A 12-year-old girl has recently begun menstruating and is well into puberty. The child is visiting the health care provider today for a routine physical examination. Which finding should cause concern in the nurse?

Correct Answer: C

Rationale: Vulvar irritation may indicate an infection or other issues and should be further evaluated. In a pubescent girl, breasts of slightly different sizes and irregular periods are common variations of normal development. Supernumerary nipple, an extra nipple, is a benign condition that is not typically concerning during puberty.

Correct Answer: A

Rationale: In this question from the ATI RN Nursing Care of Children exam, the correct answer is A) Cystitis. Cystitis refers to inflammation of the bladder, commonly caused by bacterial infection. This condition is prevalent in children, especially girls, due to their anatomy and proximity of the urethra to the anus. Option B) Urethritis is incorrect as it specifically refers to inflammation of the urethra, not the bladder. Option C) Urosepsis is a severe condition characterized by bacteria in the bloodstream, not localized to the bladder. Option D) Bacteriuria simply means bacteria in the urine, which may be present in cystitis but does not define the specific inflammation of the bladder. Educationally, understanding the differences in terminology is crucial for accurate diagnosis and treatment in pediatric patients. Nurses must be able to differentiate between these conditions to provide appropriate care and prevent complications. It highlights the importance of assessing urinary symptoms in children and implementing interventions to manage and treat cystitis effectively.

Correct Answer: C

Rationale: In teaching a client about preventing future urinary tract infections (UTIs), emphasizing urinary stasis as the potential cause is crucial. Urinary stasis refers to the stagnant flow of urine within the urinary system, which can lead to bacterial overgrowth and UTIs. By educating the client on the importance of maintaining adequate hydration, regular voiding, and complete bladder emptying, nurses can help prevent urinary stasis and subsequent infections. Poor hygiene, while important in UTI prevention, is not the most critical factor to emphasize in this scenario. Proper hygiene practices such as wiping from front to back can help reduce the risk of introducing bacteria into the urinary tract but may not address the underlying issue of urinary stasis. Constipation can contribute to UTIs by putting pressure on the bladder and urinary tract, but it is not as directly linked to UTIs as urinary stasis. Constipation management should still be addressed in overall client education but may not be the primary focus when discussing UTI prevention. Congenital anomalies, while they can predispose individuals to UTIs, are not typically within the client's control for prevention. Emphasizing factors that the client can actively manage, like urinary stasis, provides practical and actionable steps for UTI prevention. In an educational context, teaching about UTI prevention is essential for promoting client wellness and reducing healthcare costs associated with UTI treatment. By empowering clients with knowledge about modifiable risk factors like urinary stasis, nurses can play a vital role in promoting long-term urinary health and overall well-being.

Correct Answer: C

Rationale: The correct answer is C) Urinary tract infection (UTI). The child's presentation of urinary incontinence is concerning for a possible UTI. UTIs are fairly common in children and can present with symptoms such as frequent urination, urgency, and incontinence. It is important to promptly diagnose and treat UTIs in children to prevent complications such as kidney damage. Option A) School phobia is unlikely to cause urinary incontinence. School phobia is characterized by anxiety related to attending school. Option B) Glomerulonephritis typically presents with symptoms such as hematuria, proteinuria, and hypertension, rather than urinary incontinence. Option D) Attention deficit hyperactivity disorder (ADHD) does not typically cause urinary incontinence as a primary symptom. It is more commonly associated with symptoms related to inattention, hyperactivity, and impulsivity. As educators, it is crucial to highlight the importance of recognizing common pediatric conditions like UTIs and understanding their diverse presentations in children. Educating parents and caregivers on the signs and symptoms of UTIs can lead to early detection and appropriate management, ultimately promoting the health and well-being of children.

Correct Answer: C

Rationale: The correct recommendation to prevent urinary tract infections (UTIs) in young girls is to cleanse the perineum with water after voiding (Option C). This is because good perineal hygiene helps to reduce the risk of introducing bacteria into the urinary tract, which can lead to UTIs. By cleansing the perineum with water after voiding, the nurse can help to maintain cleanliness and reduce the likelihood of bacterial contamination. Option A, avoiding public toilet facilities, is not the most effective recommendation for preventing UTIs in young girls. While it is important to use clean and hygienic toilet facilities, simply avoiding public toilets does not address the root cause of UTIs. Option B, limiting long baths as much as possible, is also not the most appropriate recommendation. While prolonged exposure to water can sometimes contribute to UTIs, the key factor in preventing UTIs is maintaining good perineal hygiene rather than solely focusing on the duration of baths. Option D, ensuring clear liquid intake of 2 L/day, is a general recommendation for overall health but may not directly prevent UTIs. While adequate hydration is important for urinary tract health, it is not as directly related to preventing UTIs as maintaining good perineal hygiene. In an educational context, it is important for nurses to understand the specific measures that can help prevent UTIs in young girls. Teaching proper perineal hygiene practices can empower both the young girls and their caregivers to take proactive steps in reducing the risk of UTIs, promoting overall health and well-being.