Maternity and Pediatric Nursing 4th Edition Ricci
Kyle Carman Test Bank Containing Question and
Answers
1. The nurse is caring for a child who is experiencing an acute renal transplant rejection and is to receive
muromonab-CD3. What would the nurse most likely expect to assess after the first dose is administered?
A) Fever with chills, chest tightness
B) Cough, hyperkalemia
C) Photosensitivity, gastrointestinal (GI) upset
D) Urinary retention, decreased appetite - Correct Answer>>Ans: A
Feedback:
The first dose of muromonab-CD3 can cause fever, chills, chest tightness, wheezing, nausea, and
vomiting. Cough and hyperkalemia are associated with angiotensin-converting enzyme inhibitors.
Photosensitivity and GI upset are often associated with diuretics. Urinary retention and decreased
appetite are associated with imipramine.
2. The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross
hematuria with a specimen of which color?
A) Cloudy yellow
B) Cola colored
C) Pale to almost clear urine
D) Light orange to moderately yellow colored - Correct Answer>>Ans: B
Feedback:
Gross hematuria causes the urine to appear tea, cola, or even dirty green colored. Cloudy urine is
typically a sign of infection. Normal urine ranges from moderately yellow to pale or almost clear. Orange-
colored urine can occur because of medication.
3. The nurse is caring for a 4-year-old with a suspected urinary tract infection. What would be most
appropriate when obtaining a urine specimen from the child?
A) "I will need a urine sample."
B) "Let your mom help you tinkle in this cup."
C) "Please tinkle in this cup right now."
D) "Please void in this cup instead of the toilet." - Correct Answer>>Ans: B
, Feedback:
The nurse needs to use familiar terms to explain to the child what is needed and to gain cooperation.
The most positive approach would be to let the child's mother help rather than demanding that he tinkle
right now. Using the terms "urine sample" or "void" is not appropriate for a 4-year-old.
4. The nurse is providing postsurgical care for an infant who has undergone a hypospadias repair. Which
action by the nurse would be most important to help keep the area clean while maintaining proper
position of the drainage tubing?
A) Keeping the drainage tube taped in an upright position
B) Administering antibiotics as ordered
C) Administering analgesics as prescribed
D) Using a double-diapering technique - Correct Answer>>Ans: D
Feedback:
Double diapering is a method used to protect a child's urethra and stent or catheter after surgery and
additionally helps to keep the area clean and free from infection. Keeping the drainage tube taped in an
upright position, administering antibiotics, and administering analgesics are also important, but double
diapering keeps the area clean and helps prevent infection.
5. The nurse is caring for an infant with bladder exstrophy. As part of the infant's preoperative plan of
care, the nurse monitors for abdominal skin excoriation. Which action would be most appropriate for
promoting healing and preventing further skin breakdown?
A) Cleaning the area well with a scented diaper wipe
B) Applying a barrier/healing cream or paste on skin
C) Keeping the bladder moist and covered with a sterile bag
D) Covering the area with sterile gauze pads after tub baths - Correct Answer>>Ans: B
Feedback:
The nurse should use a barrier/healing cream or paste on surrounding skin to promote healing and
prevent further skin breakdown. Diaper wipes that contain fragrance or alcohol can sting if used on
nonintact skin and can worsen skin breakdown. It is important to protect the bladder, but this will not
address the skin excoriation. Meticulous attention to cleanliness is important, but the nurse should
sponge-bathe the infant rather than immerse him in water to prevent pathogens from the water possibly
entering the bladder.
Kyle Carman Test Bank Containing Question and
Answers
1. The nurse is caring for a child who is experiencing an acute renal transplant rejection and is to receive
muromonab-CD3. What would the nurse most likely expect to assess after the first dose is administered?
A) Fever with chills, chest tightness
B) Cough, hyperkalemia
C) Photosensitivity, gastrointestinal (GI) upset
D) Urinary retention, decreased appetite - Correct Answer>>Ans: A
Feedback:
The first dose of muromonab-CD3 can cause fever, chills, chest tightness, wheezing, nausea, and
vomiting. Cough and hyperkalemia are associated with angiotensin-converting enzyme inhibitors.
Photosensitivity and GI upset are often associated with diuretics. Urinary retention and decreased
appetite are associated with imipramine.
2. The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross
hematuria with a specimen of which color?
A) Cloudy yellow
B) Cola colored
C) Pale to almost clear urine
D) Light orange to moderately yellow colored - Correct Answer>>Ans: B
Feedback:
Gross hematuria causes the urine to appear tea, cola, or even dirty green colored. Cloudy urine is
typically a sign of infection. Normal urine ranges from moderately yellow to pale or almost clear. Orange-
colored urine can occur because of medication.
3. The nurse is caring for a 4-year-old with a suspected urinary tract infection. What would be most
appropriate when obtaining a urine specimen from the child?
A) "I will need a urine sample."
B) "Let your mom help you tinkle in this cup."
C) "Please tinkle in this cup right now."
D) "Please void in this cup instead of the toilet." - Correct Answer>>Ans: B
, Feedback:
The nurse needs to use familiar terms to explain to the child what is needed and to gain cooperation.
The most positive approach would be to let the child's mother help rather than demanding that he tinkle
right now. Using the terms "urine sample" or "void" is not appropriate for a 4-year-old.
4. The nurse is providing postsurgical care for an infant who has undergone a hypospadias repair. Which
action by the nurse would be most important to help keep the area clean while maintaining proper
position of the drainage tubing?
A) Keeping the drainage tube taped in an upright position
B) Administering antibiotics as ordered
C) Administering analgesics as prescribed
D) Using a double-diapering technique - Correct Answer>>Ans: D
Feedback:
Double diapering is a method used to protect a child's urethra and stent or catheter after surgery and
additionally helps to keep the area clean and free from infection. Keeping the drainage tube taped in an
upright position, administering antibiotics, and administering analgesics are also important, but double
diapering keeps the area clean and helps prevent infection.
5. The nurse is caring for an infant with bladder exstrophy. As part of the infant's preoperative plan of
care, the nurse monitors for abdominal skin excoriation. Which action would be most appropriate for
promoting healing and preventing further skin breakdown?
A) Cleaning the area well with a scented diaper wipe
B) Applying a barrier/healing cream or paste on skin
C) Keeping the bladder moist and covered with a sterile bag
D) Covering the area with sterile gauze pads after tub baths - Correct Answer>>Ans: B
Feedback:
The nurse should use a barrier/healing cream or paste on surrounding skin to promote healing and
prevent further skin breakdown. Diaper wipes that contain fragrance or alcohol can sting if used on
nonintact skin and can worsen skin breakdown. It is important to protect the bladder, but this will not
address the skin excoriation. Meticulous attention to cleanliness is important, but the nurse should
sponge-bathe the infant rather than immerse him in water to prevent pathogens from the water possibly
entering the bladder.
