What is an initial sign of nephrosis that the nurse might note in a child?
- A. Raspberry-like rash
- B. Periorbital edema
- C. Temperature elevation
- D. Abdominal pain
Correct Answer: B
Rationale: The edema of nephrotic syndrome is generalized and not readily noticed, even by the parents, but an early sign that can be assessed is periorbital edema.
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A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. What is the most appropriate nursing intervention for this child?
- A. Providing activities for the child on restricted activity
- B. Feeding the child a protein-restricted diet
- C. Carefully handling edematous extremities
- D. Observing the child for evidence of hypotension
Correct Answer: A
Rationale: Although children may feel well, activity is limited until hematuria resolves.
The nurse is aware that genitourinary surgery is especially stressful for preschool children. What factor(s) lend to this stress? (Select all that apply.)
- A. They may perceive the treatment as punishment.
- B. They are especially prone to separation anxiety.
- C. They are sexually curious and developmentally fixated on their genitals.
- D. They have a fear of castration.
- E. They fear death.
Correct Answer: A,B,C,D
Rationale: Preschool children undergoing genitourinary surgery may experience stress due to perceiving treatment as punishment, separation anxiety, sexual curiosity, and fear of castration.
What foods does the nurse recommend the child with acute glomerulonephritis avoid to prevent hyperkalemia?
- A. Dairy products
- B. Whole-grain cereals
- C. Organ meats
- D. Bananas
Correct Answer: D
Rationale: Bananas are very high in potassium and should be avoided.
What is it important to assess in a child receiving prednisone to treat nephrotic syndrome?
- A. Infection
- B. Urinary retention
- C. Easy bruising
- D. Hypoglycemia
Correct Answer: A
Rationale: Prednisone depresses the immune response and increases susceptibility to infection.
Which urinary diversion procedure is the least damaging to the body image of the adolescent?
- A. Urostomy
- B. Ileal conduit
- C. Nephrostomy
- D. Suprapubic placement
Correct Answer: B
Rationale: The ileal conduit diverts urine to the colon, and the urine is excreted with the feces, requiring no external appliance.
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