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 genitourinary nursing interventions, understanding the appropriate management of children with end-stage renal disease (ESRD) is crucial. The correct answer is A) 15 ml/min/1.73 m2. This is because children with ESRD typically require intervention when their glomerular filtration rate drops below this level, indicating severe kidney dysfunction. Option B) 25 ml/min/1.73 m2 is incorrect as waiting for the GFR to drop to this level may delay necessary interventions and jeopardize the child's health. Option C) 35 ml/min/1.73 m2 is also incorrect as it is above the threshold at which intervention is usually recommended for ESRD in children. Option D) 45 ml/min/1.73 m2 is well above the critical level at which renal replacement therapy is typically initiated in children with ESRD. Educationally, this question highlights the importance of early recognition and intervention in pediatric patients with ESRD to prevent complications and improve outcomes. Nurses and healthcare providers must be aware of the appropriate thresholds for dialysis or renal transplantation in children to provide timely and effective care for this vulnerable population.

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: In pediatric genitourinary nursing, diaper dermatitis is a common condition that requires appropriate management. The first-line treatments focus on maintaining a dry and clean diaper area to promote healing and prevent further irritation. Option A, frequent diaper changes, is crucial in preventing prolonged exposure to moisture and irritants, which can exacerbate diaper rash. Option B, increasing diaper-free period, allows the skin to breathe and reduces friction, aiding in the healing process. Option C, frequent bathing, helps in cleaning the area and keeping it free from irritants. The correct answer, option D, antifungal treatment, is not typically a first-line treatment for diaper dermatitis unless there is a confirmed fungal infection. In most cases, diaper dermatitis is caused by irritation and moisture, making antifungal treatment unnecessary as an initial intervention. Educationally, understanding the appropriate first-line treatments for diaper dermatitis is essential for pediatric nurses to provide effective care for infants and children. By recognizing the importance of maintaining a dry and clean diaper area, nurses can help prevent and manage diaper dermatitis efficiently, ensuring the well-being of their pediatric patients.

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.