All of the following are true about nephrotic syndrome EXCEPT

Correct Answer: C

Rationale: In nephrotic syndrome, the correct answer is C) reduced sodium reabsorption by the kidney. This is because nephrotic syndrome is characterized by increased glomerular permeability leading to proteinuria, hypoalbuminemia, edema, and hyperlipidemia. The reduced sodium reabsorption is not a typical feature of nephrotic syndrome. Option A) elevated serum cholesterol is true because nephrotic syndrome leads to increased synthesis of lipoproteins due to loss of proteins in the urine. Option B) 85% experience minimal change in disease is true as most cases of nephrotic syndrome in children are due to minimal change disease. Option D) elevated serum triglycerides is also true as hypertriglyceridemia is commonly seen in nephrotic syndrome. Educationally, understanding the pathophysiology of nephrotic syndrome is crucial for nurses and healthcare professionals caring for pediatric patients. Recognizing the characteristic features of the syndrome, such as the lipid abnormalities and proteinuria, is essential for accurate diagnosis and management. This knowledge also helps in providing appropriate patient education and family support regarding the condition and its treatment.

Correct Answer: A

Rationale: The correct answer is renal abscess (Option A). A horseshoe kidney is a congenital anomaly where the kidneys are fused at the lower poles. This abnormality can lead to complications due to its altered position and blood supply. Renal abscess is a potential complication of a horseshoe kidney due to the presence of stagnant urine in the renal pelvis, which creates an environment conducive to infection and abscess formation. Option B, neuroblastoma, is a type of cancer that arises from immature nerve cells and is not directly related to horseshoe kidney anomalies. Option C, bladder outlet obstruction, is not a common complication of horseshoe kidney but can occur due to other structural or functional abnormalities in the urinary tract. Option D, familial renal dysplasia, is a genetic disorder characterized by abnormal kidney development and is not specifically associated with horseshoe kidney malformation. In an educational context, understanding the potential complications of horseshoe kidney is crucial for nurses, pharmacists, and other healthcare providers caring for pediatric patients. This knowledge helps in early identification and management of complications, ensuring optimal patient outcomes. It also underscores the importance of comprehensive assessment and monitoring in pediatric patients with congenital genitourinary anomalies.

Correct Answer: C

Rationale: In pyelonephritis, a high risk of renal scarring is associated with an elevated procalcitonin level. Procalcitonin is a biomarker that is specifically elevated in response to bacterial infections such as pyelonephritis. The presence of elevated procalcitonin levels indicates a severe bacterial infection, which can lead to renal scarring if not promptly treated. This is crucial in pediatric patients as renal scarring can have long-term consequences on kidney function. Option A, erythrocyte sedimentation rate (ESR), is a nonspecific marker of inflammation and does not directly correlate with the severity of pyelonephritis or the risk of renal scarring. Option B, C-reactive protein (CRP), is also a general marker of inflammation and infection, but it is not as specific to bacterial infections as procalcitonin. Option D, white blood cell count (WBC), can be elevated in response to any infection, not specifically bacterial ones like pyelonephritis. Understanding the significance of procalcitonin levels in pyelonephritis is essential for nurses and healthcare professionals caring for pediatric patients with genitourinary infections. Monitoring procalcitonin levels can help in early detection of severe bacterial infections like pyelonephritis and guide appropriate treatment to prevent complications such as renal scarring.

Correct Answer: D

Rationale: The correct answer is D: "contrast VCUG is significantly exposed to less radiation than radionuclide cystogram." In pediatric pharmacology, it is crucial to understand the diagnostic procedures used to assess conditions like vesicoureteral reflux (VUR). A voiding cystourethrogram (VCUG) is a common imaging test to diagnose VUR in children. The use of contrast during VCUG allows for clear visualization of the urinary tract, specifically the bladder and ureters, to detect any reflux of urine from the bladder into the ureters. Among the options provided, option D is the most appropriate statement because it highlights an important aspect of VCUG compared to radionuclide cystogram, which involves exposure to ionizing radiation. VCUG uses contrast media, which exposes the child to less radiation compared to radionuclide studies, making it a safer option for diagnosing VUR in pediatric patients. Options A, B, and C are incorrect because they do not address the specific differences between VCUG and radionuclide cystogram in terms of radiation exposure. Understanding the nuances of diagnostic tests is essential in pediatric pharmacology to ensure safe and effective patient care. Educationally, this question highlights the importance of selecting the most appropriate diagnostic test based on factors such as radiation exposure, efficacy, and safety when evaluating pediatric patients for conditions like VUR. It reinforces the need for healthcare providers to have a solid understanding of diagnostic procedures to make informed decisions for optimal patient outcomes.

Correct Answer: D

Rationale: The most appropriate statement among the options regarding ureteroceles being a cystic dilation of the terminal ureter is option D: it commonly causes bladder outlet obstruction. Rationale: - Option D is correct because ureteroceles, by their nature as cystic dilations at the end of the ureter, can obstruct the flow of urine from the ureter into the bladder, leading to bladder outlet obstruction. This obstruction can result in various complications such as urinary retention, urinary tract infections, and renal damage. - Option A is incorrect because ureteroceles are actually more common in girls rather than boys. This is due to anatomical differences in the genitourinary tract between males and females. - Option B is incorrect because ureteroceles can indeed be diagnosed prenatally using imaging techniques such as ultrasound. Early detection and management of ureteroceles are crucial in preventing complications. - Option C is incorrect as it does not provide a coherent statement. However, if we assume the intended statement was that ureteroceles can be associated with other ureteral abnormalities prenatally, this would not be the most appropriate statement as the primary characteristic of ureteroceles is the cystic dilation of the terminal ureter, not its association with other ureteral abnormalities. Educational Context: Understanding ureteroceles and their potential complications is essential for healthcare providers, especially those working with pediatric patients. Recognizing the signs and symptoms of ureteroceles, as well as understanding their management and potential impact on the genitourinary system, is crucial for providing safe and effective care to pediatric patients with this condition. This knowledge is particularly relevant for nurses, nurse practitioners, and other healthcare professionals who may encounter pediatric patients with genitourinary issues in various clinical settings.