When providing teaching to the caregivers of a 3-year-old girl who is toilet training and just diagnosed with a UTI, what statements by the caregivers indicate further teaching is needed? Select all that apply.

1.“Baths are fine as long as we avoid using bubbles.”

2.“Using a stool softener may be helpful.”

3.“It is important to make sure wiping after urination is back to front.”

4.“We will limit fluids until the pain from the UTI improves to limit amount of painful urination episodes.”

5.“We will ensure taking all the medication even after symptoms disappear.”

1.“Baths are fine as long as we avoid using bubbles.”

3.“It is important to make sure wiping after urination is back to front.”

4.“We will limit fluids until the pain from the UTI improves to limit amount of painful urination episodes.”

When admitting a child with hemolytic uremic syndrome (HUS), which signs and symptoms are associated with the disorder? Select all that apply.

1.Low platelet count

2.Increased red blood cell count

3.Proteinuria

4.Fluid overload

5.Gastroenteritis

1.Low platelet count

3.Proteinuria

5.Gastroenteritis

Thomas is a 3-year-old who is being started on prophylactic antibiotics for vesicoureteral reflux (VUR). Proper teaching about this treatment should include:

1.The medication should be taken in the morning with food.

2.A urine culture should be obtained at least every 3 months.

3.There are no side effects of the medication it is used in low-dose.

4.The treatment can lead to false positive proteinuria.

2.A urine culture should be obtained at least every 3 months.

A student nurse is learning about acute kidney injury (AKI) in the pediatric population. The nursing instructor knows the student needs remediation based on which of the following student statements? Select all that apply.

1.“AKI results in metabolic alkalosis.”

2.“A child with AKI may develop Kussmaul’s respirations.”

3.“Seizures may result from AKI.”

4.“Hypophosphatemia is a result of AKI.”

5.“Hypercalcemia is a result of AKI.”

1.“AKI results in metabolic alkalosis.”

4.“Hypophosphatemia is a result of AKI.”

5.“Hypercalcemia is a result of AKI.”

When teaching the caregiver of a child who was just diagnosed with a urinary tract infection about risk factors, what should be included? Select all that apply.

1.Obstruction

2.Reflux

3.Diaper rash

4.Toilet training

5.Constipation

1.Obstruction

2.Reflux

3.Diaper rash

4.Toilet training

5.Constipation

Tommy, a 4-year-old child, is being treated in the emergency room for severe dehydration due to gastroenteritis causing severe vomiting and diarrhea. His sodium blood level is within a normal range. The nurse caring for him knows Tommy likely has which type of dehydration?

1.Isotonic

2.Hypotonic

3.Hypertonic

4.Blood loss

1.Isotonic

The lab calls to notify the nurse caring for 5-year-old Taylor that the child’s serum sodium level is 152 mEq/L. Which signs and symptoms the nurse noted during the head-to-toe assessment are consistent with this lab finding? Select all that apply.

1.Lung crackles on auscultation

2.Lethargic

3.Muscle twitching

4.Oliguria

5.Hematuria

1.Lung crackles on auscultation

2.Lethargic

3.Muscle twitching

4.Oliguria

When assessing a child with kidney trauma, which finding is present in kidney trauma but not a UTI?

1.Grey-Turner sign

2.Hematuria

3.Flank pain

4.Fever

1.Grey-Turner sign

While caring for Emilia, a 4-year-old girl who weighs 39 pounds on the pediatric in-patient floor, what does the nurse figure as the child’s daily maintenance fluid requirement?

1.)1,770 mL

2.)1,385 mL

3)1,155 mL

4)1,500 mL

2.)1,385 mL

A newborn is admitted to the nursery immediately after birth. The following figure indicates where the urethral opening is on the newborn during assessment. This nurse documents this as:

1.Epispadias

2.Hypospadias

3.Phimosis

4.A normal finding

1.Epispadias

When caring for a child, which of the following lab findings would warrant further investigation? Select all that apply.

1.GFR is 125 mL/minute

2.Creatinine clearance is 87 mL/min

3.Creatinine is 2.1 mg/dL

4.BUN is 35 mg/dL

5.Urine specific gravity is 1.025

3.Creatinine is 2.1 mg/dL

4.BUN is 35 mg/dL

5.Urine specific gravity is 1.025

A 15-year-old girl is prescribed cefixime for a kidney infection. What statement by the patient indicates understanding of the teaching the nurse performed about the medication?

1.“I will eat yogurt daily while on the medication.”

2.“I will not take this medication with grapefruit juice.”

3.“I will monitor for new numbness in my extremities.”

4“I will report hearing issues to the physician immediately.”

1.“I will eat yogurt daily while on the medication.”

A caregiver brings in their 4-year-old for concerns of “more daytime accidents.” To obtain more information, what does the nurse ask? Select all that apply.

1.“Has anyone else in the family had a history of ‘daytime accidents’?”

2.“Has there been any changes or stressful events at home or school?”

3.“Does your child seem in pain when urinating?”

4.“Is your child drinking more fluids than normal?”

5.“Does your child have any allergies?”

1.“Has anyone else in the family had a history of ‘daytime accidents’?”

2.“Has there been any changes or stressful events at home or school?”

4.“Is your child drinking more fluids than normal?”

A parent explains to the grandparent of a newborn that the child has hypospadias. When changing the child’s diaper, the grandparent would expect to find all of the following except:

1.Opening of the urethra below the tip on the bottom side of the penis

2.Excessive foreskin

3.Curvature of the penis during erection

4.Abnormal position of the scrotum in relation to the penis.

2.Excessive foreskin

A nurse caring for a child with chronic kidney disease reviews the child’s lab results. The glomerular filtration rate is 12. The nurse expects what intervention to be ordered?

