Question

Which is prescribed for the therapeutic management of minimal change nephrotic syndrome?

Answer 1

Correct Answers:

Corticosteroids

Rationale :

💊 Corticosteroids (e.g., prednisone) are the first-line treatment for minimal change nephrotic syndrome (MCNS), the most common form in children.

💊 They reduce glomerular permeability, which helps stop protein loss in urine (proteinuria).

💊 The majority of children respond well to steroid therapy, often within 1–3 weeks.

💊 Other options like increased fluids, antihypertensives, or antibiotics are not standard unless complications (like infection or hypertension) are present.

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Answer 2

Correct Answers:

Low-sodium, fluid-restricted

Rationale :

🧂 Sodium restriction helps reduce fluid retention, which is key in managing edema and hypertension.

🧂 Fluid restriction is necessary when there's oliguria or risk of fluid overload due to poor kidney filtration.

🧂 A low-protein diet is not indicated unless there's severe renal insufficiency with rising BUN/creatinine.

🧂 Potassium and protein restrictions are only considered based on lab trends, not by default.

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Answer 3

Correct Answers:

Notify the provider.

Rationale :

🧪 The child weighs 33 lb = ~15 kg, and minimum acceptable urine output is 0.5–1 mL/kg/hr.

🧪 Over 8 hours, the expected minimum output = 60 mL (15 kg × 0.5 mL × 8 hrs).

🧪 The output was 160 mL, which is within normal range. However, the presence of any renal symptoms, recent illness, or lab abnormalities warrants communication with the provider.

🧪 Prompt reporting allows for early intervention if renal function is declining or if clinical status changes.

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Answer 4

Correct Answers:

Place the client in a side-lying position.
Assess the client's airway patency.
Remove objects from the client's bed.

Rationale :

✔️ Place the client in a side-lying position

⚠️ This is a priority action during any seizure to prevent aspiration of saliva, vomit, or blood.

⚠️ The lateral position allows secretions to drain from the mouth, keeping the airway clear.

⚠️ It also helps reduce risk of choking and facilitates easier postictal recovery.

⚠️ Children in the tonic-clonic phase often produce excessive secretions, making this intervention crucial.

✔️ Assess the client’s airway patency

⚠️ Airway obstruction is a major concern during seizures, especially if the child becomes cyanotic or stops breathing.

⚠️ During and after the seizure, the nurse must observe for stridor, gurgling, or apnea, and prepare to intervene if needed.

⚠️ This includes checking for tongue obstruction or excessive saliva, and suctioning if safe and necessary post-seizure.

⚠️ While active seizure movements limit interventions, airway monitoring is constant.

✔️ Remove objects from the client’s bed

⚠️ Any surrounding objects (pillows, toys, hard objects, IV poles) pose a risk of trauma if the client strikes them during convulsions.

⚠️ Removing these protects against secondary injuries, including facial trauma, bruising, or limb injury.

⚠️ Ensure that bed rails are padded and the environment is cleared quickly once a seizure begins.

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Answer 5

Correct Answers:

Increasing fluids will help prevent and treat UTIs.

Rationale :

🚰 Increased fluid intake dilutes urine and promotes frequent voiding, reducing bacterial growth.

🚰 It helps flush out any bacteria ascending into the bladder or urethra.

🚰 Good hydration also encourages healthy bowel function, indirectly reducing UTI risk due to constipation.

❌ Wiping back to front increases the risk of fecal contamination.

❌ Tub baths, especially with soap or bubbles, can cause urethral irritation.

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Answer 6

Correct Answers:

"I give my child aspirin to reduce his fever."

Rationale :

🧠 Aspirin use in children recovering from viral illnesses (especially influenza and varicella) is directly linked to Reye syndrome.

🧠 Reye syndrome causes liver damage and cerebral edema, leading to confusion, seizures, or coma.

🧠 Safer alternatives like acetaminophen or ibuprofen are recommended for fever management.

