The practical nurse is caring for a preschooler with spina bifida who was admitted with a febrile urinary tract infection.
Which action should the practical nurse prioritize to minimize complications of vesicoureteral reflux?
Assess elimination hygiene habits.
Complete post void bladder scans.
Implement a frequent voiding schedule.
Encourage adequate oral fluid intake.
The Correct Answer is C
Choice A rationale
Assessing elimination hygiene habits is important for preventing recurrent UTIs, but it does not directly address the immediate goal of minimizing complications of vesicoureteral reflux (VUR) in an acute febrile UTI. While good hygiene reduces bacterial entry, VUR involves retrograde urine flow.
Choice B rationale
Completing post-void bladder scans helps assess bladder emptying and residual urine, which are risk factors for UTIs. However, in the context of VUR and a febrile UTI, it's a diagnostic tool rather than a primary intervention to actively minimize the reflux itself during the infection.
Choice C rationale
Implementing a frequent voiding schedule minimizes the volume of urine in the bladder and reduces the duration of bladder distention. This decreases the likelihood of vesicoureteral reflux and helps to flush out bacteria, thus minimizing the risk of renal parenchymal damage during a febrile UTI.
Choice D rationale
Encouraging adequate oral fluid intake helps flush bacteria from the urinary tract and prevents dehydration, which is beneficial for overall health and UTI management. However, while important, it does not directly impact the mechanics of vesicoureteral reflux as effectively as frequent bladder emptying.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
A soft, spongy fundus, often described as boggy, indicates uterine atony. This condition means the uterine muscles are not contracting effectively, which is abnormal postpartum and significantly increases the risk of postpartum hemorrhage due to inadequate compression of uterine blood vessels.
Choice B rationale
Unilateral lower leg pain, especially accompanied by warmth, redness, or swelling, is an abnormal finding and can be indicative of a deep vein thrombosis (DVT). Postpartum women are at an increased risk for DVT due to hypercoagulability and venous stasis, making this a critical assessment requiring immediate attention.
Choice C rationale
Saturating two perineal pads per hour is an excessive amount of lochia and suggests postpartum hemorrhage. Normal lochia flow should not saturate more than one pad per hour in the immediate postpartum period, indicating that the uterus is not contracting adequately to control bleeding.
Choice D rationale
A heart rate of 56 beats/minute, also known as puerperal bradycardia, is considered a normal physiological finding for a primigravida client 12 hours postpartum. This transient bradycardia often occurs due to the increased stroke volume and cardiac output that result from the significant decrease in uterine blood flow after delivery.
Correct Answer is D
Explanation
Choice A rationale
Consumption of whole milk as a toddler is generally appropriate for growth and development, providing essential fats and nutrients. Unless consumed in excessive quantities or as part of an overall diet high in calories without sufficient physical activity, it is not typically identified as a primary singular contributor to early obesity.
Choice B rationale
Dedicated breastfeeding for 6 months is protective against childhood obesity. Breast milk provides optimal nutrition and growth-promoting factors, and breastfeeding is associated with better self-regulation of caloric intake by infants, potentially reducing the risk of later obesity compared to formula feeding.
Choice C rationale
Exclusive soy-based formula for the first year, while an alternative for specific dietary needs, does not inherently contribute to early obesity more than other formulas. The caloric density and nutritional composition of standard infant formulas are regulated and designed to support healthy growth, making it unlikely to be a primary cause of obesity.
Choice D rationale
Introducing solid foods, such as fortified cereal, before 4 months of age is associated with an increased risk of obesity. Infants lack the necessary gastrointestinal and renal maturity to process solids effectively before this age, and early introduction can lead to excessive caloric intake, disruption of feeding cues, and altered gut microbiome development, predisposing to weight gain.
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