Nokea
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 nurse's 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: Acute hypertension is a common complication of acute glomerulonephritis, requiring frequent monitoring to prevent complications such as encephalopathy or heart failure. Blood pressure fluctuations can occur but are not necessarily indicative of chronic disease.
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A newborn has been diagnosed with Hirschsprung's disease. The parent asks the nurse about the symptoms that led to the diagnosis. Which symptoms should the nurse include in the response?
- A. Acute diarrhea and dehydration
- B. Current jelly-like stools and pain
- C. Failure to pass meconium and abdominal distension
- D. Projectile vomiting and altered electrolytes
Correct Answer: C
Rationale: The correct answer is C: Failure to pass meconium and abdominal distension. Hirschsprung's disease is commonly diagnosed in newborns due to the failure to pass meconium within the first 24-48 hours after birth and abdominal distension, indicating a bowel obstruction. Choices A, B, and D are incorrect because they do not correspond to the typical symptoms of Hirschsprung's disease. Acute diarrhea and dehydration, current jelly-like stools and pain, and projectile vomiting with altered electrolytes are not characteristic of this condition.
A 7-year-old has been diagnosed with cystic fibrosis. Chest physiotherapy has been ordered. What information should the nurse give to the parents regarding when chest physiotherapy is done?
- A. Before aerosol treatment
- B. After suctioning
- C. Before postural drainage
- D. Before meals
Correct Answer: D
Rationale: The correct answer is D: 'Before meals'. Chest physiotherapy should be performed before meals to reduce the risk of vomiting and to ensure that the airways are clear for effective nutrition. Choices A, B, and C are incorrect because chest physiotherapy is ideally done before meals to optimize its benefits and avoid complications associated with timing.
A child diagnosed with a soft tissue tumor is being treated with chemotherapy. Prior to administering the chemotherapy, which laboratory test should the nurse monitor to determine if the child has any capability of fighting infections?
- A. Hemoglobin
- B. Red blood cell count
- C. Platelets
- D. Absolute neutrophil count (ANC)
Correct Answer: D
Rationale: The Absolute Neutrophil Count (ANC) is crucial for determining the child's ability to fight infections. Neutrophils play a key role in combating bacterial infections. Monitoring the ANC is essential before administering chemotherapy, as a low ANC indicates an increased risk of infection. Hemoglobin, red blood cell count, and platelets are important for assessing oxygen-carrying capacity, anemia, and clotting function, respectively, but they do not directly reflect the child's capability to fight infections.
A parent asks the nurse what would be the first indication that acute glomerulonephritis was improving. What would be the nurse's best response?
- A. Blood pressure will stabilize.
- B. Your child will have more energy.
- C. Urine will be free of protein.
- D. Urine output will increase.
Correct Answer: D
Rationale: Increased urine output is often the first sign that acute glomerulonephritis is improving, as it indicates a reduction in fluid retention and better kidney function. Stabilization of blood pressure and other symptoms typically follow.
An infant has been diagnosed with bladder obstruction. What do symptoms of this disorder include?
- A. Renal colic
- B. Strong urinary stream
- C. Urinary tract infections
- D. Post urination dribbling
Correct Answer: D
Rationale: Post-urination dribbling is a symptom of bladder obstruction due to the incomplete emptying of the bladder. A strong urinary stream is typically absent in such cases. UTIs are common, but dribbling is more directly related to the obstruction.