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exam 4 v4
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A woman arrives at the clinic seeking confirmation that she is pregnant. The following information is obtained: She is 24 years old with a body mass index (BMI) of 17.5. She admits to having used cocaine “several times” during the past year and drinks alcohol occasionally. Her blood pressure (BP) is 108/70 mm Hg, her pulse rate is 72 beats/min, and her respiratory rate is 16 breaths/min. The family history is positive for diabetes mellitus and cancer. Her sister recently gave birth to an infant with a neural tube defect (NTD). Which characteristics place the woman in a high risk category? Blood pressure, age, BMIDrug/alcohol use, age, family historyFamily history, blood pressure, BMI>>Family history, BMI, drug/alcohol abuse
A 39-year-old primigravida thinks that she is about 8 weeks pregnant, although she has had irregular menstrual periods all her life. She has a history of smoking approximately one pack of cigarettes a day, but she tells you that she is trying to cut down. Her laboratory data are within normal limits. What diagnostic technique could be used with this pregnant woman at this time? >>Ultrasound examinationMaternal serum alpha-fetoprotein screening (MSAFP)AmniocentesisNonstress test (NST)
The nurse sees a woman for the first time when she is 30 weeks pregnant. The woman has smoked throughout the pregnancy, and fundal height measurements now are suggestive of growth restriction in the fetus. In addition to ultrasound to measure fetal size, what would be another tool useful in confirming the diagnosis? >>Doppler blood flow analysisAmniocentesisContraction stress test (CST)Daily fetal movement counts
A 41-week pregnant multigravida presents in the labor and delivery unit after a nonstress test indicated that her fetus could be experiencing some difficulties in utero. Which diagnostic tool would yield more detailed information about the fetus? Ultrasound for fetal anomalies>>Biophysical profile (BPP)Maternal serum alpha-fetoprotein screening (MSAFP)Percutaneous umbilical blood sampling (PUBS)
At 35 weeks of pregnancy a woman experiences preterm labor. Although tocolytics are administered and she is placed on bed rest, she continues to experience regular uterine contractions, and her cervix is beginning to dilate and efface. What would be an important test for fetal well-being at this time? Percutaneous umbilical blood sampling (PUBS)Ultrasound for fetal size>>Amniocentesis for fetal lung maturityNonstress test
A 40-year-old woman is 10 weeks pregnant. Which diagnostic tool would be appropriate to suggest to her at this time? Biophysical profileAmniocentesisMaternal serum alpha-fetoprotein (MSAFP)>>Transvaginal ultrasound
A maternal serum alpha-fetoprotein (AFP) test indicates an elevated level. It is repeated and again is reported as higher than normal. What would be the next step in the assessment sequence to determine the well-being of the fetus? Percutaneous umbilical blood sampling (PUBS)>>Ultrasound for fetal anomaliesBiophysical profile (BPP) for fetal well-beingAmniocentesis for genetic anomalies
A client asks her nurse, “My doctor told me that he is concerned with the grade of my placenta because I am overdue. What does that mean?” The best response by the nurse is: >>“Your placenta changes as your pregnancy progresses, and it is given a score that indicates the amount of calcium deposits it has. The more calcium deposits, the higher the grade, or number, that is assigned to the placenta. It also means that less blood and oxygen can be delivered to your baby.”“Your placenta isn’t working properly, and your baby is in danger.”“This means that we will need to perform an amniocentesis to detect if you have any placental damage.”“Don’t worry about it. Everything is fine.”
A woman is undergoing a nipple-stimulated contraction stress test (CST). She is having contractions that occur every 3 minutes. The fetal heart rate (FHR) has a baseline of approximately 120 beats/min without any decelerations. The interpretation of this test is said to be: >>Negative.Satisfactory.Positive.Unsatisfactory.
In the United States today: More than 20% of pregnancies meet the definition of high risk to either the mother or the infant.>>Other than biophysical criteria, the chief factor in high risk pregnancies is the number of women who have no access to prenatal care.High risk pregnancy status extends from first confirmation of pregnancy to birth.High risk pregnancy is less critical a medical concern because of the reduction in family size and the decrease in unwanted pregnancies.
