The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine “looks funny.” He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100 °F (37.8 °C). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have:

Choice A reason: Rheumatic fever follows streptococcal infection but typically presents with joint pain, carditis, or rash, not puffy eyes or abnormal urine. Glomerulonephritis better matches the symptoms post-infection, making this incorrect for the suspected condition based on the child’s presentation and history. Choice B reason: Lipoid nephrosis causes edema and proteinuria but is not typically linked to recent infections or hematuria. Acute glomerulonephritis, often post-streptococcal, explains puffy eyes and abnormal urine, making this less fitting and incorrect for the child’s symptoms following ear infections. Choice C reason: Urinary tract infections cause dysuria or frequency, not puffy eyes or hematuria post-infection. Acute glomerulonephritis aligns with the history of ear infections (possible streptococcal link) and symptoms, making this incorrect for the suspected condition in this child with these signs. Choice D reason: Acute glomerulonephritis, often post-streptococcal (e.g., after ear infections), causes hematuria (“funny” urine), periorbital edema (puffy eyes), and headache. This aligns with pediatric nephrology evidence, making it the correct condition the nurse suspects based on the child’s symptoms and medical history.