BSN 2 - B8

NUR 145 – LECTURE

SESSION 29

1. Enlargement of the pelvis of the kidney with urine as a result of back-pressure is generally caused by
obstruction, either of the ureter or of the point where the ureter joins the bladder, as with vesicoureteral reflux.

A. Patent Urachus
B. Hydronephrosis
C. Hypospadias
D. Epispadias
ANSWER: B
RATIO: Hydronephrosis may occur at any age, it occurs most often in the first 6 months of life and is often
diagnosed by ultrasound during intrauterine life

2. A urethral defect in which the urethral opening is not at the end of the penis but on the ventral (lower) aspect
of the penis:

A. Patent Urachus
B. Hydronephrosis
C. Hypospadias
D. Epispadias ANSWER: C
RATIO: Hypospadias tends to be familial or may occur from a multifactorial genetic focus. The most extreme
cases in males result in a penopubic location of the meatus and complete incontinence

3. A narrow tube that connects bladder and umbilicus fails to close during embryonic development.

A. Patent Urachus
B. Hydronephrosis
C. Hypospadias
D. Epispadias
ANSWER: A
RATIO: A narrow tube that connects bladder and umbilicus fails to close during embryonic development.

4. You care for a 3-year-old with hypospadias. After a surgical repair, he has a urethral urinary catheter inserted.
You would want to teach his parents that:

A. the catheter insertion site will leave only a minimal scar.

B. back pressure from such drainage may result in nephrotic syndrome.
C. He must be reevaluated at puberty for testicular function.
D. He will always have tenderness on penile erection.
ANSWER: A
RATIO: After surgical repair, a urethral urinary drainage catheter will be inserted to allow urine output without
putting tension against the urethral sutures.

5. A child is administered oxybutynin (Ditropan) following surgical repair of a hypospadias. The purpose of this
drug is to:

A. prevent nausea and vomiting.

B. stimulate kidney function.
C. acidify urine.
D. relieve bladder spasms.
ANSWER: D
RATIO: Spasms are not harmful, but they are uncomfortable. The child is struggling with this then may need to
give the child Ditropan while the tube is in place.

6. A procedure in which the urethra is extended to a usual position to establish better urinary function:
A. Chordee Procedure
B. Meatotomy
C. Bladder Neck Reconstruction
D. Vagotomy
ANSWER: B
RATIO: Meatotomy is a procedure in which the urethra is extended to a usual position to establish better
urinary function.

7. A surgery to straighten the penis. It is done for a condition of the penis:

A. Chordee Procedure
B. Meatotomy
C. Bladder Neck Reconstruction
D. Vagotomy
ANSWER: A
RATIO: Chordee repair is a surgery to straighten the penis. It is done for a condition of the penis called
chordee. Chordee causes the penis to be curved, which is most obvious during an erection

8. An alternate continence procedure that reconstruct bladder capacity, pelvic floor function, and bladder
contractility:
A. Chordee Procedure
B. Meatotomy
C. Bladder Neck Reconstruction
D. Vagotomy
ANSWER: C
RATIO: A BNR reconstructs the bladder neck and urethra and allows the child to void via the urethra and
achieve continence.

9. All of the following are management of Exstrophy of the Bladder, EXCEPT:

A. Surgical closure of the bladder and the anterior abdominal wall, and construction of a urethra
B. Bladder mucosa should be kept moist and covered with plastic wrap to prevent the bladder surface both from
drying out and from adhering to bedclothes
C. Sponge bathe rather than tub bathe the infant to prevent water from entering the ureters and becoming a
source of infection.
D. The treatment is surgical correction of the obstruction before glomerular or tubular destruction occurs.
ANSWER: D
RATIO: A treatment for Hydronephrosis.

10. The following are postoperative management of Exstrophy of the Bladder, EXCEPT:

A. After surgical repair, a urethral urinary drainage catheter will be inserted to allow urine output without
putting tension against the urethral sutures.
B. After bladder closure, a suprapubic tube is placed for urine drainage and will typically remain in place for 4
to 6 weeks to allow the bladder to drain continuously and the surgical anastomoses to heal.
C. The infant should be positioned on the back with the legs raised in traction at 90 degrees is maintained for 4
to 6 weeks after surgery and is essential to prevent failure of the closure
D. A Bladder Neck Resection reconstructs the bladder neck and urethra and allows the child to void via the
urethra and achieve continence.
ANSWER: B
RATIO: A therapeutic management of Hypospadias.