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: VUR has a 36% incidence in siblings, necessitating screening to detect and prevent scarring. Fluid restriction is not advised, cranberry juice lacks proven efficacy in children, and surgery may be needed for severe VUR but doesn?t reverse existing scarring.
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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: Hematuria is common in renal trauma but doesn?t correlate with injury severity. Flank pain often occurs due to bleeding, most renal trauma in children is from blunt injuries like accidents, and children?s kidneys are more mobile and less protected, increasing injury risk.
Urinary tract anomalies are frequently associated with what irregularities in fetal development?
- A. Myelomeningocele
- B. Cardiovascular anomalies
- C. Malformed or low-set ears
- D. Defects in lower extremities
Correct Answer: C
Rationale: Malformed or low-set ears are frequently associated with urinary tract anomalies, prompting heightened suspicion during newborn exams. Myelomeningocele may impair urinary function due to neural defects, but it?s less directly linked. Cardiac and extremity defects have weaker associations with renal anomalies.
The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?
- A. Consuming a regular diet
- B. Increasing protein
- C. Restricting fluids
- D. Decreasing calories
Correct Answer: C
Rationale: Restricting fluids and sodium during severe edema in MCNS helps manage fluid retention. A regular diet isn?t advised, high protein doesn?t alter disease course, and adequate calories are needed for growth, despite appetite challenges.
A girl, age 5 1/2 years, has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for what condition?
- A. School phobia
- B. Glomerulonephritis
- C. Urinary tract infection (UTI)
- D. Attention deficit hyperactivity disorder (ADHD)
Correct Answer: C
Rationale: Incontinence in a toilet-trained 5½-year-old girl suggests a UTI, common in this age group. UTI evaluation precedes psychosocial causes like school phobia or ADHD, and glomerulonephritis typically presents with reduced urine output and fluid retention, not incontinence.
The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause?
- A. Poor hygiene
- B. Constipation
- C. Urinary stasis
- D. Congenital anomalies
Correct Answer: C
Rationale: Urinary stasis is the primary host factor promoting UTIs by providing a bacterial growth medium. Poor hygiene and constipation contribute by facilitating bacterial entry or causing stasis via rectal pressure, but stasis is the key driver. Congenital anomalies are less common causes.