1.Dialysis

2.Antibiotics

3.Fluid administration

4.Straight catheterization

1.Dialysis

A 6-month-old is seen in the health-care provider’s office, and a urine specimen is collected due to concern of a urinary tract infection (UTI). Which signs and symptoms support a UTI diagnosis? Select all that apply.

1.Fever

2.Colic irritability

3.Ammonia odor of urine

4.10,00 0mL bacteria growth from urine specimen

5.Enuresis

1.Fever

2.Colic irritability

Oxybutynin chloride is prescribed to a post-op child after surgical correction of hypospadias. This medication helps prevent what common side effect?

1.Pain

2.Bladder spasm

3.Constipation

4.Infection

2.Bladder spasm

When working in an emergency room that treats children and adults, the nurse understands that the children being treated are at a greater risk for fluid and electrolyte imbalance than adults because of which of the following? Select all that apply.

1.They have a greater body surface area.

2.They have a greater potential for fluid loss.

3.They have an increased incidence of fever.

4.They have an increased ability to concentrate urine.

5.They have a decreased ability to verbalize thirst.

1.They have a greater body surface area.

2.They have a greater potential for fluid loss.

3.They have an increased incidence of fever.

5.They have a decreased ability to verbalize thirst.

A nursing student is assessing a 2-year-old child in the hospital with fluid volume deficit. The nursing instructor provides remediation when the student states which signs and symptoms support the child’s condition? Select all that apply.

1.Increased urinary output

2.Urine specific gravity of 1.010

3.Bradycardia

4.Hypotension

5.Increased hematocrit

1.Increased urinary output

2.Urine specific gravity of 1.010

3.Bradycardia

A nursing student is learning the differences between adult and children fluid and electrolyte balance. Remediation is needed when the student indicates: Select all that apply.

1.Children have a proportionately greater amount of body water.

2.Children require more fluid intake.

3.Adults excrete more fluid.

4.Children are more likely to suffer from end-stage kidney disease.

5.Adults have a greater metabolic rate.

3.Adults excrete more fluid.

4.Children are more likely to suffer from end-stage kidney disease.

5.Adults have a greater metabolic rate.

Metabolic complications of acute kidney injury (AKI) include all of the following except:

1.Hypermagnesemia

2.Hyperkalemia

3.Hypernatremia

3.Metabolic acidosis

3.Hypernatremia

A nurse is caring for a child in the pediatric emergency room with suspected postinfectious acute glomerulonephritis. The nurse anticipates which test that is ordered will confirm diagnosis?

1.Anti-streptolysin-O (ASO) titer

2.Urinalysis

3.Complete blood count

4.Blood culture

1.Anti-streptolysin-O (ASO) titer

Thomas is a 3-year-old who is being started on prophylactic antibiotics for vesicoureteral reflux (VUR). Proper teaching about this treatment should include:

1.The medication should be taken in the morning with food.

2.A urine culture should be obtained at least every 3 months.

3.There are no side effects of the medication it is used in low-dose.

4.The treatment can lead to false positive proteinuria.

2.A urine culture should be obtained at least every 3 months.

When caring for a hospitalized preschooler weighing 32 pounds, what is the minimum amount of urine output to maintain adequate fluid balance?

1.0.5 mL/kg/hr

2.1 mL/kg/hr

3.1.5 mL/kg/hr

4.2 mL/kg/hr

4.2 mL/kg/hr

A 2-year-old boy is admitted to the emergency room. On assessment, his scrotum is dusky colored with a palpable mass. There is no pain when moving the testicles. Immediate interventions include which of the following? Select all that apply.

1.Obtain surgical consent

2.NPO

3.Administer antibiotics

4.Insert IV

5.Apply ice

1.Obtain surgical consent

2.NPO

4.Insert IV

A nurse receives report on a child who with nephrotic syndrome is being transferred to the pediatric floor from the emergency room. Which findings would the nurse find in this child that are consistent with the diagnosis? Select all that apply.

1.Proteinuria

2.Hyperalbuminemia

3.Edema

4.Unexplained weight loss

5.Hyperlipidemia

1.Proteinuria

3.Edema

5.Hyperlipidemia

When evaluating laboratory results of a 4-year-old child with chronic kidney disease, which would the nurse expect? Select all that apply.

1.Sodium 148 mEq/L

2.Vitamin D 10 ng/mL

3.Potassium 5.7 mEq/L

4.Calcium 8 mg/dL

5.BUN 19 mg/dL

2.Vitamin D 10 ng/mL

3.Potassium 5.7 mEq/L

4.Calcium 8 mg/dL

5.BUN 19 mg/dL

When preparing to administer dialysis to a child using an AV fistula, with which finding would you notify the physician immediately?

1.Absence of thrill

2.Presence of a thrill

3.Presence of a bruit

4.Clear dialysate return

1.Absence of thrill

A nurse is preparing a 3-year-old child for a nuclear cystography. The parent asks what the test is for. What is the nurse’s best response?

1.“It helps determine the type of bacteria present in the urinary tract.”

2.“It helps determine the length of time for passage of urine through the kidneys.”

3.“It helps detect vesicoureteral reflux (VUR).”

4..“It is helpful in determining tubular defects and possible scarring.

3.“It helps detect vesicoureteral reflux (VUR).”

Kara is a 34-year-old in the hospital for kidney issues. She has a 25% of normal reduction of GFR with GFR of 65. What stage of renal failure is Kara likely in?

1.Reduced renal reserve

2.Renal insufficiency

3.Renal failure

4.End-stage renal disease

2.Renal insufficiency