1. Which statement by a school-age girl indicates the need for further teaching about
the prevention of urinary tract infections (UTIs)?
a. “I always wear cotton underwear.”
b. “I really enjoy taking a bubble bath.”
c. “I go to the bathroom every 3 to 4 hours.”
d. “I drink four to six glasses of fluid every day.”
ANS: B
Bubble baths should be avoided because they tend to cause urethral irritation, which leads
to UTI. It is desirable to wear cotton rather than nylon underwear. Nylon tends to hold in
moisture and promote bacterial growth, whereas cotton absorbs moisture. Children should
be encouraged to urinate at least four times a day. An adequate fluid intake prevents the
buildup of bacteria in the bladder.
PTS: 1 
REF: p. 1009  | DIF: Cognitive Level: Evaluation/Evaluating
OBJ: Nursing Process: EvaluationMSC: Client Needs: Health Promotion and Maintenance
2. The nurse assessing a child with acute poststreptococcal glomerulonephritis should be
alert for which finding?
a. Increased urine output
b. Hypotension
c. Tea-colored urine
d. Weight gain
ANS: C
Acute poststreptococcal glomerulonephritis is characterized by hematuria, proteinuria,
edema, and renal insufficiency. Tea-colored urine is an indication of hematuria. In acute
poststreptococcal glomerulonephritis the urine output may be decreased. In acute
poststreptococcal glomerulonephritis blood pressure may be increased. Edema may be
noted around the eyelids and ankles in patients with acute post streptococcal
glomerulonephritis and can contribute to weight gain; however, weight gain is associated
more with nephrotic syndrome.
PTS: 1 
REF: p. 1016  | DIF: Cognitive Level: Knowledge/Remembering
OBJ: Nursing Process: AssessmentMSC: Client Needs: Physiologic Integrity
3. The mother of a child who was recently diagnosed with acute glomerulonephritis asks
the nurse why the physician keeps talking about “casts” in the urine. The nurse explains
that casts in the urine indicate
a. glomerular injury.
b. glomerular healing.
c. recent streptococcal infection.
d. excessive amounts of protein in the urine.
ANS: A
The presence of red blood cell casts in the urine indicates glomerular injury. Casts in the
urine are abnormal findings and are indicative of glomerular injury, not glomerular healing.
A urinalysis positive for casts does not confirm a recent streptococcal infection. Casts in the
urine are unrelated to proteinuria.
PTS: 1 
REF: p. 1016  | DIF: Cognitive Level: Comprehension/Understanding
OBJ: Nursing Process: ImplementationMSC: Client Needs: Physiologic Integrity
4. Which clinical finding warrants further intervention for the child with acute
post streptococcal glomerulonephritis?
a. Weight loss to within 1 lb of the preillness weight
b. Urine output of 1 mL/kg/hr
c. A positive antistreptolysin O (ASO) titer
d. Inspiratory crackles
ANS: D
Children with excess fluid volume may have pulmonary edema. Inspiratory crackles
indicate fluid in the lungs. Pulmonary edema can be a life-threatening complication. Weight
loss is an indication that the child is responding to treatment. The urine output of 1
mL/kg/hr is acceptable. A positive ASO titer indicates the presence of antibodies to
streptococcal bacteria; it is used to aid in diagnosis of acute po