The caregivers 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 infections but typically presents with joint pain or carditis, not puffy eyes or abnormal urine. Glomerulonephritis matches the post-infectious symptoms, making this incorrect, as it does not align with the child’s clinical presentation after ear infections.
Choice B reason: Lipoid nephrosis causes edema but lacks a clear link to recent infections or hematuria. Acute glomerulonephritis better explains the symptoms post-ear infection, making this less fitting and incorrect for the suspected condition based on the child’s reported signs and history.
Choice C reason: Urinary tract infections cause dysuria or frequency, not typically puffy eyes or hematuria post-infection. Glomerulonephritis aligns with the streptococcal history and symptoms, making this incorrect compared to the condition suspected based on the child’s clinical presentation to the nurse.
Choice D reason: Acute glomerulonephritis, often post-streptococcal from 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, prompting immediate evaluation by a care provider for the child.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Half an aspirin with a viral infection poses a small Reye syndrome risk, warranting monitoring for symptoms like lethargy or vomiting. This aligns with pediatric safety guidelines, making it the best response to inform the mother while ensuring vigilance for the 9-year-old’s health.
Choice B reason: Nasal discharge and sneezing are unrelated to Reye syndrome, which involves neurological symptoms like stupor. Monitoring for lethargy or vomiting is correct, making this incorrect, as it lists irrelevant symptoms for the mother’s concern about Reye syndrome in her child.
Choice C reason: Admitting for observation overstates the risk, as a single half aspirin rarely causes Reye syndrome. Monitoring for specific symptoms is sufficient, making this alarmist and incorrect compared to the nurse’s balanced response to the mother’s concern about the viral infection.
Choice D reason: Downplaying the risk as unlikely ignores the potential, though rare, link between aspirin and Reye syndrome in viral infections. Monitoring for symptoms is prudent, making this dismissive and incorrect compared to advising vigilance for the 9-year-old’s safety post-aspirin use.
Correct Answer is D
Explanation
Choice A reason: Slightly crooked teeth may complicate oral hygiene but are not a primary cause of cavities, which depend more on brushing and diet. Malocclusions affect chewing efficiency, making this less accurate and incorrect compared to the functional impact of misaligned teeth noted during the assessment.
Choice B reason: Malocclusions do not directly cause infections or tooth loss unless severe and untreated. Slight cross-over primarily impacts chewing and jaw function, not infection risk, making this exaggerated and incorrect for the primary reason to seek orthodontic consultation for the teenager’s teeth.
Choice C reason: Social impacts like dating or hiring are speculative and not the primary clinical concern for slight malocclusions. Chewing and jaw efficiency are direct functional issues, making this psychosocial focus less relevant and incorrect for the orthodontic referral rationale in this clinical scenario.
Choice D reason: Slight malocclusions, like crossed front teeth, can impair chewing and jaw function, leading to inefficient mastication or strain. This functional concern justifies orthodontic evaluation, aligning with dental health principles, making it the correct reason to recommend seeing an orthodontist for the teenager.
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