TRIAL 1. A child with nephritic syndrome is most likely to present with: A. Massive proteinuria B. Haematuria C. Polyuria D. Hypotension 2. The most common cause of acute nephritic syndrome in children is: A. Viral infection B. Fungal infection C. Post-streptococcal infection D. Tuberculosis 3. Which of the following is a key feature of nephritic syndrome? A. Severe edema B. Hypertension C. Hyperglycemia D. Dehydration 4. The nurse expects urine in nephritic syndrome to appear: A. Clear and pale B. Milky C. Tea-coloured D. Colourless 5. Oliguria in nephritic syndrome is defined as: A. Increased urine output B. Normal urine output C. Reduced urine output D. Painful urination 6. Which laboratory test confirms recent streptococcal infection? A. ESR B. ASO titre C. Hemoglobin level D. Platelet count 7. The priority nursing intervention in acute nephritic syndrome is: A. Encourage high fluid intake B. Monitor blood pressure C. Promote ambulation D. Provide high-protein diet 8. A child with nephritic syndrome is placed on fluid restriction to: A. Prevent dehydration B. Reduce edema C. Increase urine output D. Improve appetite 9. Which diet is most appropriate for a child with nephritic syndrome? A. High salt diet B. Low salt diet C. High fat diet D. Low carbohydrate diet 10. A major complication of nephritic syndrome is: A. Diabetes mellitus B. Acute kidney failure C. Asthma D. Liver cirrhosis 11. The presence of periorbital edema in nephritic syndrome is due to: A. Infection B. Fluid retention C. Trauma D. Allergy 12. Which of the following indicates improvement in nephritic syndrome? A. Increased edema B. Decreased urine output C. Normal blood pressure D. Persistent haematuria 13. Bed rest is recommended in acute nephritic syndrome to: A. Prevent infection B. Reduce metabolic demand C. Improve appetite D. Enhance mobility 14. Which electrolyte imbalance is likely in nephritic syndrome? A. Hypokalemia B. Hypernatremia C. Hyperkalemia D. Hypocalcemia 15. The nurse should educate parents to seek care immediately if the child develops: A. Increased appetite B. Severe headache and vomiting C. Mild cough D. Sweating 16. A fracture is best defined as: A. Dislocation of a joint B. Break in a bone C. Muscle tear D. Ligament injury 17. The most common type of fracture in children is: A. Comminuted fracture B. Spiral fracture C. Greenstick fracture D. Open fracture 18. A greenstick fracture is characterized by: A. Complete bone break B. Bone shattering C. Partial break of bone D. Bone infection 19. The most common cause of fractures in children is: A. Infection B. Falls C. Genetic disorders D. Nutritional deficiency 20. Which of the following is a sign of fracture? A. Hyperactivity B. Deformity C. Increased appetite D. Sweating 21. The confirmatory investigation for fracture is: A. MRI B. CT scan C. X-ray D. Ultrasound 22. Which fracture involves the growth plate? A. Spiral fracture B. Epiphyseal fracture C. Comminuted fracture D. Simple fracture 23. The priority nursing assessment in a child with fracture is: A. Skin colour B. Neurovascular status C. Temperature D. Appetite 24. The “5 Ps” of neurovascular assessment include all EXCEPT: A. Pain B. Pallor C. Pulse D. Pyrexia 25. Compartment syndrome is characterized by: A. Reduced pain B. Increased circulation C. Severe pain and swelling D. Decreased pressure 26. Which intervention helps reduce swelling in a fractured limb? A. Lowering the limb B. Elevating the limb C. Applying heat D. Encouraging movement 27. A major complication of open fractures is: A. Hypertension B. Infection C. Diabetes D. Asthma 28. Cast care includes: A. Keeping the cast wet B. Inserting objects into cast C. Keeping the cast dry D. Removing the cast daily 29. Which nutrient is essential for bone healing? A. Vitamin C B. Iron C. Calcium D. Sodium 30. The nurse should suspect child abuse when: A. Injury matches history B. Multiple fractures at different stages of healing C. Single fracture from fall D. Child is active
This history question requires analysis of historical events, causes, and consequences. The detailed answer below provides context, evidence, and a well-structured explanation.
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Here are the answers to your questions:
1. A child with nephritic syndrome is most likely to present with:
B. Haematuria
Explanation: Haematuria (blood in the urine), often described as tea-colored or smoky, is a hallmark of nephritic syndrome due indicating glomerular inflammation.
2. The most common cause of acute nephritic syndrome in children is:
C. Post-streptococcal infection
Explanation: Post-streptococcal glomerulonephritis (PSGN) is the most common cause of acute nephritic syndrome in children, occurring after an infection with certain strains of Streptococcus bacteria.
3. Which of the following is a key feature of nephritic syndrome?
B. Hypertension
Explanation: Hypertension (high blood pressure) is a common feature of nephritic syndrome due to fluid retention and impaired kidney function.
