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NURS366 FINAL EXAM QUESTIONS AND ANSWERS
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NURS366 Final Exam Questions AndAnswers @ 2023
1. The bladder capacity of a 3-year-old is approximately how much?
1. 1.5 fl. oz.
2. 3 fl. oz.
3. 4 fl. oz.
4. 5 fl. oz. - Answer 4. 5 fl. oz.
*The capacity of the bladder in fluid ounces can be estimated by adding 2 to the child's
age in years.
2. The nurse is caring for a 4-year-old who weighs 15 kg. At the end of a 10-hour
period, the nurse notes the urine output to be 150 mL. What action does the nurse
take?
1. Notifies the physician because this urine output is too low.
2. Encourages the child to increase oral intake to increase urine output.
3. Records the child's urine output in the chart.
4. Administers isotonic fluid intravenously to help with rehydration. - Answer 3. Records
the child's urine output in the chart.
*Recording the child's urine output in the chart is the appropriate action because the
urine output is within the expected range of 0.5-1 mL/kg/hr, or 75-150 mL for the 10-
hour period.
3. A child had a urinary tract infection (UTI) 3 months ago and was treated with an oral
antibiotic. A follow-up urinalysis revealed normal results. The child has had no other
problems until this visit when the child was diagnosed with another UTI. Which is the
most appropriate plan?
1. Urinalysis, urine culture, and VCUG.
2. Evaluate for renal failure.
3. Admit to the pediatric unit.
4. Discharge home on an antibiotic. - Answer 1. Urinalysis, urine culture, and VCUG.
*Urinalysis and urine culture are routinely used to diagnose UTIs. VCUG is used to
determine the extent of urinary tract involvement when a child has a second UTI within
1 year.
,4. Which should the nurse teach a group of girls and parents about the importance of
preventing urinary tract infections (UTIs)?
1. Avoiding constipation has no effect on the occurrence of UTIs.
2. After urinating, always wipe from back to front to prevent fecal contamination.
3. Hygiene is an important preventive measure and can be accomplished with frequent
tub baths.
4. Increasing fluids will help prevent and treat UTIs. - Answer 4. Increasing fluids will
help prevent and treat UTIs.
*Increasing fluids will help flush the bladder of any organism, encourage urination, and
prevent stasis of urine.
5. Which child does not need a urinalysis to evaluate for a urinary tract infection (UTI)?
1. A 4-month-old female presenting with a 2-day history of fussiness and poor appetite;
current vital signs include axillary T 100.8°F (38.2°C), HR 120 beats per minute.
2. A 4-year-old female who states, "It hurts when I pee"; she has been urinating every
30 minutes; vital signs are within normal range.
3. An 8-year-old male presenting with a finger laceration; mother states he had surgical
reimplantation of his ureters 2 years ago.
4. A 12-year-old female complaining of pain to her lower right back; she denies any
burning or frequency at this time; oral temperature of 101.5°F (38.6°C). - Answer 3. An
8-year-old male presenting with a finger laceration; mother states he had surgical
reimplantation of his ureters 2 years ago.
*Although this child has had a history of urinary infections, the child is currently not
displaying any signs and therefore does not need a urinalysis at this time.
6. Which is the best way to obtain a urine sample in an 8-month-old being evaluated for
a urinary tract infection (UTI)?
1. Carefully cleanse the perineum from front to back, and apply a self-adhesive urine
collection bag to the perineum.
2. Insert an indwelling Foley catheter, obtain the sample, and wait for results.
3. Place a sterile cotton ball in the diaper, and immediately obtain the sample with a
syringe after the first void.
4. Using a straight catheter, obtain the sample, and immediately remove the catheter
without waiting for the results of the urine sample. - Answer 4. Using a straight catheter,
obtain the sample, and immediately remove the catheter without waiting for the results
of the urine sample.
*An in-and-out catheterization is the best way to obtain a urine culture in a child who is
not yet toilet-trained.
,7. Which child is at risk for developing glomerulonephritis?
