ATI RN
NCLEX Pediatric Genitourinary Practice Questions Questions
Question 1 of 5
A 12-year-old girl with nephrotic syndrome (NS) secondary to hepatitis B infection.
Correct Answer: B
Rationale: In this scenario, the correct answer is B) membranous nephropathy. Membranous nephropathy is the most common cause of nephrotic syndrome in adults but can also occur in children. In this case, the 12-year-old girl with nephrotic syndrome secondary to hepatitis B infection is likely to have membranous nephropathy as it is a known complication of hepatitis B infection. Regarding the incorrect options: A) Membranoproliferative glomerulonephritis is characterized by mesangial cell proliferation and thickening of the glomerular capillary wall, which is not typically associated with hepatitis B infection-related nephrotic syndrome. C) Focal segmental glomerulosclerosis is more commonly seen in African American children and is not directly linked to hepatitis B infection. D) Minimal change nephrotic syndrome is often seen in children and is characterized by foot process effacement on electron microscopy, but it is not specifically associated with hepatitis B infection-related nephrotic syndrome. Educationally, understanding the different types of glomerulonephritis and their associations with specific conditions is crucial for nurses and healthcare providers caring for pediatric patients with renal disorders. This knowledge helps in accurate diagnosis, appropriate management, and better patient outcomes. It also highlights the importance of considering underlying etiologies in nephrotic syndrome cases to provide targeted treatment and supportive care.
Question 2 of 5
A 3-month-old baby boy had history of upper respiratory tract infection before two days ago presented to ER with repeated fit, rapid breathing, face swelling, and urine output <0.5 ml/kg/h.
Correct Answer: A
Rationale: The correct answer is A) Increased lactate dehydrogenase (LDH). In this scenario, the presentation of the 3-month-old baby boy with repeated fits, rapid breathing, face swelling, and decreased urine output indicates a possible hemolytic crisis, which can be seen in conditions like glucose-6-phosphate dehydrogenase (G6PD) deficiency. Increased LDH is a marker of hemolysis, which occurs in G6PD deficiency during hemolytic episodes. Option B) increased haptoglobin would be decreased in hemolysis as it binds free hemoglobin in the blood. Option C) Increased direct bilirubin would be seen in conditions like biliary obstruction, not typically in hemolysis. Option D) decreased aspartate aminotransferase (AST) is not specifically associated with hemolysis. Educationally, understanding the laboratory markers associated with different conditions is crucial in pediatric pharmacology. Recognizing the significance of LDH elevation in hemolytic crises like in G6PD deficiency can aid in timely diagnosis and management in pediatric patients. This case underscores the importance of thorough assessment and interpretation of clinical and laboratory findings in pediatric genitourinary emergencies.
Question 3 of 5
Of the following, the MOST common intrinsic cause of acute kidney injury (AKI) in childhood is
Correct Answer: D
Rationale: The correct answer is D) Acute tubular necrosis. Acute tubular necrosis is the most common intrinsic cause of acute kidney injury in children. This condition is characterized by damage to the renal tubules due to ischemia, nephrotoxic medications, or sepsis. In children, factors such as dehydration, sepsis, and exposure to nephrotoxic medications can contribute to the development of acute tubular necrosis. Option A) Acute interstitial nephritis is more commonly seen in adults and is characterized by inflammation of the renal interstitium due to medications or infections. Option B) Rhabdomyolysis can lead to kidney injury due to the release of myoglobin into the bloodstream, but it is not the most common cause of AKI in children. Option C) Glomerulonephritis involves inflammation of the glomeruli in the kidney and is more commonly seen in chronic kidney disease rather than acute kidney injury in children. Educationally, it is important for healthcare providers to be able to differentiate between the various causes of acute kidney injury in children to provide prompt and appropriate management. Understanding the etiology of AKI helps in implementing preventive strategies and tailored treatment plans to improve patient outcomes.
Question 4 of 5
Children with end-stage renal disease (ESRD) are typically treated with either dialysis or renal transplantation when glomerular filtration rate is less than
Correct Answer: A
Rationale: In pediatric patients with end-stage renal disease (ESRD), the glomerular filtration rate (GFR) is a crucial indicator of kidney function and the need for renal replacement therapy. The correct answer, A) 15 ml/min/1.73 m2, is the threshold at which children with ESRD are typically considered for either dialysis or renal transplantation. Option B) 25 ml/min/1.73 m2 is higher than the typical GFR threshold for initiating renal replacement therapy in children with ESRD. Option C) 35 ml/min/1.73 m2 and Option D) 45 ml/min/1.73 m2 are even further above the threshold, indicating relatively preserved renal function that would not usually necessitate immediate intervention such as dialysis or transplantation. Educationally, understanding the GFR threshold for initiating renal replacement therapy in pediatric ESRD is vital for nurses and healthcare providers caring for these vulnerable patients. This knowledge helps in timely intervention to prevent complications associated with advanced kidney disease and ensures optimal management to improve outcomes and quality of life for pediatric patients with ESRD.
Question 5 of 5
Children with kidney transplant generally do well, but have to take immunosuppressive medications associated with a variety of side effects which include all the following EXCEPT
Correct Answer: D
Rationale: In the context of pediatric kidney transplant patients, it is crucial for nurses and healthcare professionals to have a comprehensive understanding of the medications and potential side effects associated with post-transplant care. In this scenario, the correct answer is option D) sudden death. The rationale behind sudden death not being associated with immunosuppressive medications is that while these medications have a range of potential side effects, sudden death is not a common or direct side effect linked to their use. Instead, sudden death in pediatric kidney transplant patients is more likely to be related to other factors such as rejection episodes, infections, or underlying medical conditions. Option A) nephrotoxicity is a potential side effect of immunosuppressive medications, as these drugs can put additional strain on the kidneys over time. Option B) cardiovascular complications can also be a concern due to the impact of these medications on the cardiovascular system. Option C) increased risk for certain malignancies is another known side effect, as immunosuppression can make patients more susceptible to developing certain types of cancers. In an educational context, understanding the side effects of immunosuppressive medications in pediatric kidney transplant patients is vital for providing safe and effective care. Nurses need to be able to recognize and manage potential complications, monitor for signs of adverse effects, and educate patients and families on the importance of adherence to medication regimens while being vigilant for any concerning symptoms that may arise.