Nokea
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.
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What diagnostic test allows visualization of renal parenchyma and renal pelvis without exposure to external-beam radiation or radioactive isotopes?
- A. Renal ultrasonography
- B. Computed tomography
- C. Intravenous pyelography
- D. Voiding cystourethrography
Correct Answer: A
Rationale: Renal ultrasonography uses ultrasonic waves to visualize renal structures without radiation or isotopes. CT and intravenous pyelography involve external radiation, often with contrast, and voiding cystourethrography uses radiation and contrast injected into the bladder.
What urine test result is considered abnormal?
- A. pH 4.0
- B. WBC 1 or 2 cells/ml
- C. Protein level absent
- D. Specific gravity 1.020
Correct Answer: A
Rationale: A urine pH of 4.0 is below the normal range (4.8-7.8) and may indicate urinary tract infection or metabolic imbalances. WBC of 1-2 cells/ml, absent protein, and specific gravity of 1.020 (within 1.001-1.030) are normal and not indicative of pathology.
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.
What measure of fluid balance status is most useful in a child with acute glomerulonephritis?
- A. Proteinuria
- B. Daily weight
- C. Specific gravity
- D. Intake and output
Correct Answer: B
Rationale: Daily weight is the most accurate measure of fluid balance in acute glomerulonephritis, reflecting edema changes. Proteinuria indicates disease severity, specific gravity is unreliable due to proteinuria and hematuria, and intake/output is less accurate, especially in non-toilet-trained children.
The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurses reply?
- A. The antibiotic therapy contributes to labile blood pressure values.
- B. Hypotension leading to sudden shock can develop at any time.
- C. Acute hypertension is a concern that requires monitoring.
- D. Blood pressure fluctuations indicate that the condition has become chronic.
Correct Answer: C
Rationale: Frequent blood pressure monitoring is critical in acute glomerulonephritis to detect acute hypertension, which requires aggressive management to prevent renal damage. Antibiotics aren?t typically used, hypotension is not a primary concern, and fluctuations don?t indicate chronicity.