1. A 3-year-old who had impetigo 1 week ago.
2. A 5-year-old with a history of five UTIs in the previous year.
3. A 6-year-old with new-onset type 1 diabetes.
4. A 10-year-old recovering from viral pneumonia. - Answer 1. A 3-year-old who had
impetigo 1 week ago.
*Impetigo is a skin infection caused by the streptococcal organism that is commonly
associated with glomerulonephritis.
8. Which combination of signs is commonly associated with glomerulonephritis?
1. Massive proteinuria, hematuria, decreased urinary output, and lethargy.
2. Mild proteinuria, increased urinary output, and lethargy.
3. Mild proteinuria, hematuria, decreased urinary output, and lethargy.
4. Massive proteinuria, decreased urinary output, and hypotension. - Answer 3. Mild
proteinuria, hematuria, decreased urinary output, and lethargy.
9. The parent of a child with glomerulonephritis asks the nurse why the urine is such a
funny color. Which is the nurse's best response?
1. "It is not uncommon for the urine to be discolored when children are receiving
steroids and blood pressure medications."
2. "There is blood in your child's urine that causes it to be tea-colored."
3. "Your child's urine is very concentrated, so it appears to be discolored."
4. "A ketogenic diet often causes the urine to be tea-colored." - Answer 2. "There is
blood in your child's urine that causes it to be tea-colored."
10. Which finding requires immediate attention in a child with glomerulonephritis?
1. Sleeping most of the day and being very "cranky" when awake; blood pressure is
170/90.
2. Urine output is 190 mL in an 8-hour period and is the color of Coca-Cola.
3. Complaining of a severe headache and photophobia.
4. Refusing breakfast and lunch and stating he "just is not hungry." - Answer 3.
Complaining of a severe headache and photophobia.
A severe headache and photophobia can be signs of encephalopathy due to
hypertension, and the child needs immediate attention.
11. The parents of a child with glomerulonephritis ask how they will know their child is
improving after they go home. Which is the nurse's best response?
1. "Your child's urine output will increase, and the urine will become less tea-colored."
2. "Your child will rest more comfortably as lab tests become more normal."
, 3. "Your child's appetite will decrease as urine output increases."
4. "Your child's laboratory values will become more normal." - Answer 1. "Your child's
urine output will increase, and the urine will become less tea-colored."
12. Which statement by a parent is most consistent with minimal change nephrotic
syndrome (MCNS)?
1. "My child missed 2 days of school last week because of a really bad cold."
2. "After camping last week, my child's legs were covered in bug bites."
3. "My child came home from school a week ago due to vomiting and stomach cramps."
4. "We have a pet turtle but no one washes their hands after playing with the turtle." -
Answer 1. "My child missed 2 days of school last week because of a really bad cold."
*An upper respiratory infection often precedes MCNS by a few days.
13. The clinical manifestations of minimal change nephrotic syndrome (MCNS) are due
to which of the following?
1. Chemical changes in the composition of albumin.
2. Increased permeability of the glomeruli.
3. Obstruction of the capillaries of the glomeruli.
4. Loss of the kidney's ability to excrete waste and concentrate urine. - Answer 2.
Increased permeability of the glomeruli.
*Increased permeability of the glomeruli in MCNS allows large substances such as
protein to pass through and be excreted in the urine.
14. The parents of a child hospitalized with minimal change nephrotic syndrome
(MCNS) ask why the last blood test revealed elevated lipids. Which is the nurse's best
response?
1. "If your child had just eaten a fatty meal, the lipids may have been falsely elevated."
2. "It's not unusual to see elevated lipids in children because of the dietary habits of
today."
3. "Since your child is losing so much protein, the liver is stimulated and makes more
lipids."
4. "Your child's blood is very concentrated because of the edema, so the lipids are
falsely elevated." - Answer 3. "Since your child is losing so much protein, the liver is
stimulated and makes more lipids."
*In MCNS, the lipids are truly elevated. Lipoprotein production is increased because of
the increased stimulation of the liver hypoalbuminemia.
15. A child with minimal change nephrotic syndrome (MCNS) has generalized edema.
The skin appears stretched, and areas of breakdown are noted over the bony
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