Practice Question
The nurse is providing discharge education to the parents of a 3-year-old recently diagnosed with vesicoureteral reflux (VUR). The child has had multiple urinary tract infections (UTIs). The mother asks what to expect with treatment. Which response by the nurse is correct?
Answer Choices:
Correct Answer:
"Your child may be daily antibiotics to help prevent future infections."
Rationale:
💎 In vesicoureteral reflux (VUR), urine flows backward from the bladder to the ureters and kidneys, increasing the risk of recurrent UTIs and potential renal scarring.
💎 For many children, especially those with mild to moderate VUR, the standard management includes long-term, low-dose prophylactic antibiotics to prevent recurrent infection while the child grows.
💎 The goal is to reduce bacterial colonization of the urinary tract and minimize renal damage while allowing possible spontaneous resolution of reflux as the child matures.
💎 Parents should be taught the importance of medication adherence, regular follow-up, and monitoring for symptoms of UTI such as fever, dysuria, or foul-smelling urine.
💎 This response correctly reflects realistic, evidence-based management of VUR and sets an appropriate expectation about daily antibiotic prophylaxis.
“VUR is caused by bladder stones, so treatment focuses on dissolving them.”
💎 VUR is not caused by bladder stones; it is usually due to a congenital defect in the ureterovesical junction, resulting in an incompetent valve mechanism.
💎 Bladder stones can cause irritation, obstruction, or infection, but they are not the underlying cause of vesicoureteral reflux.
💎 Falsely teaching that “treatment focuses on dissolving stones” misdirects parents away from monitoring reflux severity and preventing UTIs and renal injury.
💎 Management is instead based on reflux grading, infection history, and kidney status, not on stone dissolution.
💎 This statement is incorrect pathophysiologically and would provide inaccurate education to the parents.
“Surgical correction is required immediately to prevent kidney damage.”
💎 While surgical intervention (e.g., ureteral reimplantation) may be indicated in severe or persistent VUR, it is not always required immediately, especially in low-grade cases.
💎 Many children experience spontaneous improvement or resolution of VUR as they grow, particularly with appropriate infection prophylaxis and monitoring.
💎 Immediate surgery for all cases would expose children to unnecessary surgical risk, anesthesia, and potential complications.
💎 Current management often follows a stepwise approach, starting with medical management and reserving surgery for refractory or high-grade reflux with ongoing damage.
💎 Therefore, stating that surgery is required immediately is misleading and does not reflect standard practice.
“Your child will need to avoid all physical activity to prevent worsening of the condition.”
💎 There is no evidence that normal physical activity worsens VUR or increases reflux severity.
💎 Restricting a child from all physical activity could negatively affect growth, development, and psychosocial well-being.
💎 Management of VUR focuses on infection prevention, monitoring kidney function, and sometimes hydration and bladder habits, not activity restriction.
💎 Children with VUR are typically encouraged to live as normally as possible, with routine play unless otherwise indicated by another condition.
💎 This response would impose unnecessary limitations and does not align with appropriate pediatric guidance.
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This question is from Exam 4 - Modules 8, 9, and 10 which contains 74 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: General Exams
- Domain: 👶🏼Pediatrics
- Answer Choices: 4