Peds Exam 3- GI/ GU Practice Questions with Correct Answers and Explanations
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Course
GU Peds
Institution
GU Peds
1 An 18-month-old client is brought in for a well-child visit. The parent reports feeling a lump to the right of the "bellybutton" during bathing. Initial assessments should include: (Select all that apply.) 1. Measuring weight and height. 2. Palpation of the area. 3. Routine urine testing. 4. Vita...
Peds Exam 3- GI/ GU Practice Questions
with Correct Answers and Explanations
1 An 18-month-old client is brought in for a well-child
visit. The parent reports feeling a lump to the right of
the "bellybutton" during bathing. Initial assessments
should include: (Select all that apply.)
1. Measuring weight and height.
2. Palpation of the area.
3. Routine urine testing.
4. Vital signs.
5. Questioning the parents about abuse. ✅1 Answers: 1, 3, 4This is the usual
presentation of Wilm's
tumor (nephroblastoma), and palpating the area may
cause the tumor to spread. Since Wilm's tumor is a cancer of the kidney, it important to
assess growth and development; kidney function; and blood pressure, which
may be elevated due to increased renin production.
There is no evidence of abuse or rationale for performing a neuro check.
Following diagnosis of Wilms' tumor, the child undergoes removal of the affected
kidney. In the postoperative period, priority nursing assessments should
focus on:
1. The incision.
2. Lung sounds.
3. Temperature.
4. Kidney function. ✅9 Answer: 4All of these assessments look at possible
postoperative complications. Since the child is left with
only one kidney, failure of that kidney due to inadequate blood flow, infection, or any
other cause could be
fatal.
3 A client is to begin radiation therapy after the removal of Wilms' tumor. The parent
statement that indicates to the nurse a lack of understanding of
related skin care would be "We will:
1. Use loose-fitting clothes on our child."
2. Protect our child from sun exposure."
3. Keep the area moist with petrolatum jelly."
4. Prevent our child from scratching the site." ✅3 Answer: 3Self-care during external
radiation therapy
includes loose-fitting clothes, gentle washing with mild
soap, avoiding sun exposure, and avoiding scratching
and other irritation. Any lubricant must be watersoluble, not oil-based such as
petrolatum jelly.
,1 A newborn is found to have exstrophy of the bladder. The nurse should evaluate the
infant for: (Select
all that apply.)
1. Hypospadias.
2. Epispadias.
3. Cryptorchidism.
4. Acute tubular necrosis.
5. Bilateral inguinal hernias. ✅Answers: 2, 5Epispadias and bilateral inguinal hernias
are frequent anomalies associated with exstrophy of the
bladder. The other conditions listed are not
2 A child has been admitted to the hospital with a diagnosis of "rule out nephrosis." The
nurse would assess the child for:
1. Hematuria.
2. Edema.
3. Petechial rash.
4. Dehydration. ✅Answer: 2Edema is the major clinical symptom of
nephrosis. The child may gain twice his or her normal
weight in severe cases
3 The nurse is caring for a toddler who is not toilettrained. The doctor has ordered
intake and output
measurement. The nurse will most accurately measure the urine by:
1. Estimating output as small, moderate, or large and
recording on the child's chart.
2. Weighing each wet diaper and recording the weight of
the diaper as the amount of urine output.
3. Subtracting the weight of a dry diaper from a wet diaper
and record this amount.
4. Determining urine output by the number of diaper
changes in each 24-hour period. ✅Answer: 3Diapers are weighed on a gram scale
before
using them and after removal (1 g = 1 mL). The weight
of the dry diaper is then subtracted from the weight of
the wet diaper to determine urine output
3 The nurse is caring for a toddler who is not toilettrained. The doctor has ordered
intake and output
measurement. The nurse will most accurately measure the urine by:
1. Estimating output as small, moderate, or large and
recording on the child's chart.
2. Weighing each wet diaper and recording the weight of
the diaper as the amount of urine output.
