21. Which is the most common cause of acute renal failure in children?

a. Pyelonephritis

b. Tubular destruction

c. Urinary tract obstruction

d. Severe dehydration

22. The nurse is conducting an admission assessment on a school-age child with acute renal failure. Which are the primary clinical manifestations the nurse expects to find with this condition?

a. Oliguria and hypertension

b. Hematuria and pallor

c. Proteinuria and muscle cramps

d. Bacteriuria and facial edema

23. The nurse is caring for a child with acute renal failure. Which clinical manifestation should the nurse recognize as a sign of hyperkalemia?

a. Dyspnea

b. Seizure

c. Oliguria

d. Cardiac arrhythmia

24. 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:

a. uremia.

b. oliguria.

c. proteinuria.

d. pyelonephritis.

25. Which is a major complication in a child with chronic renal failure?

a. Hypokalemia

b. Metabolic alkalosis

c. Water and sodium retention

d. Excessive excretion of blood urea nitrogen

26. Which clinical manifestation would be seen in a child with chronic renal failure?

a. Hypotension

b. Massive hematuria

c. Hypokalemia

d. Unpleasant “uremic” breath odor

27. One of the clinical manifestations of chronic renal failure is uremic frost. Which best describes this term?

a. Deposits of urea crystals in urine

b. Deposits of urea crystals on skin

c. Overexcretion of blood urea nitrogen

d. Inability of body to tolerate cold temperatures

28. Calcium carbonate is given with meals to a child with chronic renal disease. The purpose of this is to:

a. prevent vomiting.

b. bind phosphorus.

c. stimulate appetite.

d. increase absorption of fat-soluble vitamins.

29. Which should the nurse recommend for the diet of a child with chronic renal failure?

a. High in protein

b. Low in vitamin D

c. Low in phosphorus

d. Supplemented with vitamins A, E, and K

30. 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:

a. neurologic manifestations that occur with dialysis.

b. physiologic manifestations of renal disease.

c. adolescents having few coping mechanisms.

d. adolescents often resenting the control and enforced dependence imposed by dialysis.