When nurses help their expectant mothers assess the daily fetal movement counts, they should be aware that: Alcohol or cigarette smoke can irritate the fetus into greater activity.“Kick counts” should be taken every half hour and averaged every 6 hours, with every other 6-hour stretch off.>>The fetal alarm signal should go off when fetal movements stop entirely for 12 hours.Obese mothers familiar with their bodies can assess fetal movement as well as average-size women.
In comparing the abdominal and transvaginal methods of ultrasound examination, nurses should explain to their clients that: Both require the woman to have a full bladder.The abdominal examination is more useful in the first trimester.Initially the transvaginal examination can be painful.>>The transvaginal examination allows pelvic anatomy to be evaluated in greater detail.
In the first trimester, ultrasonography can be used to gain information on: Amniotic fluid volume.>>The presence and location of an intrauterine contraceptive device.Placental location and maturity.Cervical length.
Nurses should be aware that the biophysical profile (BPP): >>Is an accurate indicator of impending fetal death.Is a compilation of health risk factors of the mother during the later stages of pregnancy.Consists of a Doppler blood flow analysis and an amniotic fluid index.Involves an invasive form of ultrasonic examination.
With regard to amniocentesis, nurses should be aware that: Because of new imaging techniques, it is now possible in the first trimester.Despite the use of ultrasonography, complications still occur in the mother or infant in 5% to 10% of cases.>>The shake test, or bubble stability test, is a quick means of determining fetal maturity.The presence of meconium in the amniotic fluid is always cause for concern.
Nurses should be aware of the strengths and limitations of various biochemical assessments during pregnancy, including that: Chorionic villus sampling (CVS) is becoming more popular because it provides early diagnosis.Screening for maternal serum alpha-fetoprotein (MSAFP) levels is recommended only for women at risk for neural tube defects.Percutaneous umbilical blood sampling (PUBS) is one of the triple-marker tests for Down syndrome.>>MSAFP is a screening tool only; it identifies candidates for more definitive procedures.
In comparison to contraction stress tests (CSTs), the nonstress test (NST) for antepartum fetal assessment: >>Has no known contraindications.Has fewer false-positive results.Is more sensitive in detecting fetal compromise.Is slightly more expensive.
The nurse providing care for the antepartum woman should understand that the contraction stress test (CST): Sometimes uses vibroacoustic stimulation.Is an invasive test; however, contractions are stimulated.>>Is considered negative if no late decelerations are observed with the contractions.Is more effective than the nonstress test (NST) if the membranes have already been ruptured.
A woman has been diagnosed with a high risk pregnancy. She and her husband come into the office in a very anxious state. She seems to be coping by withdrawing from the discussion, showing declining interest. The nurse can best help the couple by: Telling her that the physician will isolate the problem with more tests.>>Encouraging her and urging her to continue with childbirth classes.Becoming assertive and laying out the decisions the couple needs to make.Downplaying her risks by citing success rate studies.
In the past factors to determine whether a woman was likely to develop a high risk pregnancy were evaluated primarily from a medical point of view. A broader, more comprehensive approach to high risk pregnancy has been adopted today. There are now four categories based on threats to the health of the woman and the outcome of pregnancy. These categories include all of these except: Biophysical.>>Geographic.Psychosocial.Environmental.
Risk factors tend to be interrelated and cumulative in their effect. While planning the care for a laboring client with diabetes mellitus, the nurse is aware that he or she is at a greater risk for: Oligohydramnios.Postterm pregnancy.>>Polyhydramnios.Chromosomal abnormalities.
Intrauterine growth restriction is associated with what pregnancy-related risk factors? Choose all that apply. a. Poor nutrition b. Maternal collagen disease c. Gestational hypertension d. Premature rupture of membranes e. Smoking >>A, B, C, EABC
A woman’s obstetric history indicates that she is pregnant for the fourth time and all of her children from previous pregnancies are living. One was born at 39 weeks of gestation, twins were born at 34 weeks of gestation, and another child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system? 3-1-1-1-33-0-3-0-3>>4-1-2-0-44-2-1-0-3
A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her gravidity and parity using the GTPAL system? 2-0-0-1-1>>3-1-0-1-02-1-0-1-03-0-1-1-0
Over-the-counter (OTC) pregnancy tests usually rely on which technology to test for human chorionic gonadotropin (hCG)? RadioimmunoassayRadioreceptor assayLatex agglutination test>>Enzyme-linked immunosorbent assay (ELISA)
A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have: >>Amenorrhea.Chadwick’s sign.Positive pregnancy test.Hegar’s sign.
