Nokea
What nursing consideration is most important when caring for a child with end-stage renal disease (ESRD)?
- A. Children with ESRD usually adapt well to minor inconveniences of treatment.
- B. Children with ESRD require extensive support until they outgrow the condition.
- C. Multiple stresses are placed on children with ESRD and their families until the illness is cured.
- D. Multiple stresses are placed on children with ESRD and their families because children's lives are maintained by drugs and artificial means.
Correct Answer: D
Rationale: ESRD places significant stress on both the child and the family due to the ongoing need for dialysis, medications, and lifestyle restrictions, making it important for healthcare providers to offer extensive support and resources to manage these challenges.
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A child is refusing to use the potty and having accidents, even though he has achieved toilet training. This is an example of which type of behavior?
- A. Positive reinforcement
- B. Desensitization
- C. Phobia
- D. Regression
Correct Answer: D
Rationale: The correct answer is D, regression. Regression occurs when a child reverts to an earlier behavior, such as having accidents after being successfully toilet trained. This regression often happens due to stress or changes in routine. Choices A, B, and C are incorrect because positive reinforcement involves encouraging desired behavior, desensitization is a process of reducing sensitivity to a stimulus, and phobia is an intense fear or aversion to a specific object or situation, none of which directly apply to the described situation of the child having accidents after being toilet trained.
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: Urinary tract infections are a common cause of sudden onset urinary incontinence in children. While school phobia and ADHD can cause behavioral changes, a medical condition like a UTI should be ruled out first.
What statement is descriptive of renal transplantation in children?
- A. It is an acceptable means of treatment after age 10 years.
- B. Children can receive kidneys only from other children.
- C. It is the preferred means of renal replacement therapy in children.
- D. The decision for transplantation is difficult because a relatively normal lifestyle is not possible.
Correct Answer: C
Rationale: Renal transplantation is the preferred method of treatment for children with end-stage renal disease, as it offers the best chance for a normal lifestyle compared to long-term dialysis. Transplantation can be performed at any age, and kidneys can come from adult donors as well.
Parents of a child who will need hemodialysis ask the nurse, What are the advantages of a fistula over a graft or external access device for hemodialysis? (Select all that apply.)
- A. It is ready to be used immediately.
- B. All below
- C. There is less restriction of activity with a fistula.
- D. It produces dilation and thickening of the superficial vessels.
Correct Answer: A
Rationale: A fistula typically has fewer complications, allows for greater freedom of movement, and involves natural vessel changes that improve dialysis efficiency. However, it is not ready for immediate use, which is why it may take weeks to mature before it can be used.
The nurse is preparing to admit a child to the hospital with a diagnosis of minimal change nephrotic syndrome. The nurse understands that the peak age at onset for this disease is what?
- A. 2 to 3 years
- B. 4 to 5 years
- C. 6 to 7 years
- D. 8 to 9 years
Correct Answer: B
Rationale: The peak age for the onset of minimal change nephrotic syndrome (MCNS) is typically between 4 and 5 years old. MCNS is the most common cause of nephrotic syndrome in children, particularly within this age range.