Stefan was diagnosed with secondary vesicoureteral reflux; such condition usually results from which of the following?

Correct Answer: D

Rationale: Secondary vesicoureteral reflux is a condition where urine flows backward from the bladder into the ureters and possibly towards the kidneys due to an underlying cause. In the majority of cases, it results from an infection in the urinary tract, particularly in the bladder. The infection leads to inflammation and weakening of the valves that normally prevent urine from refluxing back towards the kidneys. This condition is more common in children but can also occur in adults. Treating the underlying infection is essential to managing secondary vesicoureteral reflux and preventing complications such as kidney damage.

Correct Answer: C

Rationale: The correct action for the LPN to take in this situation is to inform the registered nurse. The patient's statement indicates a high level of fear and anxiety about the surgery and their potential outcome. It is important to involve the registered nurse, who can provide further assessment, support, and interventions to address the patient's concerns appropriately. Simply reassuring the patient or providing statistics about national surgery death rates may not address the underlying fear and may require additional support and intervention. Asking the family to comfort the patient may not be the most appropriate immediate action as the patient's concerns are specific and may require professional support. Bringing the registered nurse into the situation allows for a comprehensive approach to addressing the patient's emotional needs before the surgery.

Correct Answer: B

Rationale: When applying a new system for pain management, it is recommended to choose a site on the lower torso. This area is often a suitable location for applying transdermal pain medication patches because it tends to have fewer hair follicles, making it easier for the patch to adhere properly and be absorbed effectively. The lower torso also typically provides a discreet location for patch placement, helping to maintain patient privacy and comfort.

Correct Answer: D

Rationale: Hyperkalemia is a condition characterized by elevated levels of potassium in the blood. This can have serious effects on the heart, leading to cardiac arrhythmias which can be life-threatening. In acute renal failure, the kidneys are not able to properly regulate potassium levels in the blood, leading to a potential buildup of potassium, resulting in hyperkalemia. The nurse should recognize cardiac arrhythmias as a critical sign of hyperkalemia in a child with acute renal failure and take prompt action to address this electrolyte imbalance. Dyspnea, seizure, and oliguria are not typically directly correlated with hyperkalemia.

Correct Answer: D

Rationale: Chiari type II malformation is strongly associated with myelomeningocele, occurring in approximately 80-90% of cases due to abnormal cerebellar development and cranial settling.