Acute Glomerulonephritis
Which laboratory result would indicate worsening acute glomerulonephritis?
A. Serum creatinine 1.0 mg/dL
B. ASO titer decreasing
C. Potassium 6.1 mEq/L
D. GFR improving to 70 mL/min
What is C. Potassium 6.1 mEq/L
A client with acute nephritis reports sudden shortness of breath and has crackles in the lower lung fields. What is the nurse’s priority action?
A. Administer a PRN bronchodilator
B. Assess the client’s urine output
C. Elevate the head of the bed
D. Notify the provider about fluid overload
What is C-Elevate the head of the bed
Which statement about administering opioids to a client with appendicitis is most accurate?
A. Opioids should never be given until diagnosis is confirmed
B. Small doses may be given to relieve pain without obscuring assessment
C. Opioids mask pain completely and are unsafe
D. IV opioids should always be withheld preoperatively
What is B. Small doses may be given to relieve pain without obscuring assessment
A client with a history of PUD suddenly reports severe, sharp mid-epigastric pain that radiates to the shoulders. The abdomen is rigid and board-like. Which action is the nurse’s priority?
A. Administer prescribed antacids
B. Insert a nasogastric tube to low suction
C. Check for occult blood in the stool
D. Prepare the client for emergency surgery
What is D. Prepare the client for emergency surgery
A 45-year-old presents with right upper quadrant (RUQ) pain radiating to the right shoulder, nausea, and vomiting after eating a fatty meal. The pain lasts for 2 hours and subsides gradually. Which condition is most likely?
A. Acute pancreatitis
B. Cholelithiasis (gallstones)
C. Peptic ulcer disease
D. Appendicitis
What is B. Cholelithiasis (gallstones)
A 9-month-old infant with suspected cerebral palsy has poor head control, stiff arms and legs, and persistent scissoring of the legs. Which is the most appropriate nursing action?
A. Teach the parents passive range-of-motion exercises
B. Schedule physical therapy evaluation
C. Document as normal developmental variation
D. Recommend a high-protein diet
What is B. Schedule physical therapy evaluation
The nurse is reviewing the provider’s orders for a client with acute glomerulonephritis. Which order should the nurse question?
A. Daily weights
B. Low-sodium diet
C. Increase protein intake
D. Fluid restriction
What is C. Increase protein intake
A client with nephritis is prescribed high-dose corticosteroids. Which instruction is most important for the nurse to include?
A. “Avoid grapefruit juice.”
B. “Monitor your weight daily.”
C. “Take this medication with food.”
D. “Report any signs of infection immediately.”
What is D. “Report any signs of infection immediately.”
A 19-year-old presents with abdominal pain that began around the umbilicus and now localizes to the right lower quadrant. They also report nausea and anorexia. Which assessment finding is most concerning?
A. Mild fever (100.4°F / 38°C)
B. Guarding on palpation of RLQ
C. Slightly elevated WBC 12,500/mm³
D. Pain improves after passing gas
What is B. Guarding on palpation of RLQ
An older adult taking NSAIDs daily for osteoarthritis presents with dizziness, weakness, and melena. What is the nurse’s priority action?
A. Obtain vital signs
B. Encourage oral hydration
C. Administer prescribed sucralfate
D. Draw coagulation studies
What is A. Obtain vital signs
A client with cholecystitis develops jaundice, clay-colored stools, and dark urine. Which complication should the nurse suspect?
A. Gallbladder perforation
B. Choledocholithiasis (common bile duct obstruction)
C. Pancreatitis
D. Gastroenteritis
What is B. Choledocholithiasis (common bile duct obstruction)
A 6-year-old with spastic CP is prescribed baclofen. Which assessment finding requires immediate nursing intervention?
A. Mild drowsiness
B. Muscle relaxation
C. Hypotension and respiratory depression
D. Improved gait
What is C. Hypotension and respiratory depression
Which statement by the client recovering from acute post-streptococcal glomerulonephritis indicates the need for further teaching?
A. “I should monitor my urine for changes in color.”
B. “I will finish all of my antibiotics as prescribed.”
C. “I will check my blood pressure regularly at home.” D. “My activity level can return to normal immediately.”
What is D. “My activity level can return to normal immediately.”
Which medication order should the nurse question for a client diagnosed with acute nephritis?
A. Sodium polystyrene sulfonate
B. Furosemide
C. Ibuprofen
D. Hydralazine
What is C. Ibuprofen
An older adult presents with vague abdominal discomfort, mild nausea, and low-grade fever. Which statement is most important for the nurse to remember?
A. Appendicitis always presents with RLQ pain
B. Older adults may present atypically, delaying diagnosis
C. WBC count is always elevated in appendicitis
D. Surgery can usually be delayed safely in older adults
What is B. Older adults may present atypically, delaying diagnosis
A client with suspected perforated ulcer has an NG tube inserted. Which finding should the nurse report immediately?
