The parents of a child with acute glomerulonephritis are describing to the practical nurse (PN) what originally motivated them to seek medical care. Which sign did the child most likely exhibit?
Hematuria.
Weight loss.
Polydipsia.
A sore throat.
The Correct Answer is A
A. Hematuria is the classic clinical hallmark of acute glomerulonephritis that typically prompts parents to seek medical consultation. The presence of red blood cells in the urine often results in a "cola-colored" or smoky appearance due to the leakage of erythrocytes through the inflamed glomerular basement membrane. This visual change is sudden and alarming to caregivers, serving as a primary reason for acute healthcare visits.
B. Weight loss is an unlikely finding in the initial presentation of acute glomerulonephritis. Instead, these children typically experience rapid weight gain and edema due to sodium and water retention caused by a decreased glomerular filtration rate. The clinical manifestation of fluid overload, including periorbital edema and hypertension, is much more characteristic of the acute inflammatory phase than any nutritional or fluid deficit.
C. Polydipsia, or excessive thirst, is not a typical symptom of acute glomerulonephritis and is more commonly associated with diabetes mellitus or diabetes insipidus. In glomerulonephritis, the renal system is struggling to filter and excrete fluid, often leading to oliguria rather than the polyuria that drives thirst. Consequently, parents would be more likely to report a decrease in urinary frequency and volume rather than increased intake.
D. A sore throat is a precursor to post-streptococcal glomerulonephritis but is usually no longer present by the time the renal symptoms manifest. The typical latency period between a Group A beta-hemolytic streptococcal infection and the onset of kidney inflammation is approximately 1 to 3 weeks. While the history of a sore throat is diagnostically significant, the active renal symptoms like hematuria are what usually motivate the immediate visit.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The screening test that should be scheduled for a client who is gravida 4 para 3 at 16-weeks gestation is **Maternal serum alpha-feto protein (MSAFP)**. Second trimester prenatal screening may include several blood tests, called multiple markers. These markers provide information about a woman's risk of having a baby with certain genetic conditions or birth defects. Screening is usually done by taking a sample of the mother's blood between the 15th and 20th weeks of pregnancy (16th to 18th is ideal)².
Correct Answer is D
Explanation
Rationale:
A. Increased appetite is not a direct therapeutic indicator of baclofen efficacy. While improved comfort from muscle relaxation might indirectly support better intake, the drug does not possess orexigenic properties. Nutritional status is monitored in cerebral palsy patients, but it remains unrelated to the specific pharmacological mechanism of this skeletal muscle relaxant.
B. Sufficient urinary output is a vital assessment of general physiological and renal function, yet it is not the target of baclofen therapy. Baclofen acts primarily on the central nervous system to inhibit monosynaptic and polysynaptic reflexes at the spinal level. Urinary monitoring ensures adequate drug clearance, but output levels do not reflect the medication's clinical success.
C. Fewer temper outbursts might suggest a reduction in physical discomfort, but baclofen is not an antianxiety or antipsychotic medication. Cerebral palsy may involve behavioral challenges, but the primary goal of this therapy is physical rather than psychological. Behavioral changes are subjective and do not provide a scientific measure of the drug’s specific muscle-relaxing influence.
D. Decreased muscular spasticity is the primary therapeutic goal for a client with cerebral palsy receiving baclofen. This medication functions as a gamma-aminobutyric acid (GABA) analogue, effectively reducing the transmission of excitatory signals that cause hypertonia and involuntary muscle contractions. A reduction in resistance to passive movement confirms that the drug is achieving its intended neuromuscular effect.
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