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 B

Explanation

A. Raising the head of the bed may help with respiratory effort but does not address the underlying issue of decreased responsiveness. Immediate assessment and intervention are necessary.

B. Notifying the healthcare provider is critical as the child’s decreased responsiveness and respiratory rate indicate a potential deterioration in condition that requires prompt medical evaluation.

C. While obtaining an oximeter reading can provide useful information about oxygenation, the priority is to notify the HCP about the change in the child's neurological status.

D. Implementing seizure precautions is important for a child with a brain tumor, but the immediate concern is the change in responsiveness, necessitating HCP notification first.

A. Weighing on the same scale each day B. Testing the urine for glucose levels regularly C. Increasing fluid intake by 50 ml per hour D. Ambulating 3 to 4 times a day E. Complete the course of prescribed antibiotics

Correct Answer is A

Explanation

A. Weighing the child daily on the same scale is critical for monitoring fluid retention and managing edema, which are primary concerns in nephrotic syndrome.

B. Testing urine for glucose levels is not a routine part of nephrotic syndrome management, as glucose levels are not typically affected by this condition.

C. Increasing fluid intake is not advisable in nephrotic syndrome if there is significant edema; fluid management must be tailored to the child's condition.

D. While ambulation is beneficial, it is not as critical as daily weight monitoring in managing nephrotic syndrome.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A child with a brain tumor has a decreased respiratory hate and is less responsive to verbal commands than he was when the nurses assessed the client the previous hour. What should the nurse do next?

Correct Answer is B

Explanation

In caring for a child with nephrotic syndrome, which intervention will be most important to be included in the child's plan of care?

Correct Answer is A

Explanation

A parent calls a clinic and reports to a nurse that his 2-month-old infant is hungry more than usual but is having projectile vomiting immediately after eating Which of the following responses should the nurse make?

The nurses reviewing triggers of sickle cell crisis with a 14-year-old male client with sickle cell anemia. Which statement by the client indicates an understanding of the teaching? Select all that apply.

A nurse is preparing to discharge a child who has a new prescription for an oral antibiotic. Which of following information should the nurse include in the discharge instructions? (Select all that apply.)

The parents of a child with hemophilia ask the nurse about appropriate activities and sports that they should encourage the child to participate in. What activity would be the safest for the nurse to suggest?

A nurse in an emergency department is caring for an Infant who has a 2-day history of vomiting and an elevated temperature. Which of the following should the nurse recognize as the most reliable indicator of fluid loss?

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?

A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following types of fluid?

The nurse is reviewing appropriate nutritional options for a child who is receiving chemotherapy and has been prescribed a neutropenic diet. The nurse would recommend which of the following options