The nurse should recognize that the findings in the Electronic Medical Records are consistent with acute glomerulonephritis as evidenced by which of the following?
Urinalysis record showing low specific gravity.
Urinalysis record showing decreased protein levels.
Urinalysis record showing red blood cell casts.
Urinalysis record showing urine with a pH of 8.0.
The Correct Answer is C
Choice A rationale
Urinalysis findings in acute glomerulonephritis typically reveal a high specific gravity due to concentrated urine resulting from the kidneys' attempt to conserve fluid in the presence of decreased glomerular filtration. Low specific gravity, on the other hand, is a finding more consistent with conditions like diabetes insipidus, chronic renal failure, or overhydration, where the renal tubules have impaired concentrating ability. A specific gravity of 1.010 to 1.030 is considered normal.
Choice B rationale
Acute glomerulonephritis is characterized by increased glomerular capillary permeability, allowing larger molecules like protein to leak into the urine. This results in significant proteinuria, which is a key diagnostic finding. Decreased protein levels in the urine would be considered a normal finding, or a finding in conditions without glomerular damage, and would therefore not be consistent with a diagnosis of acute glomerulonephritis. Normal urine protein is less than 150 mg/24 hours.
Choice C rationale
Red blood cell casts are a definitive microscopic finding in acute glomerulonephritis and are formed when red blood cells aggregate in the renal tubules and are molded into a cylindrical shape by the Tamm-Horsfall protein. Their presence confirms a glomerular origin of the hematuria and is a specific indicator of an active inflammatory process within the glomeruli. This finding is highly specific to glomerulonephritis.
Choice D rationale
The urine pH in acute glomerulonephritis is typically acidic, with a normal range of 4.5 to 8.0. A pH of 8.0 is at the upper end of the normal range and could indicate an alkaline state, which is more commonly associated with conditions like urinary tract infections caused by urease-producing bacteria, or a vegetarian diet, rather than the inflammatory process of acute glomerulonephritis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C"]
Explanation
Choice A rationale
Gastroesophageal reflux (GER) involves the retrograde flow of gastric contents into the esophagus. By thickening the infant's formula with a substance like cereal, the viscosity of the feeding is increased. This higher viscosity makes it more difficult for the stomach contents to flow back up the esophagus, thereby reducing the frequency and severity of regurgitation episodes. The increased density helps the food stay in the stomach.
Choice B rationale
While citrus juices are known to be acidic and may exacerbate symptoms of GER in some individuals by irritating the esophageal mucosa, avoiding them is a management strategy for symptom control rather than a primary action to physically prevent the act of regurgitation itself. The mechanism of regurgitation is mechanical, related to the lower esophageal sphincter, not solely to the pH of the consumed liquid. This choice does not directly prevent the physical reflux.
Choice C rationale
Elevating the infant's head after meals leverages gravity to help keep gastric contents in the stomach and away from the esophagus. A head elevation of at least 30 degrees is often recommended to reduce the pressure on the lower esophageal sphincter (LES), thus decreasing the likelihood of stomach acid and food flowing backward, which is the physiological basis of regurgitation.
Choice D rationale
Placing an infant on a soft pillow while sleeping poses a significant risk of sudden infant death syndrome (SIDS) due to potential suffocation. Soft bedding can obstruct the infant's airway. The American Academy of Pediatrics recommends that infants sleep on a firm surface without any pillows, blankets, or soft toys to minimize these risks, making this a dangerous and contraindicated practice for an infant.
Choice E rationale
Antiemetics are medications used to treat nausea and vomiting by acting on chemoreceptor trigger zones in the brain or other peripheral receptors. They do not prevent the mechanical process of regurgitation in infants with GER. Furthermore, these medications are generally not recommended for routine use in infants with uncomplicated GER due to potential adverse effects and the self-limiting nature of the condition.
Correct Answer is B
Explanation
Choice A rationale
Placing the shoulder harness straps above the level of the baby's shoulders is an incorrect and unsafe practice. The shoulder harnesses should be positioned at or below the shoulders for a rear-facing car seat. This placement ensures that in a crash, the force is distributed across the strong parts of the baby's body and that the child is properly restrained, preventing ejection and minimizing head injury.
Choice B rationale
The American Academy of Pediatrics (AAP) and other safety organizations recommend keeping children in a rear-facing car seat for as long as possible, typically until they reach the maximum weight or height limit for the seat, which can be up to 2 years of age or even longer. This position provides superior protection for the child's head, neck, and spine in a frontal crash by distributing forces over the entire back.
Choice C rationale
The retainer clip (also called the chest clip) is designed to be placed at the level of the armpits, not the abdomen. Its purpose is to keep the shoulder harness straps properly positioned on the child's chest. Placing it over the abdomen is dangerous because the force of a crash could cause internal injuries to the child's soft abdominal organs. This is a critical safety guideline.
Choice D rationale
A 30-degree angle is too upright for a car seat and is considered unsafe. The correct angle for a rear-facing infant car seat is typically between 45 and 45 degrees. A steeper angle could cause the infant's head to fall forward, obstructing their airway. The specific angle may vary slightly depending on the car seat model, but 30 degrees is generally too vertical.
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