An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep throat a little over a week ago. Assessment findings: Temp 100.6F, RR-22. HR-105, BP= 130/89 Which condition should the nurse suspect?

Acute glomerulonephritis

Renal agenesis

Nephrotic syndrome

Polycystic kidney disease

Answer and Explanation

The Correct Answer is A

A. Acute glomerulonephritis is characterized by the sudden onset of hematuria (reddish-brown urine), proteinuria (4+ protein), and a recent history of streptococcal infection, making it the most likely diagnosis.

B. Renal agenesis is a congenital condition and would not present suddenly with abdominal pain and hematuria.

C. Nephrotic syndrome typically presents with significant proteinuria, but the acute onset of symptoms and recent strep throat history point more toward glomerulonephritis.

D. Polycystic kidney disease usually presents with abdominal or flank pain, hypertension, and hematuria over a more chronic course, not typically after an acute infection.

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Correct Answer is C

Explanation

A. Respiratory precautions are necessary for preventing the spread of respiratory infections but are not specifically indicated here.

B. Airborne precautions are required for diseases transmitted through the air (e.g., TB), not relevant in this scenario.

C. Bleeding precautions should be initiated due to the critically low platelet count, as this increases the risk of bleeding complications. Nurses should be vigilant in monitoring for signs of bleeding and minimizing invasive procedures.

D. Contact precautions are important for preventing the spread of infections, but in this case, the primary concern is bleeding due to low platelet counts.

A. I will remind my child to wash their hands well and frequently B. I will remind my child not to touch their face while the rash is present C. I will give my child a separate towel from other family members D. I will fill a prescription for antiviral ointment to apply to the rash

Correct Answer is D

Explanation

A. Encouraging handwashing is important to prevent spreading infection and shows understanding of hygiene practices.

B. Advising the child not to touch their face is important to prevent secondary infections and spread of the rash.

C. Providing a separate towel helps prevent the spread of infection, demonstrating good understanding of precautions.

D. Filling a prescription for antiviral ointment is inappropriate in this case; the honey-crusted plaques suggest impetigo, which is typically treated with topical or oral antibiotics, not antiviral ointment.

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Naxlex Comprehensive Predictor Exams

A nurse is admitting a child who has sepsis and a critically low platelet count. Based on this information which of the following precautions should the nurse initiate?

Correct Answer is C

Explanation

A 6 year old child presents to the pediatric clinic with vesicular rash and honey crusted plaques around the nose and mouth. Which of the following statements by the parent indicates the need for further teaching?

Correct Answer is D

Explanation

The nurse is providing care to a child with acute abdominal pain, currant-jelly-like stools and suspected intussusception. The nurse will discuss with the caregivers that the child will have which procedure

The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital for the treatment of vaso- occlosive crisis which prescription documented in the child's chart should the nurse question?

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