PEDs Chapter 21 Nursing Care of the Child with a Genitourinary Disorder Questions and Correct Answers
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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?
a) Performing a suprapubic aspiration b) Placing an indwelling urinary catherter c) Placing a cotton ball in the underwear to catch urine d) Obtainin...
PEDs Chapter 21 Nursing Care of the
Child with a Genitourinary Disorder
Questions and Correct Answers
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?
a) Performing a suprapubic aspiration
b) Placing an indwelling urinary catherter
c) Placing a cotton ball in the underwear to catch urine
d) Obtaining a clean catch voided urine ✅Obtaining a clean catch voided urine
Correct
Explanation:
In the cooperative, toilet-trained child, a clean midstream urine may be used
successfully to obtain a "clean catch" voided urine. If a culture is needed, the child may
be catheterized, but this is usually avoided if possible. A suprapubic aspiration also may
be done to obtain a sterile specimen. In the toilet trained child, using a cotton ball to
collect the urine would not be appropriate.
To prevent further urinary tract infections in a preschooler, what measures would you
teach her mother?
a) Teach her to take frequent tub baths to clean her perineal area.
b) Teach her to wipe her perineum front to back after voiding.
c) Suggest she drink less fluid daily to concentrate urine.
d) Encourage her to be more ambulatory to increase urine output. ✅Teach her to wipe
her perineum front to back after voiding.
Correct
Explanation:
Escherichia coli can be easily spread from the rectum to the urinary meatus and cause
infection if girls do not take precautions against this.
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?
a) Yes, all children who get pyelonephritis have renal scarring.
b) The child's risk for renal scarring is increased with pyelonephritis.
c) As long as IV antibiotics are started, there is no risk of renal damage.
d) No, if the child is urinating normally, the kidneys were not damaged. ✅The child's
risk for renal scarring is increased with pyelonephritis.
Correct
Explanation:
,It would not be possible to determine if the child has renal scarring with pyelonephritis
until more testing is performed. It can result in renal scarring with this type of problem,
but that does not mean there will definitely be complications. Antibiotics are usually the
treatment of choice in this situation, but it cannot be determined when the damage had
occurred.
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?
a) Thick, white cheese-like discharge
b) Yellow-green discharge
c) Milky, gray, fishy-odor discharge
d) Frothy, gray-green discharge ✅Thick, white cheese-like discharge
Correct
Explanation:
With candidiasis, the vaginal discharge is thick, white, and cheese-like. A frothy, gray-
green discharge is noted with trichomoniasis. A milky, gray discharge with a fishy odor
suggests gardnerella. A yellow-green vaginal discharge suggests gonorrhea.
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?
a) Glomerular filtration rate is faster in infants than in adults.
b) Bladder capacity reaches adult capacity by age 1 year.
c) The renal system usually reaches functional maturity by age 5 years.
d) A child's kidneys are surrounded by more fat padding than an adult's kidneys.
✅Bladder capacity reaches adult capacity by age 1 year.
Correct
Explanation:
Bladder capacity is about 30 mL in the newborn and increases to the usual adult
capacity of about 270 mL by 1 year of age. Glomerular filtration rate is slower in the
infant and young toddler compared with the adult. The renal system usually reaches
functional maturity by 2 years of age. The kidneys of a child are less well protected from
injury by the ribs and fat padding than they are in the adult.
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?
a) Smoky colored urine
b) Jaundiced skin
c) Strawberry red tongue
d) Loose, dark stools ✅Smoky colored urine
Explanation:
, The presenting symptom in acute glomerulonephritis is grossly bloody urine. The
caregiver may describe the urine as smoky or bloody. Periorbital edema may
accompany or precede hematuria. Loose stools are seen in diarrhea. A strawberry
colored tongue is a symptom seen in the child with Kawasaki disease. Jaundiced skin is
noted in Hepatitis.
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?
a) "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."
b) "That doesn't make being a woman sound very good. It would probably be easier for
her if you could be more supportive."
c) "That must be hard on you, especially because you are raising her by yourself."
d) "PMS is a problem for a lot of women, but sometimes it's worse in the beginning.
She might outgrow it." ✅"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."
Correct
Explanation:
Women of all ages are subject to the discomfort of premenstrual syndrome (PMS), but
the symptoms may be alarming to the adolescent. Symptoms include edema (resulting
in weight gain), headache, increased anxiety, mild depression, and mood swings.
Generally the discomforts of PMS are minor and can be relieved by reducing salt intake
during the week before menstruation, taking mild analgesics, and applying local heat.
When symptoms are more severe, the physician may prescribe a mild diuretic to be
taken the week before menstruation to relieve edema; occasionally oral contraceptive
pills are prescribed to prevent ovulation.
The child with nephrotic syndrome who has ascites and difficulty breathing is probably
most comfortable sleeping in which position?
a) Supine
b) Sims' position
c) Prone
d) Fowler's ✅Fowler's
Correct
Explanation:
A Fowler's position (sitting upright) allows ascites fluid to settle downward and not press
against the diaphragm, compromising breathing.
A child in kidney failure has had a kidney transplantation. You would prepare the child
for which of the following to occur postoperatively?
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