PEDIATRIC NURSING EXAM 2 PRACTICE
NCLEX QUESTIONS AND ANSWERS
COMPREHENSIVE AND DETAILED. GRADE
A+ GURANTEED PASS
With which problems would open surgery of the urinary tract be
recommended to a pt? - ANSWER - Significant anatomic abnormality at
uterovesical junction, severe VUR (reflux), noncompliance with med
,therapy, intolerance to abx, VUR (reflux) after puberty in women, and
chronic recurrent UTIs
What age is most at risk of renal injury associated with UTI? - ANSWER
- Young children, especially 2 and under. (even more so with congenital
renal malformations and reflux)
Three major quality outcomes for urinary tract infections - ANSWER -
Treatment based on culture and sensitivity (right meds!), renal function
is maintained, and appropriate diagnosis of renal abnormalities
What is a hint when a UTI might be suspected of a child wearing
diapers? - ANSWER - Check the diaper every 1/2 hour, it can increase
opportunity for observing the stream for such findings as straining,
fretting before voiding begins, discomfort signs during urination, or
dripping of small amounts of urine at a time frequently.
What would be the best way to explain a procedure for the Urinary
tract system to a 3-4 year old? - ANSWER - Show them using a doll
What would be the best way to explain a procedure for the urinary tract
system to an older child? - ANSWER - A simple drawing of the system
involved with explanation.
,When should once daily dose antibiotics be given for UTI - ANSWER -
Usually at bedtime, this allows the drug to remain in the bladder
overnight.
When there is interference of urine flow by a structural abnormality or
obstruction, it can lead to back up of urine into the kidneys and renal
pelvis resulting in this condition - ANSWER - Hydronephrosis (to treat,
resolve infection or blockage)
Damage to this part of the urinary system can alter the ability to
concentrate urine, increasing urine flow and leading to metabolic
acidosis from decreased excretion of acid. - ANSWER - Damage to the
distal nephrons
What are the age recommendations for the child requiring surgery of
the genital area and why? - ANSWER - After extensive review of the
emotional , cognitive and body image problems that may occur in
children undergoing surgical reconstruction of a genital deformity, it is
recommended that it be accomplished between 6 and 15 months of age
to minimize the psychological effects of surgery and anesthesia.
This is an autoimmune (attacks itself) process leading to structural
alteration of glomerular membrane that results in increased
permeability to plasma proteins particularly - albumin. (leads to
edema/hypertension) - ANSWER - Nephrotic Syndrome (Nephrosis)
, What are the three types of Nephrosis that a pt could have? - ANSWER
- Congenital, Minimal Change nephrotic syndrome, or secondary.
This type of nephrosis usually requires dialysis or a renal transplant.
Usually not good and does not respond well to therapy - ANSWER -
Congenital Nephrosis
This type of nephrosis accounts for 80% of occurrences, for some
reason (thought autoimmune) the glomerular basement membrane
which is usually impermeable to albumin and other proteins (mostly
albumin), becomes permeable to them allowing them to be lost in the
urine. - ANSWER - Minimal Change Nephrotic Syndrome. (MCNS)
(Nephrosis)
Explain the pathophysiology or MCNS (Minimal change nephrotic
syndrome) - ANSWER - Because the glomerular membrane allows the
proteins and albumin to spill out of the urine, this reduces the serum
albumin level, decreasing the colloidal osmotic pressure in the
capillaries, as a result the vascular hydrostatic pressure exceeds the pull
of the colloidal osmotic pressure and fluid begins to accumulate in the
insterstitial spaces (edema) and body cavities, particularly fluid builds
up in the abdominal cavity (ascities). This shift of fluid from plasma to
interstitial spaces reduces vascular volume (hypovolemia), stimulates
ADH and aldosterone hormones and tubular absorption of sodium and
NCLEX QUESTIONS AND ANSWERS
COMPREHENSIVE AND DETAILED. GRADE
A+ GURANTEED PASS
With which problems would open surgery of the urinary tract be
recommended to a pt? - ANSWER - Significant anatomic abnormality at
uterovesical junction, severe VUR (reflux), noncompliance with med
,therapy, intolerance to abx, VUR (reflux) after puberty in women, and
chronic recurrent UTIs
What age is most at risk of renal injury associated with UTI? - ANSWER
- Young children, especially 2 and under. (even more so with congenital
renal malformations and reflux)
Three major quality outcomes for urinary tract infections - ANSWER -
Treatment based on culture and sensitivity (right meds!), renal function
is maintained, and appropriate diagnosis of renal abnormalities
What is a hint when a UTI might be suspected of a child wearing
diapers? - ANSWER - Check the diaper every 1/2 hour, it can increase
opportunity for observing the stream for such findings as straining,
fretting before voiding begins, discomfort signs during urination, or
dripping of small amounts of urine at a time frequently.
What would be the best way to explain a procedure for the Urinary
tract system to a 3-4 year old? - ANSWER - Show them using a doll
What would be the best way to explain a procedure for the urinary tract
system to an older child? - ANSWER - A simple drawing of the system
involved with explanation.
,When should once daily dose antibiotics be given for UTI - ANSWER -
Usually at bedtime, this allows the drug to remain in the bladder
overnight.
When there is interference of urine flow by a structural abnormality or
obstruction, it can lead to back up of urine into the kidneys and renal
pelvis resulting in this condition - ANSWER - Hydronephrosis (to treat,
resolve infection or blockage)
Damage to this part of the urinary system can alter the ability to
concentrate urine, increasing urine flow and leading to metabolic
acidosis from decreased excretion of acid. - ANSWER - Damage to the
distal nephrons
What are the age recommendations for the child requiring surgery of
the genital area and why? - ANSWER - After extensive review of the
emotional , cognitive and body image problems that may occur in
children undergoing surgical reconstruction of a genital deformity, it is
recommended that it be accomplished between 6 and 15 months of age
to minimize the psychological effects of surgery and anesthesia.
This is an autoimmune (attacks itself) process leading to structural
alteration of glomerular membrane that results in increased
permeability to plasma proteins particularly - albumin. (leads to
edema/hypertension) - ANSWER - Nephrotic Syndrome (Nephrosis)
, What are the three types of Nephrosis that a pt could have? - ANSWER
- Congenital, Minimal Change nephrotic syndrome, or secondary.
This type of nephrosis usually requires dialysis or a renal transplant.
Usually not good and does not respond well to therapy - ANSWER -
Congenital Nephrosis
This type of nephrosis accounts for 80% of occurrences, for some
reason (thought autoimmune) the glomerular basement membrane
which is usually impermeable to albumin and other proteins (mostly
albumin), becomes permeable to them allowing them to be lost in the
urine. - ANSWER - Minimal Change Nephrotic Syndrome. (MCNS)
(Nephrosis)
Explain the pathophysiology or MCNS (Minimal change nephrotic
syndrome) - ANSWER - Because the glomerular membrane allows the
proteins and albumin to spill out of the urine, this reduces the serum
albumin level, decreasing the colloidal osmotic pressure in the
capillaries, as a result the vascular hydrostatic pressure exceeds the pull
of the colloidal osmotic pressure and fluid begins to accumulate in the
insterstitial spaces (edema) and body cavities, particularly fluid builds
up in the abdominal cavity (ascities). This shift of fluid from plasma to
interstitial spaces reduces vascular volume (hypovolemia), stimulates
ADH and aldosterone hormones and tubular absorption of sodium and
