Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
6. A 4-year-old is hospitalized with acute glomerulonephritis. A nurse should feel most confident that the client teaching has been effective and the child has a basic understanding of this condition if the child states:
. "I was mean to my sister and now I am sick."
. "I have a stomachache but it will get better."
. "I don't have much pee pee come out when I use the toilet."
. "I have an infection in my stomach."
Test-Taking Tip
Note that only one answer describes a symptom specific to kidney functioning while the others indicate no understanding (Answer 1) or are too generalized (Answers 2 and 4). Select the option that is specific to the kidneys.
Content Area: Child Health, Genitourinary; Integrated Process: Nursing Process, Evaluation; Cognitive Level: Analysis; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Alterations in Body Systems
Pre-Test 1 and 2: Introduction to Special Questions Based on Official NCLEX-RN[®]
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Answer 1 is incorrect because the child's statement demonstrates the magical thinking of a preschooler. This child needs additional teaching and reassurance that hospitalization is not a punishment. Answer 2 is incorrect because, although the child may be experiencing a stomachache, this statement is not the best evidence that the child has a basic understanding of the illness. Answer 3 is correct because the child's statement demonstrates a basic knowledge that the main reason for hospitalization pertains to a urinary problem. Acute glomerulonephritis involves altered kidney function, resulting in decreased urine output. Answer 4 is incorrect because acute glomerulonephritis is thought to be an immune-complex response to a previous streptococcal illness. Although the child may have a persistent infection and may be receiving antibiotics, Answer 3 demonstrates greater understanding of the rationale for hospitalization—so that kidney functioning may be monitored and restored.