The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse’s instructions if she states that a positive sign of pregnancy is: A positive pregnancy test.>>Fetal movement palpated by the nurse-midwife.Braxton Hicks contractions.Quickening.
A woman is at 14 weeks of gestation. The nurse would expect to palpate the fundus at which level? Not palpable above the symphysis at this time>>Slightly above the symphysis pubisAt the level of the umbilicusSlightly above the umbilicus
During a client’s physical examination the nurse notes that the lower uterine segment is soft on palpation. The nurse would document this finding as: >>Hegar’s signChadwick’s signMcDonald’s signGoodell’s sign
Cardiovascular system changes occur during pregnancy. Which finding would be considered normal for a woman in her second trimester? Less audible heart sounds (S1, S2)>>Increased pulse rateIncreased blood pressureDecreased red blood cell (RBC) production
A number of changes in the integumentary system occur during pregnancy. What change persists after birth? EpulisTelangiectasiaChloasma>>Striae gravidarum
The musculoskeletal system adapts to the changes that occur during pregnancy. A woman can expect to experience what change? Her center of gravity will shift backward.>>She will have increased lordosis.She will have increased abdominal muscle tone.She will notice decreased mobility of her pelvic joints.
A 31-year-old woman believes that she may be pregnant. She took an OTC pregnancy test 1 week ago after missing her period; the test was positive. During her assessment interview the nurse inquires about the woman’s last menstrual period and asks whether she is taking any medications. The woman states that she takes medicine for epilepsy. She has been under considerable stress lately at work and has not been sleeping well. She also has a history of irregular periods. Her physical examination does not indicate that she is pregnant. She has an ultrasound scan, which reveals that she is not pregnant. What is the most likely cause of the false-positive pregnancy test result? She took the pregnancy test too early.>>She takes anticonvulsants.She has a fibroid tumor.She has been under considerable stress and has a hormone imbalance.
A woman is in her seventh month of pregnancy. She has been complaining of nasal congestion and occasional epistaxis. The nurse suspects that: >>This is a normal respiratory change in pregnancy caused by elevated levels of estrogen.This is an abnormal cardiovascular change, and the nosebleeds are an ominous sign.The woman is a victim of domestic violence and is being hit in the face by her partner.The woman has been using cocaine intranasally.
The nurse caring for the pregnant client must understand that the hormone essential for maintaining pregnancy is: Estrogen.Human chorionic gonadotropin (hCG).Oxytocin.>>Progesterone.
The nurse providing care to the pregnant woman should know that all are normal gastrointestinal changes in pregnancy except: Ptyalism.>>Pica.Pyrosis.Decreased peristalsis.
Appendicitis may be difficult to diagnose in pregnancy because the appendix is: >>Displaced upward and laterally, high and to the right.Displaced upward and laterally, high and to the left.Deep at McBurney point.Displaced downward and laterally, low and to the right.
A woman who has completed one pregnancy with a fetus (or fetuses) reaching the stage of fetal viability is called a: >>Primipara.Multipara.Primigravida.Nulligravida.
Which time-based description of a stage of development in pregnancy is accurate? Viability—22 to 37 weeks since the last menstrual period (LMP) (assuming a fetal weight greater than 500 g)>>Term—pregnancy from the beginning of week 38 of gestation to the end of week 42Preterm—pregnancy from 20 to 28 weeksPostdate—pregnancy that extends beyond 38 weeks
Human chorionic gonadotropin (hCG) is an important biochemical marker for pregnancy and therefore the basis for many tests. A maternity nurse should be aware that: hCG can be detected as early as 2.5 weeks after conception.The hCG level increases gradually and uniformly throughout pregnancy.Much lower than normal increases in the level of hCG may indicate a postdate pregnancy.>>A higher than normal level of hCG may indicate an ectopic pregnancy or Down syndrome.
