A 3-week-old neonate with abdominal mass. Of the following the MOST common cause is

Correct Answer: A

Rationale: The correct answer is A) ureteropelvic junction obstruction. In a 3-week-old neonate with an abdominal mass, ureteropelvic junction obstruction is the most common cause. This condition occurs when there is a blockage at the junction where the ureter meets the renal pelvis, leading to dilation of the renal pelvis and calyces, resulting in an abdominal mass. Obstructive megaureter (option B) refers to the dilation of the ureter, which is less common in neonates compared to ureteropelvic junction obstruction. Posterior urethral valves (option C) are more commonly seen in male infants and typically present with hydronephrosis rather than an abdominal mass. Multicystic renal dysplasia (option D) is a congenital condition characterized by non-functional cysts in the kidney, usually presenting as a palpable flank mass rather than an abdominal mass in neonates. In an educational context, understanding the differential diagnosis of abdominal masses in neonates is crucial for pediatric genitourinary nursing interventions. Recognizing the most common causes, such as ureteropelvic junction obstruction in this case, can guide appropriate diagnostic workup and treatment strategies to ensure optimal patient outcomes.

Correct Answer: D

Rationale: Bloody nipple discharge in infants is a concerning symptom that requires careful evaluation. The correct answer is D) mammary duct ectasia. Mammary duct ectasia is a condition where the milk ducts beneath the nipple become blocked or clogged, leading to inflammation and possible bleeding. In infants, this can occur due to factors like pressure on the breast tissue during feeding or a build-up of milk within the ducts. Option A) chronic nipple irritation is less likely in infants as they are not typically exposed to the same factors that may cause chronic irritation in adults, such as friction from clothing or improper latch during breastfeeding. Option B) ducts of Montgomery are normal structures in the breast that secrete an oily fluid to lubricate the nipple. They are not typically associated with bloody discharge. Option C) hypothalamic tumors are extremely rare in infants and would present with a range of other symptoms beyond just bloody nipple discharge. In an educational context, understanding the causes of bloody nipple discharge in infants is crucial for pediatric nurses to provide appropriate care and guidance to parents. It highlights the importance of thorough assessment, proper evaluation, and the need for further investigation to rule out any underlying conditions that may be contributing to this symptom.

Correct Answer: B

Rationale: In the context of pediatric genitourinary nursing interventions, understanding the potential causes of hirsutism is crucial for providing effective care to pediatric patients. Hirsutism, the abnormal growth of hair in areas where hair growth is normally minimal or absent, can be caused by various factors, including medications. The correct answer, option B (acetazolamide), does not typically cause hirsutism. Acetazolamide is a diuretic primarily used to treat glaucoma and altitude sickness, and it is not commonly associated with hirsutism as a side effect. Option A (hydrochlorothiazide) is a diuretic that can cause hirsutism as a side effect due to its hormonal effects on the body. Option C (cyclophosphamide) is a chemotherapy drug that can lead to hirsutism as a side effect, as it can disrupt normal cell growth processes, affecting hair growth. Option D (anabolic steroids) are known to cause hirsutism due to their androgenic effects, leading to excessive hair growth. In an educational context, understanding the side effects of medications commonly used in pediatric patients is essential for nurses to anticipate and manage potential complications. By knowing which medications may cause hirsutism, nurses can monitor patients effectively, report any concerning symptoms to the healthcare team, and provide appropriate education to patients and families.

Correct Answer: C

Rationale: The correct answer is C) Yersinia. Leiomyosarcoma is a malignant smooth muscle tumor that can occur in the genitourinary system, particularly in the bladder and uterus. Yersinia is a genus of bacteria known to cause infections in humans, including Yersinia enterocolitica and Yersinia pseudotuberculosis. While the exact pathogenesis of leiomyosarcoma is not fully understood, some studies suggest a potential correlation between Yersinia infection and the development of leiomyosarcoma. Option A) Epstein-Barr virus is not associated with leiomyosarcoma. Epstein-Barr virus is linked to certain types of cancers, such as Burkitt's lymphoma and nasopharyngeal carcinoma, but not leiomyosarcoma. Option B) Haemophilus influenzae is a bacterium that commonly causes respiratory tract infections and is not linked to leiomyosarcoma. Option D) Nocardia is a genus of bacteria that can cause a variety of infections in humans, but there is no known correlation between Nocardia infection and leiomyosarcoma. In an educational context, understanding the potential etiology and risk factors for leiomyosarcoma is crucial for healthcare professionals, especially those working in pediatric genitourinary nursing. It highlights the importance of recognizing possible infectious triggers for certain malignancies and underscores the need for further research in this area to improve diagnosis and treatment strategies.

Correct Answer: D

Rationale: An imperforate hymen is a congenital condition where the hymen completely obstructs the vaginal opening, leading to menstrual blood accumulation in the vagina. The correct answer, option D, stating that it cannot be diagnosed in the newborn period, is accurate. Imperforate hymen is typically not diagnosed at birth because it does not present with immediate symptoms. Option A, stating an incidence of approximately 1 in 1,000, is a common occurrence in clinical practice, making it a plausible statement. Option B, normal secondary sex characters, is incorrect as imperforate hymen can lead to cyclic abdominal pain and distension due to the retention of menstrual blood. Option C, stating it is more often diagnosed at the time of menarche, is also incorrect as symptoms may present earlier, such as cyclic abdominal pain or urinary retention. Educationally, it is crucial for pediatric nurses to understand the signs and symptoms of imperforate hymen to facilitate early diagnosis and intervention. By recognizing the condition promptly, healthcare providers can prevent complications such as hematocolpos or hematometra. Nurses should educate both patients and caregivers about the importance of seeking medical attention for any abnormal genital symptoms to ensure timely management and prevent long-term consequences.