A. Light green drainage
B. Increasing abdominal distention
C. A small amount of red-tinged output
D. Clear drainage after flushing
What is B. Increasing abdominal distention
Which client statement indicates understanding of risk reduction for gallstones?
A. “I will continue a high-fat diet to maintain weight.”
B. “I should maintain a healthy weight and avoid rapid weight loss.”
C. “I will take birth control pills indefinitely to prevent gallstones.”
D. “Gallstones are unrelated to diet or weight.”
What is B. "I should maintain a healthy weight and avoid rapid weight loss."
A 9-year-old child is referred for evaluation due to inattention and difficulty completing schoolwork. Which observation is most consistent with ADHD?
A. Occasional daydreaming and completing tasks slowly
B. Frequent fidgeting, inability to remain seated, and interrupting others
C. Shyness and fear of social interaction
D. Prefers playing alone and limited verbal communication
What is B. Frequent fidgeting, inability to remain seated, and interrupting others
A client with acute glomerulonephritis reports a sudden headache and blurred vision. What is the nurse’s priority action?
A. Notify the provider of worsening nephron damage
B. Assess for signs of hypertensive encephalopathy
C. Administer prescribed diuretics
D. Prepare the client for possible dialysis
What is B. Assess for signs of hypertensive encephalopathy
A client with acute glomerulonephritis is on strict fluid restriction. Which finding indicates the treatment is ineffective?
A. Crackles in both lung bases
B. Decreasing daily weight
C. Blood pressure trending downward
D. Increased urine output
What is A. Crackles in both lung bases
A 7-year-old presents with vague abdominal pain, vomiting, and a temperature of 100.8°F. Parents say the child is irritable and refuses to walk. Which assessment finding is most concerning?
A. Diffuse tenderness with rebound
B. Anorexia
C. History of mild constipation
D. Slightly elevated WBC
What is A. Diffuse tenderness with rebound
Which evaluation best indicates that PPI therapy is effective for PUD?
A. Improved appetite
B. Decrease in gastric acidity
C. Resolution of nausea
D. Weight gain over 2 weeks
What is B. Decrease in gastric acidity
Which finding is most consistent with obstruction of the bile duct?
A. Elevated WBC
B. Elevated AST and ALT
C. Elevated alkaline phosphatase and bilirubin
D. Normal electrolytes
What is C. Elevated alkaline phosphatase and bilirubin
Which intervention is most effective for improving attention and behavior in a school-aged child with ADHD?
A. Consistent daily routines and structured environment
B. Allowing free play during school hours
C. Using time-outs only during evenings
D. Avoiding teacher involvement
What is A. Consistent daily routines and structured environment
Which task can the nurse safely delegate to an experienced UAP when caring for a client with acute glomerulonephritis?
A. Monitor for worsening periorbital edema
B. Measure and record strict intake and output
C. Teach the client about sodium restrictions
D. Assess lung sounds for fluid overload
What is B. Measure and record strict intake and output
A client with nephritis has the following labs: BUN 58mg/dL, creatinine 3.6mg/dL, potassium 5.8mEq/L, and GFR 18mL/min. Which assessment finding requires immediate intervention?
A. Muscle cramps in the legs
B. Tall, peaked T-waves on EKG
C. Nausea and decreased appetite
D. Urine output of 250 mL over 8 hours
What is B. Tall, peaked T-waves on EKG
A client with RLQ pain has the following labs: WBC 15,800/mm³, neutrophils 80%, CRP elevated. Which interpretation is most appropriate?
A. Normal lab values
B. Indicative of early appendicitis
C. Suggests bacterial infection / inflammation
D. Suggests viral infection
What is C. Suggests bacterial infection / inflammation
A nurse is counseling a client newly diagnosed with PUD. Which statement indicates correct understanding of risk reduction?
A. “I will switch from smoking cigarettes to chewing tobacco.”
B. “I should avoid NSAIDs unless specifically prescribed.”
C. “Alcohol in moderation is recommended to reduce acid.”
D. “I should increase my caffeine intake to soothe my stomach.”
What is B. “I should avoid NSAIDs unless specifically prescribed.”
An older adult with cholecystitis reports confusion, hypotension, and tachycardia. Which is the priority nursing action?
A. Assess pain level
B. Prepare for laparoscopic surgery
C. Initiate IV fluids and notify provider
D. Encourage oral intake
What is C. Initiate IV fluids and notify provider
A 12-month-old child is admitted for evaluation of failure to thrive. Which findings should the nurse expect? Select all that apply.
A. Weight below the 5th percentile for age
B. Delayed developmental milestones
C. Frequent infections
D. Excessive height for age
E. Thin, sparse hair and dry skin
F. Hyperactivity and irritability
What is A, B, C, E, F