To reassure and educate pregnant clients about changes in the uterus, nurses should be aware that: Lightening occurs near the end of the second trimester as the uterus rises into a different position.>>The woman’s increased urinary frequency in the first trimester is the result of exaggerated uterine antireflexion caused by softening.Braxton Hicks contractions become more painful in the third trimester, particularly if the woman tries to exercise.The uterine souffle is the movement of the fetus.
To reassure and educate pregnant clients about changes in the cervix, vagina, and position of the fetus, nurses should be aware that: Because of a number of changes in the cervix, abnormal Papanicolaou (Pap) tests are much easier to evaluate.Quickening is a technique of palpating the fetus to engage it in passive movement.The deepening color of the vaginal mucosa and cervix (Chadwick’s sign) usually appears in the second trimester or later as the vagina prepares to stretch during labor.>>Increased vascularity of the vagina increases sensitivity and may lead to a high degree of arousal, especially in the second trimester.
The mucous plug that forms in the endocervical canal is called the: >>Operculum.Funic souffle.Leucorrhea.Ballottement.
To reassure and educate pregnant clients about changes in their breasts, nurses should be aware that: The visibility of blood vessels that form an intertwining blue network indicates full function of Montgomery’s tubercles and possibly infection of the tubercles.The mammary glands do not develop until 2 weeks before labor.>>Lactation is inhibited until the estrogen level declines after birth.Colostrum is the yellowish oily substance used to lubricate the nipples for breastfeeding.
To reassure and educate pregnant clients about changes in their cardiovascular system, maternity nurses should be aware that: A pregnant woman experiencing disturbed cardiac rhythm, such as sinus arrhythmia requires close medical and obstetric observation, no matter how healthy she otherwise may appear.>>Changes in heart size and position and increases in blood volume create auditory changes from 20 weeks to term.Palpitations are twice as likely to occur in twin gestations.All of the above changes likely will occur.
To reassure and educate their pregnant clients about changes in their blood pressure, maternity nurses should be aware that: A blood pressure cuff that is too small produces a reading that is too low; a cuff that is too large produces a reading that is too high.Shifting the client’s position and changing from arm to arm for different measurements produces the most accurate composite blood pressure reading at each visit.The systolic blood pressure increases slightly as pregnancy advances; the diastolic pressure remains constant.>>Compression of the iliac veins and inferior vena cava by the uterus contributes to hemorrhoids in the later stage of term pregnancy.
Some pregnant clients may complain of changes in their voice and impaired hearing. The nurse can tell these clients that these are common reactions to: A decreased estrogen level.Displacement of the diaphragm, resulting in thoracic breathing.>>Congestion and swelling, which occur because the upper respiratory tract has become more vascular.Increased blood volume.
To reassure and educate pregnant clients about the functioning of their kidneys in eliminating waste products, maternity nurses should be aware that: Increased urinary output makes pregnant women less susceptible to urinary infection.>>Increased bladder sensitivity and then compression of the bladder by the enlarging uterus results in the urge to urinate even if the bladder is almost empty.Renal (kidney) function is more efficient when the woman assumes a supine position.Using diuretics during pregnancy can help keep kidney function regular.
Which statement about a condition of pregnancy is accurate? Insufficient salivation (ptyalism) is caused by increases in estrogen.Acid indigestion (pyrosis) begins early but declines throughout pregnancy.Hyperthyroidism often develops (temporarily) because hormone production increases.>>Nausea and vomiting rarely have harmful effects on the fetus and may be beneficial.
A first-time mother at 18 weeks of gestation is in for her regularly scheduled prenatal visit. The client tells the nurse that she is afraid that she is going into premature labor because she is beginning to have regular contractions. The nurse explains that this is the Braxton Hicks sign and teaches the client that this type of contraction: >>Is painless.Causes cervical dilation.Increases with walking.Impedes oxygen flow to the fetus.
The diagnosis of pregnancy is based on which positive signs of pregnancy? Choose all that apply. a. Identification of fetal heartbeat b. Palpation of fetal outline c. Visualization of the fetus d. Verification of fetal movement e. Positive hCG test >>A, C, DABC
A woman is in for a routine prenatal checkup. You are assessing her urine for proteinuria. You know that which findings are considered normal? Choose all that apply. a. Dipstick assessment of trace to +1 b. <300 mg/24 hours c. Dipstick assessment of +2 d. >300 mg/24 hours >>A, BDDD
Nurses must be alert for increased fluid requirements when a child has: >>Fever.Congestive heart failure.Mechanical ventilation.Increased intracranial pressure (ICP).
