A 5-year-old patient had poor growth secondary to chronic kidney disease. Of the following

Correct Answer: D

Rationale: The correct answer is D) recombinant GH. Growth hormone (GH) deficiency is a common complication of chronic kidney disease in children, leading to poor growth. Recombinant GH therapy can help stimulate growth in these patients. Option A) increased caloric intake may be necessary for some children with chronic kidney disease, but it does not directly address the underlying issue of poor growth due to GH deficiency. Option B) correction of acidosis is important in managing chronic kidney disease but does not directly address the growth issue related to GH deficiency. Option C) recombinant GH is the most appropriate intervention for poor growth due to GH deficiency in children with chronic kidney disease. Educationally, understanding the specific treatment modalities for complications of chronic kidney disease in children is crucial for nurses and healthcare providers caring for pediatric patients. Recognizing the impact of growth hormone deficiency on growth and the appropriate use of recombinant GH therapy is essential in providing comprehensive care to these patients.

Correct Answer: C

Rationale: Infectious vulvovaginitis is a common pediatric condition characterized by inflammation of the vulva and vagina due to infection. In this context, the least likely cause among the options provided is Haemophilus influenza (Option C). Haemophilus influenza is not a typical pathogen associated with vulvovaginitis. It is more commonly known for causing respiratory tract infections, otitis media, and invasive diseases like meningitis in children. Therefore, it is less likely to be the causative agent in infectious vulvovaginitis. Escherichia coli (Option A) is a common bacteria found in the gastrointestinal tract and can cause urinary tract infections that may lead to secondary vulvovaginitis. Staphylococcus aureus (Option B) is a known pathogen that can cause skin and soft tissue infections, including vulvovaginitis. Enterobius vermicularis (Option D) refers to pinworms, which can lead to vaginal itching and irritation, contributing to vulvovaginitis in children. Understanding the etiology of infectious vulvovaginitis is crucial for healthcare providers, especially when assessing pediatric patients. By recognizing the common pathogens associated with this condition, appropriate treatment and management strategies can be implemented effectively.

Correct Answer: B

Rationale: The correct answer is B) left wrist x-ray. The gold standard diagnostic investigation for precocious puberty is assessing bone age through a left wrist x-ray. This method helps determine the child's skeletal maturation and compare it to their chronological age. In precocious puberty, the child's bone age will be advanced compared to their chronological age, indicating early puberty onset. Option A) Tanner maturing rate is used to assess sexual development stages but not the gold standard for diagnosing precocious puberty. Option C) serum luteinizing hormone levels and Option D) gonadotropins measurement can be elevated in precocious puberty but are not the primary diagnostic tools. Educationally, understanding the importance of accurate diagnostic methods in pediatric endocrinology is crucial for nurses and healthcare providers. Recognizing precocious puberty early allows for appropriate management to address underlying causes and prevent potential complications related to early puberty onset. Mastery of these concepts is essential for nurses preparing for the NCLEX exam to ensure safe and competent pediatric care.

Correct Answer: B

Rationale: The correct answer is B) fibroadenoma. In adolescent girls, fibroadenomas are the most common solid breast masses. Fibroadenomas are benign tumors composed of glandular and connective tissue. They are hormone-responsive and often present as painless, well-defined masses that are mobile and smooth. A) Lipomas are benign fatty tumors and are not commonly seen in the breast tissue of adolescent girls. C) Lymphangiomas are malformations of the lymphatic system and are typically found in areas other than the breast. D) Hamartomas are disorganized benign growths of normal tissues and are not typically seen as the most common solid mass in adolescent girls. Educationally, understanding the common types of breast masses in adolescent girls is crucial for nurses and healthcare providers working with this population. Recognizing fibroadenomas helps in providing appropriate care, reassurance, and guidance to young patients and their families. This knowledge is also essential for passing exams like the NCLEX, where clinical reasoning and diagnostic skills are tested.

Correct Answer: C

Rationale: The correct answer is C) endodermal sinus tumor. Endodermal sinus tumor, also known as yolk sac tumor, has a 5-year survival rate of 100% when treated early and appropriately. This type of germ cell tumor is highly responsive to current chemotherapy regimens, leading to a favorable prognosis in pediatric patients. Option A) gonadoblastoma is not a germ cell tumor associated with 100% 5-year survival rate. Gonadoblastoma is a rare tumor primarily found in individuals with disorders of sexual development. Option B) embryonal carcinoma is a malignant germ cell tumor that can have a variable prognosis depending on the stage at diagnosis and response to treatment. It does not have a consistent 100% 5-year survival rate. Option D) dysgerminoma is a common germ cell tumor in females, most often affecting the ovaries. While dysgerminoma has a relatively good prognosis compared to other ovarian tumors, it does not guarantee a 100% 5-year survival rate. In an educational context, understanding the different types of pediatric genitourinary tumors and their prognoses is crucial for healthcare professionals working with pediatric patients. This knowledge helps in early identification, appropriate treatment planning, and providing accurate information to patients and their families regarding the expected outcomes. It also emphasizes the importance of continuous learning and staying updated on current treatment guidelines to improve patient care and outcomes.