Chapter 44 The Child with a Genitourinary Alteration
Test Bank
MULTIPLE CHOICE
1. Which statement by a school-age girl indicates the need for further teaching about the
prevention of urinary tract infections (UTIs)?
a. “I always wear cotton underwear.”
b. “I really enjoy taking a bubble bath.”
c. “I go to the bathroom every 3 to 4 hours.”
d. “I drink four to six glasses of fluid every day.”
ANS: B
Feedback
A It is desirable to wear cotton rather than nylon underwear. Nylon tends to hold in
moisture and promote bacterial growth, whereas cotton absorbs moisture.
B Bubble baths should be avoided because they tend to cause urethral irritation,
which leads to UTI.
C Children should be encouraged to urinate at least four times a day.
D An adequate fluid intake prevents the buildup of bacteria in the bladder.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1125
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
2. The nurse assessing a child with acute poststreptococcal glomerulonephritis should be
alert for which finding?
a. Increased urine output
b. Hypotension
c. Tea-colored urine
d. Weight gain
ANS: C
Feedback
A In acute poststreptococcal glomerulonephritis the urine output may be decreased.
B In acute poststreptococcal glomerulonephritis blood pressure may be increased.
C Acute poststreptococcal glomerulonephritis is characterized by hematuria,
proteinuria, edema, and renal insufficiency. Tea-colored urine is an indication of
hematuria.
D Edema may be noted around the eyelids and ankles in patients with acute
poststreptococcal glomerulonephritis; however, weight gain is associated with
, nephrotic syndrome.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1128
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
3. The mother of a child who was recently diagnosed with acute glomerulonephritis asks the
nurse why the physician keeps talking about “casts” in the urine. The nurse’s response is
based on the knowledge that the presence of casts in the urine indicates
a. Glomerular injury
b. Glomerular healing
c. Recent streptococcal infection
d. Excessive amounts of protein in the urine
ANS: A
Feedback
A The presence of red blood cell casts in the urine indicates glomerular injury.
B Casts in the urine are abnormal findings and are indicative of glomerular injury,
not glomerular healing.
C A urinalysis positive for casts does not confirm a recent streptococcal infection.
D Casts in the urine are unrelated to proteinuria.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1132
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
4. Which clinical finding warrants further intervention for the child with acute
poststreptococcal glomerulonephritis?
a. Weight loss to within 1 lb of the preillness weight
b. Urine output of 1 mL/kg/hr
c. A positive antistreptolysin O (ASO) titer
d. Inspiratory crackles
ANS: D
Feedback
A This is an indication that the child is responding to treatment.
B This is an acceptable urine output and indicates that the child is responding to
treatment.
C A positive ASO titer indicates the presence of antibodies to streptococcal
bacteria; it is used to aid in diagnosis of acute poststreptococcal
glomerulonephritis. This is an expected finding if the child has this acute illness.
D Children with excess fluid volume may have pulmonary edema. Inspiratory
crackles indicate fluid in the lungs. Pulmonary edema can be a life-threatening
complication.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1130
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
5. Which diagnostic finding is present when a child has primary nephrotic syndrome?
Test Bank
MULTIPLE CHOICE
1. Which statement by a school-age girl indicates the need for further teaching about the
prevention of urinary tract infections (UTIs)?
a. “I always wear cotton underwear.”
b. “I really enjoy taking a bubble bath.”
c. “I go to the bathroom every 3 to 4 hours.”
d. “I drink four to six glasses of fluid every day.”
ANS: B
Feedback
A It is desirable to wear cotton rather than nylon underwear. Nylon tends to hold in
moisture and promote bacterial growth, whereas cotton absorbs moisture.
B Bubble baths should be avoided because they tend to cause urethral irritation,
which leads to UTI.
C Children should be encouraged to urinate at least four times a day.
D An adequate fluid intake prevents the buildup of bacteria in the bladder.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1125
OBJ: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
2. The nurse assessing a child with acute poststreptococcal glomerulonephritis should be
alert for which finding?
a. Increased urine output
b. Hypotension
c. Tea-colored urine
d. Weight gain
ANS: C
Feedback
A In acute poststreptococcal glomerulonephritis the urine output may be decreased.
B In acute poststreptococcal glomerulonephritis blood pressure may be increased.
C Acute poststreptococcal glomerulonephritis is characterized by hematuria,
proteinuria, edema, and renal insufficiency. Tea-colored urine is an indication of
hematuria.
D Edema may be noted around the eyelids and ankles in patients with acute
poststreptococcal glomerulonephritis; however, weight gain is associated with
, nephrotic syndrome.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1128
OBJ: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
3. The mother of a child who was recently diagnosed with acute glomerulonephritis asks the
nurse why the physician keeps talking about “casts” in the urine. The nurse’s response is
based on the knowledge that the presence of casts in the urine indicates
a. Glomerular injury
b. Glomerular healing
c. Recent streptococcal infection
d. Excessive amounts of protein in the urine
ANS: A
Feedback
A The presence of red blood cell casts in the urine indicates glomerular injury.
B Casts in the urine are abnormal findings and are indicative of glomerular injury,
not glomerular healing.
C A urinalysis positive for casts does not confirm a recent streptococcal infection.
D Casts in the urine are unrelated to proteinuria.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1132
OBJ: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
4. Which clinical finding warrants further intervention for the child with acute
poststreptococcal glomerulonephritis?
a. Weight loss to within 1 lb of the preillness weight
b. Urine output of 1 mL/kg/hr
c. A positive antistreptolysin O (ASO) titer
d. Inspiratory crackles
ANS: D
Feedback
A This is an indication that the child is responding to treatment.
B This is an acceptable urine output and indicates that the child is responding to
treatment.
C A positive ASO titer indicates the presence of antibodies to streptococcal
bacteria; it is used to aid in diagnosis of acute poststreptococcal
glomerulonephritis. This is an expected finding if the child has this acute illness.
D Children with excess fluid volume may have pulmonary edema. Inspiratory
crackles indicate fluid in the lungs. Pulmonary edema can be a life-threatening
complication.
PTS: 1 DIF: Cognitive Level: Application REF: p. 1130
OBJ: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
5. Which diagnostic finding is present when a child has primary nephrotic syndrome?
