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NDEE PRACTICE Questions and Answers with Complete
Solutions UPDATED!!!!
A 3-year-old child is admitted to the pediatric unit with a
diagnosis of nephrotic syndrome. The child has ascites, oliguria,
respirations of 40 breaths/min, and a recent weight gain of 10
lb (4.5 kg). What nursing intervention may help ease the child's
respiratory difficulty?
1
Providing six small meals daily
2
Maintaining a well-ventilated room
3
Ensuring bed rest in the low Fowler position
4
Administering oxygen at 2 L/min by way of nasal cannula -
ANSWER 3 The low Fowler position decreases pressure on the
diaphragm from the abdominal organs and the ascites, thereby
increasing respiratory excursion. Frequent feedings may lead to
fatigue and quickened respiration, which will further distress
the child. Placing the child in a well-ventilated room will not
alleviate the cause of the respiratory problem, which is pressure
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on the diaphragm from the ascites. Oxygen therapy is not
necessary; the dyspnea results from pressure on the
diaphragm, not lack of oxygen.
A 3-year-old child is hospitalized with nephrotic syndrome. The
child has oliguria and generalized edema. What factor does the
nurse identify that will have the greatest effect on the child's
adjustment to hospitalization?
1
Lack of parental visits
2
Inability to select a variety of foods
3
Response of peers to the edematous appearance
4
Willingness to participate in cooperative play activities -
ANSWER 1 Hospitalization is traumatic to the preschooler
because of separation from significant family members. When
parents are unable to visit, the nurse should arrange for daily
contact with them by other means such as internet webcam
technology. Preschoolers are not interested in food; children
with nephrotic syndrome often have decreased appetites.
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Preschoolers are not concerned about attitudes of peers; it is
too early in their social development to have this concern.
Massive edema results in easy fatigability and a lack of interest
in play.
A 3-year-old preschooler has been hospitalized with nephrotic
syndrome. What is the best way for the nurse to evaluate fluid
retention or loss?
1
Measuring the abdominal girth daily
2
Having the child urinate in a bedpan
3
Testing the child's urine for proteinuria
4
Weighing the child at the same time each day - ANSWER 4
Comparison of daily weights is the most accurate way to assess
fluid retention or loss. Having the child urinate in a bedpan is
difficult for a child of this age, and the findings will not be
accurate. Measuring the abdominal girth daily is way to assess
the degree of ascites; it indirectly measures fluid retention.
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Assessment of urine for protein gives information about the
disease process, but not about the amount of fluid retention.
A 3.5-year-old child hospitalized with nephrotic syndrome. The
child has been toilet trained for longer than one year but has
been incontinent while in the hospital. The child's parents
express concern over this behavior. What is the most
therapeutic response by the nurse?
1
"Your child is wetting the bed to get attention. Set limits when
this occurs."
2
"The incontinence is caused by the renal disease. It will stop
with physical improvement."
3
"This is an expected response to hospitalization. Ignore the
regressive behavior and be supportive."
4
"Your child is using this regressive behavior to help cope with
hospitalization; just use diapers and say nothing." - ANSWER 3
Regression frequently occurs during and after hospitalization.
The child needs support and encouragement from the parents.
NDEE PRACTICE Questions and Answers with Complete
Solutions UPDATED!!!!
A 3-year-old child is admitted to the pediatric unit with a
diagnosis of nephrotic syndrome. The child has ascites, oliguria,
respirations of 40 breaths/min, and a recent weight gain of 10
lb (4.5 kg). What nursing intervention may help ease the child's
respiratory difficulty?
1
Providing six small meals daily
2
Maintaining a well-ventilated room
3
Ensuring bed rest in the low Fowler position
4
Administering oxygen at 2 L/min by way of nasal cannula -
ANSWER 3 The low Fowler position decreases pressure on the
diaphragm from the abdominal organs and the ascites, thereby
increasing respiratory excursion. Frequent feedings may lead to
fatigue and quickened respiration, which will further distress
the child. Placing the child in a well-ventilated room will not
alleviate the cause of the respiratory problem, which is pressure
, Page |2
on the diaphragm from the ascites. Oxygen therapy is not
necessary; the dyspnea results from pressure on the
diaphragm, not lack of oxygen.
A 3-year-old child is hospitalized with nephrotic syndrome. The
child has oliguria and generalized edema. What factor does the
nurse identify that will have the greatest effect on the child's
adjustment to hospitalization?
1
Lack of parental visits
2
Inability to select a variety of foods
3
Response of peers to the edematous appearance
4
Willingness to participate in cooperative play activities -
ANSWER 1 Hospitalization is traumatic to the preschooler
because of separation from significant family members. When
parents are unable to visit, the nurse should arrange for daily
contact with them by other means such as internet webcam
technology. Preschoolers are not interested in food; children
with nephrotic syndrome often have decreased appetites.
, Page |3
Preschoolers are not concerned about attitudes of peers; it is
too early in their social development to have this concern.
Massive edema results in easy fatigability and a lack of interest
in play.
A 3-year-old preschooler has been hospitalized with nephrotic
syndrome. What is the best way for the nurse to evaluate fluid
retention or loss?
1
Measuring the abdominal girth daily
2
Having the child urinate in a bedpan
3
Testing the child's urine for proteinuria
4
Weighing the child at the same time each day - ANSWER 4
Comparison of daily weights is the most accurate way to assess
fluid retention or loss. Having the child urinate in a bedpan is
difficult for a child of this age, and the findings will not be
accurate. Measuring the abdominal girth daily is way to assess
the degree of ascites; it indirectly measures fluid retention.
, Page |4
Assessment of urine for protein gives information about the
disease process, but not about the amount of fluid retention.
A 3.5-year-old child hospitalized with nephrotic syndrome. The
child has been toilet trained for longer than one year but has
been incontinent while in the hospital. The child's parents
express concern over this behavior. What is the most
therapeutic response by the nurse?
1
"Your child is wetting the bed to get attention. Set limits when
this occurs."
2
"The incontinence is caused by the renal disease. It will stop
with physical improvement."
3
"This is an expected response to hospitalization. Ignore the
regressive behavior and be supportive."
4
"Your child is using this regressive behavior to help cope with
hospitalization; just use diapers and say nothing." - ANSWER 3
Regression frequently occurs during and after hospitalization.
The child needs support and encouragement from the parents.
