The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine “looks funny.” He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100 °F (37.8 °C). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have:
Rheumatic fever.
Lipoid nephrosis (idiopathic nephrotic syndrome).
A urinary tract infection.
Acute glomerulonephritis.
The Correct Answer is D
Choice A reason: Rheumatic fever follows streptococcal infection but typically presents with joint pain, carditis, or rash, not puffy eyes or abnormal urine. Glomerulonephritis better matches the symptoms post-infection, making this incorrect for the suspected condition based on the child’s presentation and history.
Choice B reason: Lipoid nephrosis causes edema and proteinuria but is not typically linked to recent infections or hematuria. Acute glomerulonephritis, often post-streptococcal, explains puffy eyes and abnormal urine, making this less fitting and incorrect for the child’s symptoms following ear infections.
Choice C reason: Urinary tract infections cause dysuria or frequency, not puffy eyes or hematuria post-infection. Acute glomerulonephritis aligns with the history of ear infections (possible streptococcal link) and symptoms, making this incorrect for the suspected condition in this child with these signs.
Choice D reason: Acute glomerulonephritis, often post-streptococcal (e.g., after ear infections), causes hematuria (“funny” urine), periorbital edema (puffy eyes), and headache. This aligns with pediatric nephrology evidence, making it the correct condition the nurse suspects based on the child’s symptoms and medical history.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Saying the flowers aren’t alive and removing them avoids the child’s question, missing a chance to discuss death. Asking about dying opens dialogue, making this evasive and incorrect compared to the nurse’s opportunity to engage the dying child in a meaningful conversation.
Choice B reason: Acknowledging the flowers’ death and asking what dying is like invites the child to share thoughts, facilitating discussion about their own mortality. This aligns with pediatric palliative care communication, making it the most appropriate response to encourage the child to open up about dying.
Choice C reason: Calling the flowers uncheerful and removing them dismisses the child’s observation, closing off discussion about death. Asking about dying fosters dialogue, making this superficial and incorrect compared to the nurse’s role in supporting the dying child’s emotional expression and exploration.
Choice D reason: Offering to trash the flowers ignores the child’s reference to death, missing a chance to explore their thoughts. Asking about dying encourages openness, making this abrupt and incorrect compared to the nurse’s opportunity to facilitate a conversation about death with the child.
Correct Answer is B
Explanation
Choice A reason: Placing the infant on the back post-pyloromyotomy risks aspiration during anesthesia recovery, as vomiting is common with pyloric stenosis. Side-lying positioning ensures airway protection, making this unsafe and incorrect for managing the infant’s recovery period effectively after this surgical procedure.
Choice B reason: Positioning the infant on their side with support prevents aspiration and maintains airway patency post-pyloromyotomy, addressing vomiting risks from pyloric stenosis. This aligns with postoperative pediatric nursing standards, making it the most appropriate position during anesthesia recovery for the infant.
Choice C reason: Laying the infant on the stomach is unsafe post-surgery, increasing aspiration and pressure on the surgical site. Side-lying positioning protects the airway and incision, making this incorrect for the infant’s recovery period following pyloromyotomy for pyloric stenosis in the hospital setting.
Choice D reason: Allowing parents to hold the infant may comfort but risks disrupting surgical recovery or airway management during anesthesia effects. Side-lying positioning ensures safety, making this less controlled and incorrect for the immediate postoperative period in this surgical context for the infant.
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