Nokea
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.
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What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?
- A. Low specific gravity
- B. Decreased hemoglobin
- C. Normal platelet count
- D. Reduced serum albumin
Correct Answer: D
Rationale: Reduced serum albumin, due to significant proteinuria, is a hallmark of minimal change nephrotic syndrome (MCNS). Specific gravity is high due to protein loss, hemoglobin is normal or elevated, and platelet counts are elevated from hemoconcentration, not normal.
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.
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.
What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)?
- A. Reduce blood pressure.
- B. Lower serum protein levels.
- C. Minimize excretion of urinary protein.
- D. Increase the ability of tissue to retain fluid.
Correct Answer: C
Rationale: The primary goal in MCNS is to minimize urinary protein excretion, reducing edema and complications. Blood pressure is typically normal, serum protein levels need to increase, and fluid retention (edema) is a problem to be reduced, not increased.
A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication?
- A. Propranolol (Inderal)
- B. Calcium gluconate
- C. Mannitol (Osmitrol) or furosemide (Lasix) (or both)
- D. Sodium, chloride, and potassium
Correct Answer: C
Rationale: Mannitol or furosemide promotes urine flow in ARF if glomerular function is intact, inducing osmotic diuresis. Propranolol doesn?t affect diuresis, calcium gluconate addresses hyperkalemia, and electrolytes like sodium, chloride, and potassium are avoided to prevent complications.