Which type of dehydration results from water loss in excess of electrolyte loss? Isotonic dehydrationHypotonic dehydrationIsosmotic dehydration>>Hypertonic dehydration
An infant is brought to the emergency department with poor skin turgor, weight loss, lethargy, and tachycardia. This is suggestive of: Overhydration.Sodium excess.>>Dehydration.Potassium excess.
Acute diarrhea is often caused by: Celiac disease.Immunodeficiency.>>Antibiotic therapy.Protein malnutrition.
The viral pathogen that frequently causes acute diarrhea in young children is: Giardia organisms.>>Rotavirus.Shigella organisms.Salmonella organisms.
A parasite that causes acute diarrhea is: Shigella organisms.>>Giardia lamblia.Salmonella organisms.Escherichia coli.
A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells. This is most suggestive of which condition? Protein intoleranceFat malabsorptionParasitic infection>>Bacterial gastroenteritis
Therapeutic management of the child with acute diarrhea and dehydration usually begins with: Clear liquids.Adsorbents such as kaolin and pectin.>>Oral rehydration solution (ORS).Antidiarrheal medications such as paregoric.
A school-age child with diarrhea has been rehydrated. The nurse is discussing the child’s diet with the family. Which statement by the parent would indicate a correct understanding of the teaching? “I will keep my child on a clear liquid diet for the next 24 hours.”“I should encourage my child to drink carbonated drinks but avoid food for the next 24 hours.”“I will offer my child bananas, rice, applesauce, and toast for the next 48 hours.”>>“I should have my child eat a normal diet with easily digested foods for the next 48 hours.”
A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child will begin with: >>Intravenous fluids.Oral rehydration solution (ORS).Clear liquids, 1 to 2 ounces at a time.Administration of antidiarrheal medication.
Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies, which are now being successfully treated with antihistamines. The nurse should suspect that the constipation is most likely caused by: Diet.>>Antihistamines.Allergies.Emotional factors.
A high-fiber food that the nurse could recommend for a child with chronic constipation is: >>Popcorn.Muffins.Pancakes.Ripe bananas.
Therapeutic management of most children with Hirschsprung’s disease is primarily: Daily enemas.Low-fiber diet.Permanent colostomy.>>Surgical removal of affected section of bowel.
A 3-year-old child with Hirschsprung’s disease is hospitalized for surgery. A temporary colostomy will be necessary. The nurse should recognize that preparing this child psychologically is: Not necessary because of child’s age.Not necessary because the colostomy is temporary.>>Necessary because it will be an adjustment.Necessary because the child must deal with a negative body image.
The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. The nurse should include: Avoiding carbohydrate-containing liquids.Giving nothing by mouth for 24 hours.>>Brushing teeth or rinsing mouth after vomiting.Giving plain water until vomiting ceases for at least 24 hours.
A 4-month-old infant has gastroesophageal reflux disease (GERD) but is thriving without other complications. What should the nurse suggest to minimize reflux? Place in Trendelenburg position after eating.>>Thicken formula with rice cereal.Give continuous nasogastric tube feedings.Give larger, less frequent feedings.
A histamine-receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with gastroesophageal reflux. The purpose of this is to: Prevent reflux.>>Reduce gastric acid production.Prevent hematemesis.Increase gastric acid production.
Which clinical manifestation would most suggest acute appendicitis? Rebound tendernessBright red or dark red rectal bleedingAbdominal pain that is relieved by eating>>Abdominal pain that is most intense at McBurney point
When caring for a child with probable appendicitis, the nurse should be alert to recognize that a sign of perforation is: Bradycardia.>>Sudden relief from pain.Anorexia.Decreased abdominal distention.
Which statement is most descriptive of Meckel’s diverticulum? It is more common in females than in males.It is acquired during childhood.>>Intestinal bleeding may be mild or profuse.Medical interventions are usually sufficient to treat the problem.
