A 3-week-old neonate with abdominal mass.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) posterior urethral valves. Posterior urethral valves are a congenital anomaly in male infants where there is an obstruction in the urethra, leading to urinary tract obstruction. This condition often presents with abdominal distention due to bladder distention and can lead to hydronephrosis and kidney damage if not promptly treated. Option A) ureteropelvic junction obstruction involves a blockage at the junction of the ureter and the renal pelvis, usually causing hydronephrosis, but this typically presents later in childhood and not in a 3-week-old neonate. Option B) obstructive megaureter refers to an enlarged ureter due to an obstruction, but it is less likely in a 3-week-old neonate and is usually less symptomatic compared to posterior urethral valves. Option D) multicystic renal dysplasia is a condition where the kidney develops cysts and fails to function properly, but it usually presents with a non-functional kidney rather than an abdominal mass in a neonate. Educationally, understanding pediatric genitourinary disorders is crucial for nurses and healthcare providers working with pediatric populations. Recognizing the signs and symptoms of conditions like posterior urethral valves early on can lead to timely interventions and prevent long-term complications for the child. This question highlights the importance of early assessment and intervention in pediatric patients with genitourinary issues.

Correct Answer: D

Rationale: The correct answer is D) GFR = 0.413 × Ht / Cr serum. In pediatric pharmacology, calculating Glomerular Filtration Rate (GFR) accurately is crucial for dosing medications. The revised Schwartz formula is commonly used to estimate GFR in children. In this formula, the height (Ht) of the child is divided by the serum creatinine (Cr) level. The coefficient 0.413 is determined to provide the most accurate estimation of GFR in pediatrics. Option A) GFR = 0.134 × Ht / Cr serum and Option C) GFR = 0.134 × Cr serum / Ht are incorrect because the coefficient value is not appropriate for accurately estimating GFR in pediatric patients. Option B) GFR = 0.413 × Cr serum / Ht is incorrect because the placement of variables is reversed, leading to an inaccurate estimation of GFR. Understanding the correct formula and coefficients is essential for nurses and healthcare providers working with pediatric patients to ensure safe and effective medication dosing based on renal function. Mastering pharmacology calculations like these is crucial for providing optimal patient care in pediatric settings.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) membranoproliferative glomerulonephritis. Nephrotic syndrome (NS) in pediatric patients can have various underlying causes, one of which is hepatitis B infection. Membranoproliferative glomerulonephritis is the most common type of secondary NS associated with hepatitis B infection in pediatric patients. Membranoproliferative glomerulonephritis is characterized by thickening of the glomerular basement membrane, mesangial cell proliferation, and hypercellularity. This results in impaired filtration and protein loss, leading to the clinical presentation of nephrotic syndrome. The other options (A, C, D) are less likely in this specific case. Membranous nephropathy is more commonly associated with hepatitis B infection in adults rather than children. Focal segmental glomerulosclerosis is more commonly seen in primary nephrotic syndrome rather than secondary causes. While these conditions can occur in pediatric patients, membranoproliferative glomerulonephritis is the most common type in this particular scenario. Educationally, understanding the specific associations of nephrotic syndrome in pediatric patients is crucial for healthcare providers to provide accurate diagnosis and appropriate management. This knowledge helps in tailoring treatment plans and improving patient outcomes.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) send for urine examination. The most likely finding in a 5-month-old boy with Fanconi syndrome would be low-molecular-weight proteins in the urine. Fanconi syndrome is a rare disorder where the proximal renal tubules are unable to reabsorb electrolytes and other substances properly, leading to their excretion in the urine. This results in low-molecular-weight proteins being detected in the urine, indicating renal dysfunction. Option B) hexagonal crystals is incorrect because these are more commonly associated with cystinuria, a condition characterized by the formation of cystine stones in the urinary tract, not Fanconi syndrome. Option C) red blood cell casts is incorrect as these are typically seen in conditions like glomerulonephritis or vasculitis, where there is damage to the glomeruli leading to the presence of red blood cells in the urine along with casts. Educationally, understanding the specific urinary findings associated with different pediatric genitourinary disorders is crucial for accurate diagnosis and appropriate management. This question highlights the importance of recognizing the characteristic urinary abnormalities seen in Fanconi syndrome, emphasizing the need for thorough assessment and investigation in pediatric patients presenting with renal issues.

Correct Answer: A

Rationale: In pediatric genitourinary disorders, understanding the impact of Verotoxin (VT)-producing Escherichia coli is crucial. The correct answer is A) 5% to 15% of affected children. This bacterium can lead to hemolytic uremic syndrome in a subset of affected individuals. Hemolytic uremic syndrome is a severe condition characterized by hemolytic anemia, thrombocytopenia, and acute kidney injury. Option B) 25% to 35% of affected children is incorrect because the incidence of hemolytic uremic syndrome caused by VT-producing E. coli is lower than this range. Option C) 45% to 55% and Option D) 65% to 75% are also incorrect as they overestimate the percentage of affected children who develop hemolytic uremic syndrome. Educationally, this question highlights the importance of recognizing the potential complications of VT-producing E. coli infections in pediatric patients. Understanding the prevalence of hemolytic uremic syndrome in affected children is crucial for accurate diagnosis and management in clinical practice. This knowledge is essential for nurses, nurse practitioners, and other healthcare professionals caring for pediatric patients with genitourinary disorders.