Early initiation of oral penicillin therapy in the patient in Question 12 would most likely

Correct Answer: D

Rationale: In this scenario, the correct answer is D) None of the above. Early initiation of oral penicillin therapy in a patient with pediatric genitourinary disorders would not directly lead to the outcomes mentioned in the other options. Option A) eliminate the pharyngeal spread to others: This is incorrect because penicillin therapy would not directly eliminate the spread of the disorder to others, as it primarily targets the bacterial infection within the individual. Option B) prevent the glomerulonephritis: This is incorrect because penicillin therapy is not specifically indicated for preventing glomerulonephritis, which is a condition characterized by inflammation in the kidneys. Option C) cure the glomerulonephritis: This is incorrect because while penicillin therapy may help treat bacterial infections associated with genitourinary disorders, it does not directly cure glomerulonephritis, which requires specific treatments based on the underlying cause. In an educational context, it is crucial to understand the appropriate use of antibiotics like penicillin in pediatric patients with genitourinary disorders. While antibiotics play a vital role in treating bacterial infections, it is important to use them judiciously and according to evidence-based guidelines to prevent antibiotic resistance and ensure effective treatment outcomes. Understanding the specific indications for antibiotics in different conditions is essential for providing safe and effective care to pediatric patients.

Correct Answer: C

Rationale: The correct answer is C) 35 mL/min/1.73 m2. In full-term neonates, the glomerular filtration rate (GFR) is approximately 35 mL/min/1.73 m2. This rate reflects the efficiency of the kidneys in filtering blood over a specific time period and body surface area. Neonates have immature renal function at birth, and GFR gradually increases during the first few weeks of life. Option A) 15 mL/min/1.73 m2 is too low for a full-term neonate and would indicate significant renal impairment. Option B) 25 mL/min/1.73 m2 is also lower than the typical GFR for a full-term neonate. Option D) 45 mL/min/1.73 m2 is higher than the average GFR for a full-term neonate and would be more typical of older children or adults. Understanding normal pediatric GFR values is crucial for nurses and healthcare providers caring for infants to assess renal function accurately, monitor for renal disorders, and adjust medication dosages based on renal clearance. This knowledge is particularly important in pediatric pharmacology to prevent medication-related complications in this vulnerable population.

Correct Answer: A

Rationale: In pediatric pharmacology, understanding genitourinary disorders is crucial for nursing practice. In this NCLEX question, the correct answer is A) male gender. This is because females have a higher risk of urinary tract infections (UTIs) due to a shorter urethra, facilitating the entry of bacteria into the bladder. Option B) tight clothing (underwear) can increase the risk of UTIs by creating a warm, moist environment that promotes bacterial growth. Option C) pinworm infestation is associated with perianal itching but does not directly increase the risk of UTIs. Option D) poor toilet training may contribute to UTIs due to improper hygiene practices, but it is not a direct risk factor like being male. Educationally, this question highlights the importance of understanding risk factors for UTIs in pediatric patients. Nurses need to be aware of gender-specific risks, hygiene practices, and environmental factors that can predispose children to genitourinary infections. By mastering this knowledge, nurses can provide effective patient education and preventive care to reduce the incidence of UTIs in pediatric populations.

Correct Answer: D

Rationale: In the context of pediatric genitourinary disorders, particularly acute cystitis, prompt and effective treatment is crucial to prevent the progression to pyelonephritis, a more severe condition. The LEAST effective drug among the options provided is nitrofurantoin (Option D). Nitrofurantoin is less commonly used in pediatric patients for the treatment of urinary tract infections due to its potential side effects and limited spectrum of activity. It is not recommended for use in children under the age of one month or for the treatment of pyelonephritis. Trimethoprim-sulfamethoxazole (Option A), cephalexin (Option B), and ciprofloxacin (Option C) are more commonly prescribed antibiotics for the treatment of cystitis in pediatric patients. They have a broader spectrum of activity and are generally more effective in treating urinary tract infections in this population. Educationally, understanding the appropriate selection of antibiotics for pediatric genitourinary disorders is essential for healthcare providers managing these conditions. It is important to consider factors such as the child's age, weight, previous antibiotic exposure, and the likely causative organism when choosing the most appropriate treatment to ensure optimal outcomes and prevent complications like pyelonephritis.

Correct Answer: B

Rationale: In pediatric genitourinary disorders, understanding the grading of antenatal hydronephrosis is crucial. In this scenario, the correct answer is B) ureteropelvic junction obstruction. This condition is a common cause of antenatal hydronephrosis, where there is an obstruction at the junction of the ureter and the renal pelvis. This obstruction leads to dilation of the renal pelvis, resulting in hydronephrosis. Option A) vesicoureteral reflux involves the backflow of urine from the bladder to the ureters and kidneys, which can lead to hydronephrosis but is not the most likely cause in this context. Option C) transient hydronephrosis refers to a temporary dilation of the renal pelvis, often resolving on its own without intervention. It is not typically graded based on the trimester and antero-posterior diameter. Option D) posterior urethral valve is a congenital condition affecting male infants where there is an obstruction of the urethra, leading to hydronephrosis and other complications. While it can cause hydronephrosis, ureteropelvic junction obstruction is more commonly associated with the grading criteria mentioned in the question. Educationally, understanding the different causes of antenatal hydronephrosis and their characteristic features is essential for pediatric nurses and healthcare providers to provide appropriate care and interventions for infants with genitourinary issues. Recognizing the most likely cause based on grading criteria helps in timely diagnosis and management, leading to better outcomes for pediatric patients.