🧠 Public education campaigns emphasize avoiding salicylates in pediatric care.

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Answer 7

Correct Answers:

Have a parent stay with the child during procedures.
Perform the procedure as quickly as possible.
Allow the child to keep a toy from home with her.

Rationale :

✔️ Have a parent stay with the child during procedures

🧸 Parental presence provides emotional reassurance and reduces anxiety, particularly for children under age 5.

🧸 It enhances the child’s sense of security and can improve cooperation.

🧸 Children exhibit less distress and faster recovery when their caregiver is present.

🧸 According to child development principles, toddlers and preschoolers experience separation anxiety, so having the parent near minimizes fear.

✔️ Perform the procedure as quickly as possible

🧸 Once preparation is complete, minimizing the duration of the procedure reduces anticipatory anxiety.

🧸 Prolonging the time may escalate the child’s distress and reduce their ability to cooperate.

🧸 Quick, precise technique prevents unnecessary suffering and resistance.

🧸 This principle aligns with atraumatic care—do no additional harm during required procedures.

✔️ Allow the child to keep a toy from home

🧸 Familiar items offer comfort, familiarity, and distraction.

🧸 A comfort object (like a blanket, stuffed animal, or toy) has psychological value, providing a sense of control.

🧸 It can also serve as a positive reinforcement tool, reducing emotional trauma and increasing compliance.

🧸 These items are especially effective for procedures involving needles, such as IV insertions or blood draws.

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Answer 8

Correct Answers:

Elevate the head of the bed.

Rationale :

🛏 Elevating the head of bed (30–45°) promotes venous outflow from the brain and reduces intracranial pressure (ICP).

🛏 Bright lights and loud noises stimulate the CNS and can worsen ICP symptoms.

🛏 Fluid overload contributes to cerebral edema, so intake must be carefully regulated.

🛏 Coughing increases intrathoracic pressure, which can elevate ICP—it should be minimized or suppressed if safe.

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Answer 9

Correct Answers:

Hold the infant's chin to his chest and knees to his abdomen during the procedure.

Rationale :

💉 The correct position (also called the "cannonball" or lateral recumbent" position) widens intervertebral spaces, allowing safe needle entry.

💉 Holding still is essential—this positioning reduces the risk of trauma or inaccurate sampling.

💉 EMLA cream requires at least 60 minutes for effect, so 15 minutes is insufficient.

💉 LP does not require prolonged NPO status in infants unless sedation is used.

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Answer 10

Correct Answers:

Assess pupillary reaction to light.
Palpate fontanel level
Stabilize the infant's spine.
Measure the infant's head circumference

Rationale :

✔️ Assess pupillary reaction to light

🧠 Pupillary changes are a key neurologic sign and may indicate brain swelling or herniation.

🧠 Changes such as unequal pupils, sluggish reaction, or fixed dilation suggest increased intracranial pressure (ICP).

🧠 Assessment should be done regularly post-injury, especially if consciousness or responsiveness declines.

✔️ Palpate fontanel level

🧠 In infants, the fontanels offer a non-invasive window to ICP trends.

🧠 A bulging fontanel suggests increased ICP, whereas a sunken fontanel may indicate dehydration or volume loss.

🧠 Palpation is a standard part of infant head trauma assessments.

✔️ Stabilize the infant’s spine

🧠 The fall from a porch introduces concern for cervical spine injury.

🧠 Infants should not be moved until spinal injury is ruled out or stabilization is secured.

🧠 Improper handling can worsen undetected spinal trauma, especially with scalp swelling and altered consciousness.

✔️ Measure head circumference

🧠 Measuring occipital-frontal circumference helps track acute changes in skull volume due to bleeding or swelling.

🧠 A significant increase over a short time may indicate a rapidly expanding hematoma.

🧠 Serial measurements can provide crucial clues about worsening cerebral edema.

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QLexNursing

1 :
Which is prescribed for the therapeutic management of minimal change nephrotic syndrome?

