Alaric was diagnosed with minimal-change nephrotic syndrome; which of the following signs and symptoms are characteristics of the said disorder?
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Solution
Poor appetite, edema, proteinuria
D: Clinical manifestations of nephrotic syndrome include loss of appetite due to edema of intestinal mucosa, proteinuria, and edema.
A, B: Hypertension alone or accompanied by hematuria is associated with glomerulonephritis.
C: Gross hematuria is not associated with nephrotic syndrome. Fever will occur only if infection also existed.
When educating parents regarding known antecedent infections in acute glomerulonephritis, which of the following should the nurse cover?
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Solution
Impetigo
B: Impetigo, a bacterial infection of the skin, may be caused by streptococci and may precede acute glomerulonephritis. Although most streptococcal infections do not cause acute glomerulonephritis, when they do, a latent period of 10 to 14 days occur between the infection, usually of the skin (impetigo) or upper respiratory tract, and the onset of clinical manifestations.
A, C, D: Scabies, herpes simplex, and varicella are not associated with acute glomerulonephritis.
Stefan was diagnosed with secondary vesicoureteral reflux; such condition usually results from which of the following?
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Solution
Infection
D: Infection is the most common cause of secondary vesicoureteral reflux.
A: Acidic urine is normal and helps to prevent infection.
B: Congenital defects cause primary vesicoureteral reflux.
C: Hydronephrosis may result from vesicoureteral reflux.
Niklaus was born with hypospadias; which of the following should be avoided when a child has such condition?
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Solution
Circumcision
B: Hypospadias refers to a condition in which the urethral opening is located below the glans penis or anywhere along the ventral surface (underside) of the penile shaft. The ventral foreskin is lacking, and the distal portion gives an appearance of a hood. Early recognition is important so that circumcision is avoided; the foreskin is used for the surgical repair.
A: Surgery is the procedure of choice to improve the child’s ability to stand when urinating, improve the appearance of the penis, and preserve sexual adequacy.
C: IVP is contraindicated if the child has an allergy to iodine or shellfish.
D: Catheterization may be used to ensure urinary elimination.
7-year-old Damon has cystitis; which of the following would Nurse Elena expect when assessing the child?
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Solution
Dysuria
A: Dysuria is a symptom of a lower urinary tract infection (UTI) such as cystitis.
B, C, D: Costovertebral tenderness, flank pain, and high fever are signs and symptoms of pyelonephritis, an upper UTI.
Nurse Lonnie is aware that the most common assessment finding in a child with ulcerative colitis is:
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Solution
Profuse diarrhea
B: Ulcerative colitis causes profuse diarrhea.
A,C,D: Intense abdominal cramps, anal fissures, and abdominal distensions are more common in Crohn’s disease.
Mrs. Byers tells the nurse that she is very worried because her 2-year old child does not finish his meals. What should the nurse advise the mother?
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Solution
do not give snacks to the child before meals
C: If the child is hungry he/she more likely would finish his meals. Therefore, the mother should be advised not to give snacks to the child. The child is a “busy toddler.” He/she will not able to keep still for a long time.
In pediatric gastroesophageal reflux disease (GERD), the immaturity of lower esophageal sphincter function is manifested by frequent transient lower esophageal relaxations, which result in retrograde flow of gastric contents into the esophagus. Which statement about the esophagus is TRUE? Select all that apply.
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Solution
It has upper and lower sphincters.
B: Upper and lower esophageal sphincters, located at the upper and lower ends of the esophagus, respectively, regulate the movement of food into and out of the esophagus.
A: The esophagus is a muscular tube, lined with moist stratified squamous epithelium.
C: It lies anterior to the vertebrae and posterior to the trachea within the mediastinum.
D: It extends from the pharynx to the stomach. It is about 25 centimeters (cm) long.
Nurse Joyce is assessing a child’s cultural background, she should keep in mind that:
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Solution
Behavioral patterns are passed from one generation to the next
D: A family’s behavioral patterns and values are passed from one generation to the next.
A: Cultural background commonly plays a major role in determining a family’s health practices.
B: Physical characteristics do not indicate a child’s culture.
C: Although heritage plays a role in culture, it does not dictate a group’s shared values and its effect on culture is weaker than that of behavioral patterns.
Nurse Karen is providing postoperative care for Dustin who has cleft palate (CP); she should position the child in which of the following?
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Solution
In the prone position
C: Postoperatively, children with a CP should be placed on their abdomens to facilitate drainage.
A: Using an infant seat does not facilitate drainage.
B: If the child is placed int he supine position, aspiration is a concern.
D: Side-lying does not facilitate drainage as well as the prone position.