Nokea
Which urinary diversion procedure is the least damaging to the body image of the adolescent?
- A. Urostomy
- B. Ileal conduit
- C. Nephrostomy
- D. Suprapubic placement
Correct Answer: B
Rationale: The ileal conduit diverts urine to the colon, and the urine is excreted with the feces, requiring no external appliance.
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What is an initial sign of nephrosis that the nurse might note in a child?
- A. Raspberry-like rash
- B. Periorbital edema
- C. Temperature elevation
- D. Abdominal pain
Correct Answer: B
Rationale: The edema of nephrotic syndrome is generalized and not readily noticed, even by the parents, but an early sign that can be assessed is periorbital edema.
The nurse is aware that genitourinary surgery is especially stressful for preschool children. What factor(s) lend to this stress? (Select all that apply.)
- A. They may perceive the treatment as punishment.
- B. They are especially prone to separation anxiety.
- C. They are sexually curious and developmentally fixated on their genitals.
- D. They have a fear of castration.
- E. They fear death.
Correct Answer: A,B,C,D
Rationale: Preschool children undergoing genitourinary surgery may experience stress due to perceiving treatment as punishment, separation anxiety, sexual curiosity, and fear of castration.
Parents are speaking with the urologist about their son's undescended testicle. Which statement by the child's father causes the nurse to determine he understands the information presented?
- A. An undescended testicle can reduce fertility.'
- B. The testicle usually descends spontaneously during the first month of life.'
- C. Surgical correction reduces the risk for testicular tumors.'
- D. The optimal time to surgically correct the condition is at diagnosis.'
Correct Answer: A
Rationale: Although orchiopexy improves the condition, the fertility rate among patients may be reduced even when only one testis is undescended.
What foods does the nurse recommend the child with acute glomerulonephritis avoid to prevent hyperkalemia?
- A. Dairy products
- B. Whole-grain cereals
- C. Organ meats
- D. Bananas
Correct Answer: D
Rationale: Bananas are very high in potassium and should be avoided.
During a physical assessment of a hospitalized 5-year-old child, the nurse notes that the foreskin has been retracted and is very tight on the shaft of the penis; the nurse is unable to return it over the head of the penis. What action should the nurse implement?
- A. Forcibly push the foreskin down over the head of the penis.
- B. Place a warm compress on the penis.
- C. Notify the charge nurse.
- D. Wait a few hours and try again.
Correct Answer: C
Rationale: Notify the charge nurse of this occurrence of paraphimosis. The tight foreskin can impede blood flow to the penis; this should be remedied immediately.