Chapter 26: The Child with Genitourinary Dysfunction Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition

MULTIPLE CHOICE 1. The nurse is conducting a staff in-service on renal ultrasounds. Which statement describes this diagnostic test? a. Computed tomography uses external radiation to visualize the renal system. b. Visualization of the renal system is accomplished without exposure to radiation or radioactive isotopes. c. Contrast medium and x-rays allow for visualization of the renal system. d. External radiation for x-ray films is used to visualize the renal system, before, during, and after voiding. ANS: B A renal ultrasound transmits ultrasonic waves through the renal parenchyma, allowing for visualization of the renal system without exposure to external beam radiation or radioactive isotopes. Computed tomography uses external radiation and sometimes contrast media to visualize the renal system. An intravenous pyelogram uses contrast medium and external radiation for x-ray films. The voiding cystourethrogram visualizes the renal system with injection of a contrast media into the bladder through the urethral opening and use of x-ray before, during, and after voiding. DIF: Cognitive Level: Understand REF: p. 848 TOP: Integrated Process: Teaching/Learning MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential 2. The nurse is admitting a school-age child in acute renal failure with reduced glomerular filtration rate. Which urine test is the most useful clinical indication of glomerular filtration rate? a. pH b. Osmolality c. Creatinine d. Protein level ANS: C The most useful clinical indication of glomerular filtration is the clearance of creatinine. It is a substance that is freely filtered by the glomerulus and secreted by the renal tubule cells. The pH and osmolality are not estimates of glomerular filtration. Although protein in the urine demonstrates abnormal glomerular permeability, it is not a measure of filtration rate. DIF: Cognitive Level: Understand REF: p. 850 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Physiologic Integrity: Reduction of Risk Potential 3. The nurse is conducting an assessment on a school-age child with urosepsis. Which assessment finding should the nurse expect? a. Fever with a positive blood culture b. Proteinuria and edema c. Oliguria and hypertension