Nokea
A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after administration of prednisone. The nurse realizes further teaching is required if the parents state what?
- A. We will keep our child away from anyone who is ill.
- B. We will be sure to administer the prednisone as ordered.
- C. We will encourage our child to eat a balanced diet, but we will watch his salt intake.
- D. We understand our child will not be able to attend school, so we will arrange for home schooling.
Correct Answer: D
Rationale: Children with MCNS in remission can usually return to school. Home schooling may be necessary only if there are complications. The other options show an understanding of proper care during remission.
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A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?
- A. Stimulate appetite
- B. Detect evidence of edema
- C. Minimize risk of infection
- D. Promote adherence to the antibiotic regimen
Correct Answer: C
Rationale: Prednisone, an immunosuppressant, increases the child's susceptibility to infections, making infection prevention a critical nursing goal. Detecting edema and stimulating appetite are important but secondary to preventing potentially life-threatening infections.
The nurse is caring for an adolescent who has just started dialysis. The child always seems angry, hostile, or depressed. The nurse should recognize that this is most likely related to what underlying cause?
- A. Physiologic manifestations of renal disease
- B. The fact that adolescents have few coping mechanisms
- C. Neurologic manifestations that occur with dialysis
- D. Resentment of the control and enforced dependence imposed by dialysis
Correct Answer: D
Rationale: Adolescents may feel anger and depression due to the loss of independence and control over their lives, which is imposed by the need for regular dialysis treatments. This reaction is common as they struggle with the restrictions placed on their social and personal lives.
What should the nurse include in the discharge instructions for the parents of an infant diagnosed with acute otitis media?
- A. Keep the baby in an elevated position during sleep
- B. Administer an antibiotic
- C. Place the baby to sleep with a bottle
- D. Administer acetaminophen (Tylenol) to relieve discomfort
Correct Answer: D
Rationale: Acetaminophen (Tylenol) is recommended to help relieve the discomfort associated with acute otitis media, such as pain and fever. Elevating the baby's head during sleep can also help with drainage and relieve pressure, making choice A incorrect. Administering an antibiotic may be necessary for bacterial otitis media but is not usually the first-line treatment for acute otitis media, so choice B is incorrect. Placing the baby to sleep with a bottle can increase the risk of ear infections due to the pooling of milk around the Eustachian tube, so choice C is incorrect.
A 12-year-old child is injured in a bicycle accident. When considering the possibility of renal trauma, the nurse should consider what factor?
- A. Flank pain rarely occurs in children with renal injuries.
- B. Few nonpenetrating injuries cause renal trauma in children.
- C. Kidneys are immobile, well protected, and rarely injured in children.
- D. The amount of hematuria is not a reliable indicator of the seriousness of renal injury.
Correct Answer: D
Rationale: The amount of hematuria is not a reliable indicator of the severity of renal trauma, as even minor injuries can cause significant bleeding, while severe injuries may result in little or no visible blood. Renal trauma should be evaluated through imaging and clinical assessment.
A child is admitted with acute glomerulonephritis. What should the nurse expect the urinalysis during this acute phase to show?
- A. Bacteriuria and hematuria
- B. Hematuria and proteinuria
- C. Bacteriuria and increased specific gravity
- D. Proteinuria and decreased specific gravity
Correct Answer: B
Rationale: Hematuria (blood in the urine) and proteinuria (protein in the urine) are common findings in acute glomerulonephritis due to inflammation of the glomeruli. Bacteriuria and changes in specific gravity are not as directly associated with this condition.