Nokea
Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching?
- A. I will make sure he gets his measles vaccine as soon as he gets home.'
- B. He can stop taking his medication next week.'
- C. I should check his urine for protein when he goes to the bathroom.'
- D. He should eat a low-protein diet for the next few weeks.'
Correct Answer: C
Rationale: The parents should be instructed to keep a daily record of the child's urinary proteins.
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A 6-year-old child with daytime enuresis complains of dysuria and urgency. What does the nurse recognize these signs and symptoms indicate?
- A. Urinary tract infection
- B. Nephrotic syndrome
- C. Acute glomerulonephritis
- D. Vesicoureteral reflux
Correct Answer: A
Rationale: Urinary frequency and pain during micturition are symptoms of acute urinary tract infection.
During a physical assessment of a hospitalized 5-year-old child, the nurse notes that the foreskin has been retracted and is very tight on the shaft of the penis; the nurse is unable to return it over the head of the penis. What action should the nurse implement?
- A. Forcibly push the foreskin down over the head of the penis.
- B. Place a warm compress on the penis.
- C. Notify the charge nurse.
- D. Wait a few hours and try again.
Correct Answer: C
Rationale: Notify the charge nurse of this occurrence of paraphimosis. The tight foreskin can impede blood flow to the penis; this should be remedied immediately.
The nurse caring for a child with nephrotic syndrome is alert to which classic symptoms of this disorder? (Select all that apply.)
- A. Proteinuria
- B. Grossly bloody urine
- C. Hyperalbuminemia
- D. Fatigue
- E. Generalized edema
Correct Answer: A,B,D,E
Rationale: Nephrotic syndrome is characterized by proteinuria, grossly bloody urine, fatigue, and generalized edema, but hypoalbuminemia, not hyperalbuminemia.
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.