Glomerular hematuria is associated with

Correct Answer: A

Rationale: Glomerular hematuria is associated with urinary microscopic findings of RBC casts (Option A) because RBC casts are formed when red blood cells aggregate within the renal tubules, indicating bleeding at the glomerular level. This finding is characteristic of glomerular diseases like glomerulonephritis. Option B, minimal proteinuria on dipstick (<100 mg/dL), is incorrect because proteinuria is more commonly associated with tubular or interstitial kidney disorders rather than glomerular diseases. Option C, gross hematuria that is bright red or pink, is incorrect as gross hematuria can be seen in a variety of conditions, not specific to glomerular hematuria. Option D, the presence of leukocyte casts, is incorrect as leukocyte casts are indicative of inflammation in the renal tubules, usually seen in conditions like pyelonephritis. Educationally, understanding the significance of different urinary findings in pediatric genitourinary disorders is vital for nurses and healthcare professionals caring for pediatric patients. Recognizing the specific characteristics of glomerular hematuria can aid in early identification and appropriate management of renal conditions in children.

Correct Answer: D

Rationale: In the context of pediatric genitourinary disorders, specifically acute post-streptococcal glomerulonephritis, the rationale for why a renal biopsy should not be considered in the presence of a low C3 level in the first 2 months (option D) is crucial for understanding the management of this condition. Option D is the correct answer because a low C3 level in the first 2 months is a hallmark feature of post-streptococcal glomerulonephritis (PSGN). This condition is typically associated with low serum complement levels, particularly C3, due to the immune complex deposition in the glomeruli. Therefore, the presence of a low C3 level supports the diagnosis of PSGN and obviates the need for a renal biopsy in this context. Regarding the other options: - Option A: Acute renal failure can be a complication of PSGN and may warrant a renal biopsy to determine the underlying cause of the renal dysfunction. - Option B: Nephrotic syndrome is not typically associated with PSGN, and if present, a renal biopsy may be necessary to differentiate from other glomerular diseases that can cause nephrotic syndrome. - Option C: The absence of evidence of streptococcal infection does not preclude the diagnosis of PSGN, as the clinical presentation and laboratory findings (such as low C3 levels) are more indicative of the disease than direct evidence of recent streptococcal infection. Understanding when to perform a renal biopsy in pediatric patients with genitourinary disorders is essential for healthcare providers involved in the care of these patients. It helps in ensuring appropriate diagnostic workup, guiding treatment decisions, and preventing unnecessary invasive procedures when the clinical picture and laboratory findings are already indicative of a specific diagnosis like PSGN.

Correct Answer: B

Rationale: The correct answer is B) 80% of patients. In childhood systemic lupus erythematosus (SLE), renal involvement is a common complication, affecting approximately 80% of pediatric patients with the condition. This high prevalence underscores the importance of monitoring renal function in pediatric SLE patients to prevent complications like nephritis. Option A) 100% of patients is incorrect because while renal involvement is significant in pediatric SLE, it is not present in every single patient. Option C) 60% of patients and Option D) 40% of patients are also incorrect as they underestimate the prevalence of renal involvement in pediatric SLE. Educationally, understanding the high likelihood of renal involvement in pediatric SLE is crucial for nurses and healthcare professionals caring for these patients. Regular monitoring, early detection, and appropriate management of renal complications are essential in providing optimal care for children with SLE. This knowledge is important for nurses preparing for the NCLEX exam as it tests their ability to apply pharmacological principles in pediatric populations.

Correct Answer: D

Rationale: In this question, the correct answer is D) IgA nephropathy. Pulmonary-renal syndrome is a condition characterized by both pulmonary and renal involvement. IgA nephropathy typically presents with isolated renal manifestations and does not commonly involve the lungs. A) Systemic lupus erythematosus (SLE) is associated with pulmonary-renal syndrome due to immune complex deposition in the kidneys and lungs. B) Henoch-Schönlein purpura is a systemic vasculitis that can involve the kidneys and lungs, leading to pulmonary-renal syndrome. C) Microscopic polyangiitis is a small-vessel vasculitis that affects the kidneys and lungs, causing pulmonary-renal syndrome. It is crucial for nurses and pharmacology students to understand the connection between genitourinary disorders and other organ systems, especially in pediatric patients. Recognizing the manifestations of these diseases can aid in prompt diagnosis and appropriate management. Understanding the specific characteristics of each condition is vital for providing safe and effective care to pediatric patients with genitourinary disorders.

Correct Answer: D

Rationale: In this question, the correct answer is D) renal tubular acidosis---lithium. Rationale: Renal tubular acidosis (RTA) is a condition where the kidneys are unable to effectively remove acid from the body, leading to metabolic acidosis. Lithium, a commonly used medication for mood disorders like bipolar disorder, can exacerbate this condition by impairing the renal tubules' ability to handle acid. