Nokea
The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?
- A. Poor appetite
- B. Reduction of edema
- C. Restriction to bed rest
- D. Increased potassium intake
Correct Answer: B
Rationale: Rapid weight loss of 8 lb in 4 days in acute glomerulonephritis is due to improved renal function and mobilization of edema fluid. Poor appetite and bed rest don?t cause such significant loss, and potassium is restricted, not increased, until renal function normalizes.
You may also like to solve these questions
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.
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.
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.
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.
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.