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Wong's Nursing Care of Infants and Children
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Wong's Nursing Care of Infants and Children
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Wong’s Nursing Care Of Infants And Children, 12th Edition By: Marilyn J. Hockenberry, Elizabeth A. Duffy, Karen Gibbs
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Test Bank for Wongs Nursing Care of Infants and Children 12th Edition by Hockenberry
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TEST BANK For Wong's Nursing Care of Infants and Children, 12th Edition by Hockenberry, 2024, Verified Chapters 1 - 34, Complete Newest Version ISBN-9780323776707
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TEST BANK For Wong's Nursing Care of Infants and Children,12th Edition (Hockenberry, 2024), Verified Chapters 1 - 34,
Complete Newest Version
Urinary tract anomalies are frequently associated with what irregularities in fetal
development?
a. Myelomeningocele
b. Cardiovascular anomalies
c. Malformed or low-set ears
d. Defects in lower extremities - ANSWER: ANS: C
Although unexplained, there is a frequent association between malformed or low-set
ears and urinary tract anomalies. During the newborn examination, the nurse should
have a high suspicion about urinary tract structure and function if ear anomalies are
present. Children who have myelomeningocele may have impaired urinary tract
function secondary to the neural defect. When other congenital defects are present,
there is an increased likelihood of other issues with other body systems. Cardiac and
extremity defects do not have a strong association with renal anomalies.
What urine test result is considered abnormal?
a. pH 4.0
b. WBC 1 or 2 cells/ml
c. Protein level absent
d. Specific gravity 1.020 - ANSWER: ANS: A
The expected pH ranges from 4.8 to 7.8. A pH of 4.0 can be indicative of urinary tract
infection or metabolic alkalosis or acidosis. Less than 1 or 2 white blood cells per
milliliter is the expected range. The absence of protein is expected. The presence of
protein can be indicative of glomerular disease. A specific gravity of 1.020 is within
the anticipated range of 1.001 to 1.030. Specific gravity reflects level of hydration in
addition to renal disorders and hormonal control such as antidiuretic hormone.
What diagnostic test allows visualization of renal parenchyma and renal pelvis
without exposure to external-beam radiation or radioactive isotopes?
a. Renal ultrasonography
b. Computed tomography
c. Intravenous pyelography
d. Voiding cystourethrography - ANSWER: ANS: A
The transmission of ultrasonic waves through the renal parenchyma allows
visualization of the renal parenchyma and renal pelvis without exposure to external-
beam radiation or radioactive isotopes. Computed tomography uses external
radiation, and sometimes contrast media are used. Intravenous pyelography uses
contrast medium and external radiation for radiography. Contrast medium is
injected into the bladder through the urethral opening. External radiation for
radiography is used before, during, and after voiding in voiding cystourethrography.
What name is given to inflammation of the bladder?
,a. Cystitis
b. Urethritis
c. Urosepsis
d. Bacteriuria - ANSWER: ANS: A
Cystitis is an inflammation of the bladder. Urethritis is an inflammation of the
urethra. Urosepsis is a febrile urinary tract infection with systemic signs of bacterial
infection. Bacteriuria is the presence of bacteria in the urine.
The nurse is teaching a client to prevent future urinary tract infections (UTIs). What
factor is most important to emphasize as the potential cause?
a. Poor hygiene
b. Constipation
c. Urinary stasis
d. Congenital anomalies - ANSWER: ANS: C
Urinary stasis is the single most important host factor that influences the
development of UTIs. Urine is usually sterile but at body temperature provides an
excellent growth medium for bacteria. Poor hygiene can be a contributing cause,
especially in females because their short urethras predispose them to UTIs. Urinary
stasis then provides a growth medium for the bacteria. Intermittent constipation
contributes to urinary stasis. A full rectum displaces the bladder and posterior
urethra in the fixed and limited space of the bony pelvis, causing obstruction,
incomplete micturition, and urinary stasis. Congenital anomalies can contribute to
UTIs, but urinary stasis is the primary factor in many cases.
A girl, age 5 1/2 years, has been sent to the school nurse for urinary incontinence
three times in the past 2 days. The nurse should recommend to her parent that the
first action is to have the child evaluated for what condition?
a. School phobia
b. Glomerulonephritis
c. Urinary tract infection (UTI)
d. Attention deficit hyperactivity disorder (ADHD) - ANSWER: ANS: C
Girls between the ages of 2 and 6 years are considered high risk for UTIs. This child is
showing signs of a UTI, including incontinence in a toilet-trained child and possible
urinary frequency or urgency. A physiologic cause should be ruled out before
psychosocial factors are investigated. Glomerulonephritis usually manifests with
decreased urinary output and fluid retention. ADHD can contribute to urinary
incontinence because the child is distracted, but the first manifestation was
incontinence, not distractibility.
What recommendation should the nurse make to prevent urinary tract infections
(UTIs) in young girls?
a. Avoid public toilet facilities.
b. Limit long baths as much as possible.
c. Cleanse the perineum with water after voiding.
d. Ensure clear liquid intake of 2 L/day. - ANSWER: ANS: D
Adequate fluid intake minimizes urinary stasis. The recommended fluid intake is 50
ml/kg or 100 ml/lb per day. The average 5- to 6-year-old weighs approximately 18 kg
, (40 lb), so she should drink 2 L/day of fluid. There is no evidence that using public
toilet facilities increases UTIs. Long baths are not associated with increased UTIs.
Proper hand washing and perineal cleansing are important, but no evidence exists
that these decrease UTIs in young girls.
In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis
related to vesicoureteral reflux (VUR), the nurse should include which information?
a. Limit fluids to reduce reflux.
b. Give cranberry juice twice a day.
c. Have siblings examined for VUR.
d. Surgery is indicated to reverse scarring. - ANSWER: ANS: C
Siblings are at high risk for VUR. The incidence of reflux in siblings is approximately
36%. The other children should be screened for early detection and to potentially
reduce scarring. Fluids are not reduced. The efficacy of cranberry juice in reducing
infection in children has not been established. Surgery may be necessary for higher
grades of VUR, but the scarring is not reversible.
What pathologic process is believed to be responsible for the development of
postinfectious glomerulonephritis?
a. Infarction of renal vessels
b. Immune complex formation and glomerular deposition
c. Bacterial endotoxin deposition on and destruction of glomeruli
d. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation -
ANSWER: ANS: B
After a streptococcal infection, antibodies are formed, and immune-complex
reaction occurs. The immune complexes are trapped in the glomerular capillary loop.
Infarction of renal vessels occurs in renal involvement in sickle cell disease. Bacterial
endotoxin deposition on and destruction of glomeruli is not a mechanism for
postinfectious glomerulonephritis. Embolization of glomeruli by bacteria and fibrin
from endocardial vegetation is the pathology of renal involvement with bacterial
endocarditis.
The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for
acute glomerulonephritis. What is the most likely cause of this weight loss?
a. Poor appetite
b. Reduction of edema
c. Restriction to bed rest
d. Increased potassium intake - ANSWER: ANS: B
This amount of weight loss in this period is a result of the improvement of renal
function and mobilization of edema fluid. Poor appetite and bed rest would not
result in a weight loss of 8 lb in 4 days. Foods with substantial amounts of potassium
are avoided until renal function is normalized.
What measure of fluid balance status is most useful in a child with acute
glomerulonephritis?
a. Proteinuria
b. Daily weight
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