4. The nurse expects urine in nephritic syndrome to appear:
C. Tea-coloured
Explanation: The presence of red blood cells in the urine due to glomerular inflammation gives the urine a characteristic tea-colored or smoky appearance.
5. Oliguria in nephritic syndrome is defined as:
C. Reduced urine output
Explanation: Oliguria refers to a significantly reduced urine output, which is common in nephritic syndrome due to decreased glomerular filtration.
6. Which laboratory test confirms recent streptococcal infection?
B. ASO titre
Explanation: An Antistreptolysin O (ASO) titre measures antibodies produced in response to a streptococcal infection, confirming a recent infection.
7. The priority nursing intervention in acute nephritic syndrome is:
B. Monitor blood pressure
Explanation: Monitoring blood pressure is a priority because hypertension is a common and potentially dangerous complication that can lead to serious issues like hypertensive encephalopathy.
8. A child with nephritic syndrome is placed on fluid restriction to:
B. Reduce edema
Explanation: Fluid restriction helps to manage and reduce edema and hypertension caused by the kidneys' inability to excrete excess fluid.
9. Which diet is most appropriate for a child with nephritic syndrome?
B. Low salt diet
Explanation: A low salt diet is crucial to help manage fluid retention, edema, and hypertension associated with nephritic syndrome.
10. A major complication of nephritic syndrome is:
B. Acute kidney failure
Explanation: The inflammation and damage to the glomeruli can lead to a rapid decline in kidney function, resulting in acute kidney failure.
11. The presence of periorbital edema in nephritic syndrome is due to:
B. Fluid retention
Explanation: Periorbital edema (swelling around the eyes) is a common sign of generalized fluid retention in the body due to impaired kidney function.
12. Which of the following indicates improvement in nephritic syndrome?
C. Normal blood pressure
Explanation: A return to normal blood pressure indicates that the fluid retention and renal dysfunction are resolving, signifying improvement.
13. Bed rest is recommended in acute nephritic syndrome to:
B. Reduce metabolic demand
Explanation: Bed rest helps to reduce the body's metabolic demands, which in turn can help lower blood pressure and decrease the workload on the kidneys.
14. Which electrolyte imbalance is likely in nephritic syndrome?
C. Hyperkalemia
Explanation: With impaired kidney function and reduced urine output, the body may not be able to excrete potassium effectively, leading to hyperkalemia (elevated potassium levels).
15. The nurse should educate parents to seek care immediately if the child develops:
B. Severe headache and vomiting
Explanation: Severe headache and vomiting can be signs of hypertensive encephalopathy, a serious complication of uncontrolled hypertension in nephritic syndrome, requiring immediate medical attention.
16. A fracture is best defined as:
B. Break in a bone
Explanation: A fracture is a medical term for a break, crack, or discontinuity in the structure of a bone.
17. The most common type of fracture in children is:
C. Greenstick fracture
Explanation: Greenstick fractures are common in children because their bones are more flexible than adult bones, often bending and breaking only partially, similar to a young tree branch.
18. A greenstick fracture is characterized by:
C. Partial break of bone
Explanation: In a greenstick fracture, the bone breaks on one side but only bends on the other, not breaking completely through.
19. The most common cause of fractures in children is:
B. Falls
Explanation: Children are highly active and prone to accidents, making falls the most frequent cause of fractures.
20. Which of the following is a sign of fracture?
B. Deformity
Explanation: Deformity (an abnormal shape or alignment of the limb) is a classic and often visible sign of a fracture.
21. The confirmatory investigation for fracture is:
C. X-ray
Explanation: An X-ray is the standard and most common diagnostic tool used to confirm the presence, type, and location of a fracture.
22. Which fracture involves the growth plate?
B. Epiphyseal fracture
Explanation: An epiphyseal fracture (also known as a Salter-Harris fracture) involves the epiphysis, which is the growth plate area at the end of long bones in children.
23. The priority nursing assessment in a child with fracture is:
B. Neurovascular status
Explanation: Assessing neurovascular status (checking for pain, pallor, pulselessness, paresthesia, and paralysis) is critical to ensure adequate circulation and nerve function distal to the fracture site.
24. The “5 Ps” of neurovascular assessment include all EXCEPT:
D. Pyrexia
Explanation: The "5 Ps" are Pain, Pallor, Pulselessness, Paresthesia, and Paralysis. Pyrexia (fever) is not part of this assessment.
25. Compartment syndrome is characterized by:
C. Severe pain and swelling
Explanation: Compartment syndrome is a serious condition characterized by increased pressure within a muscle compartment, leading to severe pain (often out of proportion to the injury), swelling, and potential nerve and muscle damage.
26. Which intervention helps reduce swelling in a fractured limb?
B. Elevating the limb
Explanation: Elevating the limb above the level of the heart promotes venous return and lymphatic drainage, thereby reducing swelling.
27. A major complication of open fractures is:
B. Infection
Explanation: In open fractures (where the skin is broken), the bone is exposed to the external environment, significantly increasing the risk of infection.
28. Cast