What is characterized by a chronic inflammatory process that may involve any part of the gastrointestinal (GI) tract from mouth to anus? >>Crohn’s diseaseMeckel’s diverticulumUlcerative colitisIrritable bowel syndrome
What is used to treat moderate-to-severe inflammatory bowel disease? Antacids>>CorticosteroidsAntibioticsAntidiarrheal medications
Bismuth subsalicylate, clarithromycin, and metronidazole are prescribed for a child with a peptic ulcer to: >>Eradicate Helicobacter pylori.Treat epigastric pain.Coat gastric mucosa.Reduce gastric acid production.
Which statement best characterizes hepatitis A? The incubation period is 6 weeks to 6 months.The principal mode of transmission is through the parenteral route.>>Onset is usually rapid and acute.There is a persistent carrier state.
The best chance of survival for a child with cirrhosis is: >>Liver transplantation.Treatment with immune globulin.Treatment with corticosteroids.Provision of nutritional support.
The earliest clinical manifestation of biliary atresia is: >>Jaundice.Hepatomegaly.Vomiting.Absence of stooling.
A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initial therapeutic approach to the mother should be to: Restate what the physician has told her about plastic surgery.>>Encourage her to express her feelings.Emphasize the normalcy of her baby and the baby’s need for mothering.Recognize that negative feelings toward the child continue throughout childhood.
Caring for the newborn with a cleft lip and palate before surgical repair includes: Gastrostomy feedings.Keeping the infant in near-horizontal position during feedings.Allowing little or no sucking.>>Providing satisfaction of sucking needs.
The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infant’s postoperative care include: Arm restraints, postural drainage, mouth irrigations.>>Cleansing suture line, supine and side-lying positions, arm restraints.Mouth irrigations, prone position, cleansing suture line.Supine and side-lying positions, postural drainage, arm restraints.
The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include: >>Elevating the head but giving nothing by mouth.Elevating the head for feedings.Feeding glucose water only.Avoiding suctioning unless the infant is cyanotic.
Which type of hernia has an impaired blood supply to the herniated organ? Hiatal herniaOmphaloceleIncarcerated hernia>>Strangulated hernia
The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis? Abdominal rigidity and pain on palpationRounded abdomen and hypoactive bowel sounds>>Visible peristalsis and weight lossDistention of lower abdomen and constipation
The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. The most appropriate nursing action is to: >>Notify the practitioner.Measure abdominal girth.Auscultate for bowel sounds.Take vital signs, including blood pressure.
An important nursing consideration in the care of a child with celiac disease is to: >>Refer to a nutritionist for detailed dietary instructions and education.Help the child and family understand that diet restrictions are usually only temporary.Teach proper handwashing and Standard Precautions to prevent disease transmission.Suggest ways to cope more effectively with stress to minimize symptoms.
An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include: Preparing the family for impending death.>>Teaching the family signs of central venous catheter infection.Teaching the family how to calculate caloric needs.Securing TPN and gastrostomy tubing under diaper to lessen risk of dislodgment.
What is true concerning hepatitis B? Choose all that apply. a. Hepatitis B cannot exist in a carrier state. b. Hepatitis B can be prevented by hepatitis B virus vaccine. c. Hepatitis B can be transferred to an infant of a breastfeeding mother. d. The onset of hepatitis B is insidious. e. The principal mode of transmission for hepatitis B is the fecal-oral route. f. Immunity to hepatitis B occurs after one attack. >>B, C, D, FABC
Which diagnostic test allows visualization of renal parenchyma and renal pelvis without exposure to external beam radiation or radioactive isotopes? >>Renal ultrasoundIntravenous pyelographyComputed tomographyVoiding cystourethrography
Inflammation of the bladder is called: >>Cystitis.Urethritis.Urosepsis.Bacteriuria.
Which factor predisposes the urinary tract to infection? Increased fluid intakeProstatic secretions in males>>Short urethra in young girlsFrequent emptying of the bladder
What should the nurse recommend to prevent urinary tract infections in young girls? >>Wearing cotton underpantsLimiting bathing as much as possibleIncreasing fluids; decreasing salt intakeCleansing the perineum with water after voiding
Hypospadias refers to: Absence of a urethral opening.Penis shorter than usual for age.Urethral opening along dorsal surface of penis.>>Urethral opening along ventral surface of penis.
