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The nurse is preparing to admit a child to the hospital with a diagnosis of acute poststreptococcal glomerulonephritis. The nurse understands that the peak age at onset for this disease is what?
- A. 2 to 4 years
- B. 5 to 7 years
- C. 8 to 10 years
- D. 11 to 13 years
Correct Answer: B
Rationale: The peak age for the onset of acute poststreptococcal glomerulonephritis is typically between 5 and 7 years old. This age group is most affected due to the higher incidence of streptococcal infections in school-aged children, which can lead to this renal complication.
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What statement is an advantage of peritoneal dialysis compared with hemodialysis?
- A. Protein loss is less extensive.
- B. Dietary limitations are not necessary.
- C. It is easy to learn and safe to perform.
- D. It is needed less frequently than hemodialysis.
Correct Answer: C
Rationale: Peritoneal dialysis is generally easier to learn and can be safely performed at home. Although dietary limitations still apply, this method offers greater flexibility in treatment scheduling compared to hemodialysis, which often requires multiple weekly visits to a dialysis center.
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 most important factor in the development of UTIs because it provides an environment for bacterial growth. While poor hygiene and congenital anomalies are contributing factors, preventing urinary stasis is key in UTI prevention.
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.
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.
What nursing consideration is most important when caring for a child with end-stage renal disease (ESRD)?
- A. Children with ESRD usually adapt well to minor inconveniences of treatment.
- B. Children with ESRD require extensive support until they outgrow the condition.
- C. Multiple stresses are placed on children with ESRD and their families until the illness is cured.
- D. Multiple stresses are placed on children with ESRD and their families because children's lives are maintained by drugs and artificial means.
Correct Answer: D
Rationale: ESRD places significant stress on both the child and the family due to the ongoing need for dialysis, medications, and lifestyle restrictions, making it important for healthcare providers to offer extensive support and resources to manage these challenges.