GU

Question 1

Most common cause of UTI?

Answer 1

Urinary stasis

Question 2

S/S of UTI in infants and children under two y/o?

Answer 2

NON-SPECIFIC FTT Vomiting Feeding problems Abd dist Fever Hypothermia Diaper rash

Question 3

S/S of UTI in children older than two?

Answer 3

Enuresis Incontinence Foul smelling urine Urgency Frequency Dysuria Fever Chills

Question 4

S/S of UTI in adolescence?

Answer 4

MORE SPECIFIC Frequency Fever Chills Dysuria

Question 5

MGMT of UTI?

Answer 5

Eliminate infection Prevent recurrence Prevent systemic spread Preserve renal FXN

Question 6

A 2 y/o comes to the clinic for a well-baby checkup. The RN suspects a UTI based on the following sxs (select all that apply) A. Poor Feeding B. Enuresis C. Back Pain D. Fever E. Vomiting

Answer 6

A D E

Question 7

How should a clean catch urine specimen be taken from a young girl?

Answer 7

Child should sit on toilet facing the tank

Question 8

Girls between what ages are considered HIGH-RISK groups for UTI?

Answer 8

2-6

Question 9

Which of the following urine tests of renal function is used to estimate glomerular filtration? A. pH B. Creatinine C. Osmolality D. Protein level

Answer 9

B

Question 10

A young child is diagnosed with vesicoureteral reflux. The nurse should know that this usually results in: A. incontinence. B. urinary obstruction. C. Recurrent urinary tract infections. D. infarction of renal vessels

Answer 10

C

Question 11

Which of the following best describes the cause of most cases of acute glomerulonephritis? A. Renal vascular anomalies B. Antecedent streptococcal infection C. Results from a urinary tract infection D. Structural anomalies of genitourinary tract

Answer 11

B

Question 12

In acute glomerulonephritis, the nurse is aware that an early warning sign of encephalopathy is which of the following? A. Seizures B. Psychosis C. Dizziness D. Transient loss of vision

Answer 12

C

Question 13

The clinical manifestations of nephrotic syndrome include which of the following? A. Hematuria, bacteriuria, weight gain B. Gross hematuria, albuminuria, fever C. Hypertension, weight loss, proteinuria D. Proteinuria, hypoalbuminemia, edema

Answer 13

D

Question 14

Therapeutic management of nephrotic syndrome includes which of the following? A. Corticosteroids B. Long-term diuretics C. Antihypertensive agents D. Fluid and salt restrictions

Answer 14

A 1. Most children with nephrotic syndrome respond to corticosteroids, making this group the drug of choice. Corticosteroid therapy is begun as soon as the diagnosis has been determined. 2. Children with nephrotic syndrome usually do not respond to diuretics. Furosemide, in combination with metolazone, is useful for severe edema. 3. Antihypertensive agents are not indicated in the management. 4. Fluids are rarely restricted. The child is placed on a no-added-salt diet.

Question 15

Dialysis or transplantation becomes necessary for chronic renal failure when: A. anemia develops. B. acidosis develops. C. glomerular filtration rate falls below 50% of normal. D. Glomerular filtration rate falls below 10% to 15% of normal.

Answer 15

D 4. TX with dialysis or transplantation is required when the glomerular filtration rate falls below 10% to 15% of normal. 1, 2. Anemia and acidosis may be present as part of the underlying disorder. The glomerular filtration rate determines the need for dialysis. 3. The kidneys are able to maintain the chemical composition of fluids within normal limits until more than 50% of functional renal capacity is destroyed by disease or injury.

Question 16

Which of the following is an advantage of continuous cycling peritoneal dialysis or continuous ambulatory peritoneal dialysis for adolescents who require dialysis? A. Dietary restrictions are no longer necessary. B. Hospitalization is only required several nights per week. C. Adolescents can carry out procedures themselves. D. Insertion of a catheter does not require surgical placement.

Answer 16

C

Question 17

Which of the following is the primary clinical manifestation of acute renal failure? A. Oliguria B. Hematuria C. Proteinuria D. Bacteriuria

Answer 17

A 1. Oliguria is the primary clinical symptom of acute renal failure. Generally, urinary output is less than 1 ml/kg/hr. 2. Hematuria, proteinuria, and bacteriuria may be present in renal disease, but they are not the primary manifestations of acute renal failure. 3. Hematuria, proteinuria, and bacteriuria may be present in renal disease, but they are not the primary manifestations of acute renal failure. 4. Hematuria, proteinuria, and bacteriuria may be present in renal disease, but they are not the primary

Question 18

Common features of acute glomerulonephritis are?

Answer 18

oliguria, edema, HTN, circulatory congestion, hematuria, and proteinuria

Question 19

Most common of the noninfectious renal diseases in childhood, it is easiest to identify cause with this disease?

Answer 19

APSGN

Question 20

APSGN primarily affects who? Peak age of onset?

Answer 20

Schoolage children 6-7 y/o

Question 21

When do sxs of AGN occur?

Answer 21

10-14 days after infection

Question 22

C/M of AGN?

Answer 22

Good health till infection Periorbital edema Anorexia Cola-colored urine Decreased urine o/p Mild-moderate HTN Pale, irritable, lethargic H/A, abd discomfort, dysuria

Question 23

DX evaluation of AGN?

Answer 23

Hematuria, proteinuria, increased spec gravity Discolored urine, RBC, WBC, C&S negative Elevated BUN/Creatinine Serum lytes WNL

Question 24

MASSIVE proteinuria occurs with?

Answer 24

NEPHROTIC SYNDROME

Question 25

The MAJOR complications of AGN include?

Answer 25

HTN encephalopathy Acute cardiac decompensation Acute renal failure

Question 26

Primary signs of encephalopathy?

Answer 26

H/A Dizziness Abd discomfort Vomiting

Question 27

Progression of encephalopathy causes what S/S?

Answer 27

Transient loss of vision Hemiparesis Disorientation Generalized Tonic-Clonic Seizures

Question 28

Most common presentation of glomerular injury in children?

Answer 28

Nephrotic syndrome

Question 29

What are the 3 types of nephrotic syndrome?

Answer 29

PRIMARY - restricted to glomerular injury SECONDARY - develops as part of a systemic illness. (drug toxicity, AIDS, Sickle cell, GN, TB) CONGENITAL - Recessive gene, infants are small for gestational age) - require transplant

Question 30

NURSING MGMT of nephrotic syndrome?

Answer 30

BR with edema TX infection Low salt diet Corticosteroids Diuretics I&O & Daily Wt Examine urine for albumin Abd measurements

Question 31

Most common presenting sx of Wilm’s tumor?

Answer 31

PAINLESS swelling or mass within abd mass is: - Firm - Nontender - Confined to one side - Deep w/in flank)

Question 32

TESTICULAR TUMOR

Answer 32

RARE in adolescents but usually malignant

Hard painless mass, smooth or nodular

TX: orchiectomy, chemo and radiation

Question 33

The most common solid tumor in males 15 to 34 years of age is?

Answer 33

Testicular cancer

Question 34

SX of UTI often observed in children over age 2 years include: (Select all that apply)

A. incontinence in a child previously toilet trained

B. abd pain

C. strong or foul odor to the urine

D. frequency of urination

E. diarrhea

Answer 34

A, B, C, D