The narrowing of the preputial opening of foreskin is called: Chordee.Epispadias.>>Phimosis.Hypospadias.
An objective of care for the child with nephrosis is to: Reduce blood pressure.>>Reduce excretion of urinary protein.Increase excretion of urinary protein.Increase ability of tissues to retain fluid.
Therapeutic management of nephrosis includes: >>Corticosteroids.Long-term diuretics.Antihypertensive agents.Increased fluids to promote diuresis.
A common side effect of corticosteroid therapy is: Fever.Weight loss.Hypertension.>>Increased appetite.
The nurse closely monitors the temperature of a child with nephrosis. The purpose of this is to detect an early sign of: >>Infection.Encephalopathy.Hypertension.Edema.
The diet of a child with nephrosis usually includes: High protein.Low fat.>>Salt restriction.High carbohydrate.
A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show: Bacteriuria, hematuria.>>Hematuria, proteinuria.Bacteriuria, increased specific gravity.Proteinuria, decreased specific gravity.
The most appropriate nursing diagnosis for the child with acute glomerulonephritis is: Risk for Injury related to malignant process and treatment.Deficient Fluid Volume related to excessive losses.>>Excess Fluid Volume related to decreased plasma filtration.Excess Fluid Volume related to fluid accumulation in tissues and third spaces.
Wilms’ tumors (nephroblastomas) are located in the: Bone.>>Kidney.Brain.Lymphatic system.
The most common cause of acute renal failure in children is: Pyelonephritis.Urinary tract obstruction.Tubular destruction.>>Severe dehydration.
The primary clinical manifestations of acute renal failure are: >>Oliguria and hypertension.Proteinuria and muscle cramps.Hematuria and pallor.Bacteriuria and facial edema.
The nurse is caring for a child with acute renal failure. What clinical manifestation should he or she recognize as a sign of hyperkalemia? DyspneaOliguriaSeizure>>Cardiac arrhythmia
When a child has chronic renal failure, the progressive deterioration produces a variety of clinical and biochemical disturbances that eventually are manifested in the clinical syndrome known as: >>Uremia.Proteinuria.Oliguria.Pyelonephritis.
A major complication in a child with chronic renal failure is: Hypokalemia.Metabolic alkalosis.>>Water and sodium retention.Excessive excretion of blood urea nitrogen.
Which clinical manifestation would be seen in a child with chronic renal failure? HypotensionHypokalemiaMassive hematuria>>Unpleasant “uremic” breath odor
One of the clinical manifestations of chronic renal failure is uremic frost. What best describes this term? Deposits of urea crystals in urine>>Deposits of urea crystals on skinOverexcretion of blood urea nitrogenInability of body to tolerate cold temperatures
Calcium carbonate is given with meals to a child with chronic renal disease. The purpose of this is to: Prevent vomiting.>>Bind phosphorus.Stimulate appetite.Increase absorption of fat-soluble vitamins.
The diet of a child with chronic renal failure is usually characterized as: High in protein.Low in vitamin D.>>Low in phosphorus.Supplemented with vitamins A, E, and K.
The nurse is caring for an adolescent who has just started dialysis. The child seems always angry, hostile, or depressed. The nurse should recognize that this is most likely related to: Neurologic manifestations that occur with dialysis.Physiologic manifestations of renal disease.Adolescents having few coping mechanisms.>>Adolescents often resenting the control and enforced dependence imposed by dialysis.
An advantage of peritoneal dialysis is that: Treatments are done in hospitals.Protein loss is less extensive.Dietary limitations are not necessary.>>Parents and older children can perform treatments.
Which statement is descriptive of renal transplantation in children? It is an acceptable means of treatment after age 10 years.>>It is preferred means of renal replacement therapy in children.Children can receive kidneys only from other children.The decision for transplantation is difficult since a relatively normal lifestyle is not possible.
The nurse is caring for an infant with a suspected urinary tract infection. Which clinical manifestations would be observed? Choose all that apply. a. Vomiting b. Jaundice c. Failure to gain weight d. Swelling of the face e. Back pain f. Persistent diaper rash >>A, C, FABC




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