A nurse is taking care of a school-age child with acute glomerulonephritis who is taking potassium-sparing diuretics. The nurse anticipates discussing the diet with the child and his parents. The diet should include:

Correct Answer: D

Rationale: The correct answer is D: A sodium restriction. In acute glomerulonephritis, the kidneys are not effectively filtering out waste, leading to fluid retention and high blood pressure. Potassium-sparing diuretics help the kidneys remove excess fluid and sodium, so a sodium restriction is necessary to prevent fluid buildup and maintain electrolyte balance. Potassium-rich foods (choice A) should be limited due to the risk of hyperkalemia with potassium-sparing diuretics. Foods low in cholesterol (choice B) are not specifically indicated for acute glomerulonephritis. An increase in calories (choice C) is not necessary for this condition and may lead to weight gain, complicating management.

Correct Answer: B

Rationale: The correct answer is B, failure to pass meconium and abdominal distension. Hirschsprung disease results in the absence of ganglion cells in the distal part of the colon, leading to functional obstruction. Failure to pass meconium is a classic sign due to the inability of affected segment to relax, causing stool accumulation. Abdominal distension occurs as a result of the buildup of stool and gas proximal to the affected segment. Choices A, C, and D do not align with the characteristic clinical manifestations of Hirschsprung disease. Acute diarrhea and dehydration are not typical symptoms. Currant jelly stools and pain are more indicative of intussusception. Projectile vomiting and altered electrolytes are not commonly associated with Hirschsprung disease.

Correct Answer: B

Rationale: The correct answer is B: Vitamin D. Breastfed infants, especially those with darker skin or born in late fall/winter, are at risk of vitamin D deficiency due to limited sun exposure. Vitamin D is crucial for bone health and immune function. Iron (Choice A) is typically recommended around 4-6 months, not necessarily based on race. Fluoride (Choice C) is not recommended until at least 6 months. Calcium (Choice D) is not needed as a supplement for infants under 6 months.

Correct Answer: B

Rationale: The correct answer is B because toddlers typically understand more words and concepts than they can express verbally due to their limited vocabulary and developing language skills. This is supported by research in child development showing that receptive language skills (understanding language) usually precede expressive language skills (speaking). Toddlers may struggle to articulate their thoughts and feelings, leading to frustration. Now, let's evaluate the other choices: A: Language development skills actually accelerate during the toddler period, not slow down. C: While toddlers may have pronunciation issues, most of their speech is usually understood by caregivers. D: A toddler's vocabulary usually ranges from 200 to 500 words, not strictly 600 words.

Correct Answer: B

Rationale: The correct answer is B, Notify practitioner of the observation. This is the most appropriate action because a weaker pulse distal to the catheter insertion site could indicate impaired circulation, potentially leading to complications like ischemia. Notifying the practitioner promptly allows for a timely assessment and intervention to prevent further complications. Elevating the affected extremity (A) may worsen circulation, recording data (C) is important but not as urgent as notifying the practitioner, and applying warm compresses (D) is not indicated for this situation and could exacerbate any circulatory issues.