2 :
A nurse is caring for a school-age child who has acute glomerulonephritis with peripheral edema and is producing 35 mL of urine per hour. The nurse should expect the patient to be placed on which of the following diets?

3 :
A nurse is caring for a 3-year-old child who has had 160 mL of urine output over the past 8 hr period. The child weighs 33 lb. Which of the following actions should the nurse take?

4 :
A nurse is caring for a child who is having a seizure. Which of the following actions should the nurse take? (Select all that apply.)

5 :
Which should the nurse teach a group of girls and parents about the importance of preventing urinary tract infections (UTIs)?

6 :
A nurse is caring for a child who has influenza. The nurse should identify that which of the following statements by the parent indicates the child has an increased risk for Reye syndrome?.

7 :
A nurse is caring for a 3-year-old child whose parents report that she has an intense fear of painful procedures, such as injections. Which of the following strategies should the nurse add to the child's plan of care? (Select all that apply.)

8 :
A nurse is caring for a client who has increased intracranial pressure. Which of the following interventions should the nurse take?

9 :
A nurse is planning care for a 5-month-old infant who is scheduled for a lumbar puncture to rule out meningitis. Which of the following actions should the nurse include in the plan of care?

10 :
A nurse is caring for an infant in the emergency department.

Answer Options

QLexNursing

1 : Which is prescribed for the therapeutic management of minimal change nephrotic syndrome?

2 : A nurse is caring for a school-age child who has acute glomerulonephritis with peripheral edema and is producing 35 mL of urine per hour. The nurse should expect the patient to be placed on which of the following diets?

3 : A nurse is caring for a 3-year-old child who has had 160 mL of urine output over the past 8 hr period. The child weighs 33 lb. Which of the following actions should the nurse take?

4 : A nurse is caring for a child who is having a seizure. Which of the following actions should the nurse take? (Select all that apply.)

5 : Which should the nurse teach a group of girls and parents about the importance of preventing urinary tract infections (UTIs)?

6 : A nurse is caring for a child who has influenza. The nurse should identify that which of the following statements by the parent indicates the child has an increased risk for Reye syndrome?.

7 : A nurse is caring for a 3-year-old child whose parents report that she has an intense fear of painful procedures, such as injections. Which of the following strategies should the nurse add to the child's plan of care? (Select all that apply.)

8 : A nurse is caring for a client who has increased intracranial pressure. Which of the following interventions should the nurse take?

9 : A nurse is planning care for a 5-month-old infant who is scheduled for a lumbar puncture to rule out meningitis. Which of the following actions should the nurse include in the plan of care?

10 : A nurse is caring for an infant in the emergency department.

Answer Options

1 :
Which is prescribed for the therapeutic management of minimal change nephrotic syndrome?

2 :
A nurse is caring for a school-age child who has acute glomerulonephritis with peripheral edema and is producing 35 mL of urine per hour. The nurse should expect the patient to be placed on which of the following diets?

3 :
A nurse is caring for a 3-year-old child who has had 160 mL of urine output over the past 8 hr period. The child weighs 33 lb. Which of the following actions should the nurse take?

4 :
A nurse is caring for a child who is having a seizure. Which of the following actions should the nurse take? (Select all that apply.)

5 :
Which should the nurse teach a group of girls and parents about the importance of preventing urinary tract infections (UTIs)?

6 :
A nurse is caring for a child who has influenza. The nurse should identify that which of the following statements by the parent indicates the child has an increased risk for Reye syndrome?.

7 :
A nurse is caring for a 3-year-old child whose parents report that she has an intense fear of painful procedures, such as injections. Which of the following strategies should the nurse add to the child's plan of care? (Select all that apply.)

8 :
A nurse is caring for a client who has increased intracranial pressure. Which of the following interventions should the nurse take?

9 :
A nurse is planning care for a 5-month-old infant who is scheduled for a lumbar puncture to rule out meningitis. Which of the following actions should the nurse include in the plan of care?

10 :
A nurse is caring for an infant in the emergency department.