3. Subtracting the weight of a dry diaper from a wet diaper
and record this amount.
,4. Determining urine output by the number of diaper
changes in each 24-hour period. ✅Answer: 3Diapers are weighed on a gram scale
before
using them and after removal (1 g = 1 mL). The weight
of the dry diaper is then subtracted from the weight of
the wet diaper to determine urine output
4 The nurse is teaching the parents of a preschooler information about urinary tract
infections (UTIs) and
means of reducing their recurrence. Statements from
the parents that indicate an understanding of ways to
prevent UTIs include: (Select all that apply.)
1. "I should try to get her to drink a lot of water and
juices."
2. "I will buy her underwear made with cotton."
3. "Soaking in a bubble bath will reduce meatal irritation."
4. "If I notice her starting to wet the bed again, I need to
have her checked for another urinary tract infection."
5. "I should avoid giving her cranberry juice as it has been
shown to make the urine more acidic." ✅Answers: 1, 2, 4Bubble baths are irritating to
the meatus
and increase the incidence of urinary tract infections. An
acidic urine is desirable in preventing urinary tract infections, and the proper way to
wipe is front to back
5 The nurse would include which of the following in
the care of a child with acute glomerulonephritis?
(Select all that apply.)
1. Careful handling of edematous extremities
2. Observing the child for evidence of hypertension
3. Providing fun activities for the child on bedrest
4. Monitoring the urine for hematuria
5. Encouraging fluid intake ✅Answers: 2, 3, 4Although children with acute
glomerulonephritis may feel well, they are confined to bed until
hematuria resolves. This can lead to boredom, making it
important for the nurse to provide activities that are fun
for the child to help pass the time.
6 A urinalysis is ordered for a child with a throat culture positive for group-A beta-
hemolytic streptococcus(strep throat). The mother asks why this test is
being ordered. The nurse explains:
1. The urinalysis will indicate whether an HIV infection is
also present.
2. Urinary tract infections are common with streptococcal
infections and need to receive prompt treatment.
3. Pyelonephritis is a potential complication of antibiotic
, therapy.
4. Group-A beta-hemolytic streptococcusinfections can be
followed by the complication of acute glomerulonephritis. ✅Answer: 4Urinalysis allows
for early diagnosis and
treatment of acute glomerulonephritis, which is a serious complication that can follow
group-A beta-hemolytic streptococcal infection.
7 An appropriate nursing diagnosis for a toddler with
unrepaired exstrophy of the bladder would be:
1. Disorganized infant behavior.
2. Sexual dysfunction.
3. Urinary retention.
4. Risk for infection. ✅Answer: 4The open bladder allows bacteria to enter the
urinary system, and urinary tract infections are common. At this age, sexual dysfunction
would not be an
appropriate diagnosis. The unformed bladder does not
hold urine, so urinary retention would not be an appropriate diagnosis. Disorganized
behavior doesn't apply
8 A child has been admitted to the unit with acute
glomerulonephritis. The test that would confirm this
diagnosis is:
1. Antistreptolysin-O (ASO) titer.
2. Urinalysis.
3. Blood cultures.
4. White blood cell (WBC) count. ✅Answer: 1The ASO titer indicates a preceding
infection
with group-A beta-hemolytic streptococcus.The urinalysis would show hematuria, but
this alone would not be
diagnostic of acute glomerulonephritis. Blood cultures
may be negative as the infection preceded the illness by
1 to 3 weeks
9 The doctor orders a clean-catch urine specimen on
an infant who is not toilet-trained. The best means
of collecting this urine would be to:
1. Perform a straight catheterization.
2. Apply a urine collection bag.
3. Use diaper analysis.
4. Perform Foley catheterization. ✅Answer: 1Clean-catch urine specimens are not
reliable
urine samples; therefore, catheterization is necessary. The
urine does need to be obtained at the time of voiding.
0 A 14-year-old is being treated for renal failure. The
nurse would ensure that the child follows a:
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