Nokea
In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include which information?
- A. Limit fluids to reduce reflux.
- B. Give cranberry juice twice a day.
- C. Have siblings examined for VUR.
- D. Surgery is indicated to reverse scarring.
Correct Answer: C
Rationale: Siblings should be examined for VUR as it can run in families, and early detection can prevent complications. Limiting fluids is not advisable, and cranberry juice is not effective in preventing VUR. Surgery is usually not indicated for scarring reversal.
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What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?
- A. Infarction of renal vessels
- B. Immune complex formation and glomerular deposition
- C. Bacterial endotoxin deposition on and destruction of glomeruli
- D. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation
Correct Answer: B
Rationale: Postinfectious glomerulonephritis is typically caused by immune complex deposition in the glomeruli following a streptococcal infection. This immune response leads to inflammation and impaired kidney function.
According to Erikson's developmental theory, toddlers need to be encouraged to become independent to successfully complete which developmental challenge?
- A. Trust vs. mistrust
- B. Industry vs. inferiority
- C. Autonomy vs. shame and doubt
- D. Initiative vs. guilt
Correct Answer: C
Rationale: The correct answer is C: Autonomy vs. shame and doubt. Erikson's developmental stage for toddlers focuses on the conflict between developing a sense of independence (autonomy) and feelings of inadequacy (shame and doubt). Encouraging toddlers to explore their environment and make choices helps them build self-confidence and independence. Choices A, B, and D are incorrect because trust vs. mistrust relates to infancy, industry vs. inferiority is associated with school-age children, and initiative vs. guilt is linked to preschoolers.
The mother of a child with type 1 diabetes asks the nurse why her child cannot avoid all those 'shots' and take pills like an uncle does. How should the nurse respond?
- A. The pills work with adult pancreases only.
- B. Your child needs insulin replaced, and the oral hypoglycemic only add to an existing supply of insulin.
- C. The drugs affect fat and protein metabolism, not sugar.
- D. Perhaps when your child is older the pancreas will produce its own insulin, and then your child can take oral hypoglycemic agents.
Correct Answer: B
Rationale: The correct answer is B. Children with type 1 diabetes require insulin replacement because their pancreas produces little or no insulin. Oral hypoglycemics used in type 2 diabetes work by improving the effectiveness of insulin the body already makes, which is not sufficient in type 1 diabetes. Choice A is incorrect because the issue is not about the pancreas being adult or child-specific but rather the type of diabetes. Choice C is incorrect because it misstates the mechanism of action of the medications. Choice D is incorrect because it provides inaccurate information about the potential for the child's pancreas to produce insulin in the future, which is unlikely in type 1 diabetes.
Surgery is performed on a child to correct cryptorchidism. The parents understand the reason for the surgery if they tell the nurse this was done to do what?
- A. Prevent damage to the undescended testicle.
- B. Prevent urinary tract infections.
- C. Prevent prostate cancer.
- D. Prevent an inguinal hernia.
Correct Answer: A
Rationale: The primary reason for correcting cryptorchidism through surgery is to prevent damage to the undescended testicle, which can lead to infertility and increase the risk of testicular cancer. Prevention of UTIs and prostate cancer are not the primary concerns in this context.
What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)?
- A. Reduce blood pressure
- B. Lower serum protein levels
- C. Minimize excretion of urinary protein
- D. Increase the ability of tissue to retain fluid
Correct Answer: C
Rationale: The primary objective in managing MCNS is to minimize the excretion of urinary protein, which is responsible for the hypoalbuminemia and subsequent edema in these patients.