needle insertion at each dialysis.

Question 14

MATCHING
Match the classification of urinary tract infections of inflammations to its definition.

-Febrile urinary tract infection coexisting with systemic signs of bacterial illness

Accepted Answer

A) Persistent urinary tract infection 
B) Cystitis 
C) Urethritis 
D) Pyelonephritis 
E) Urosepsis

Question 15

Calculate the 24-hour maintenance fluid requirement for a child weighing 12 kg. Fill in the blank with ml/day. Record your answer in a whole number.
___________________

Accepted Answer

The answer of Calculate the 24-hour maintenance fluid requirement for...

Question 16

What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)?

Accepted Answer

A)  Reduce blood pressure. 
B)  Lower serum protein levels. 
C)  Minimize excretion of urinary protein. 
D)  Increase the ability of tissue to retain fluid.

Question 17

What statement is descriptive of renal transplantation in children?

Accepted Answer

A)  It is an acceptable means of treatment after age 10 years. 
B)  Children can receive kidneys only from other children. 
C)  It is the preferred means of renal replacement therapy in children. 
D)  The decision for transplantation is difficult because a relatively normal lifestyle is not possible.

Question 18

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?

Accepted Answer

A)  Consuming a regular diet 
B)  Increasing protein 
C)  Restricting fluids 
D)  Decreasing calories

Question 19

A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?

Accepted Answer

A)  Stimulate appetite. 
B)  Detect evidence of edema. 
C)  Minimize risk of infection. 
D)  Promote adherence to the antibiotic regimen.

Question 20

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

Accepted Answer

A)  Renal colic 
B)  Strong urinary stream 
C)  Urinary tract infections 
D)  Posturination dribbling

Exam 25: The Child with Renal Dysfunction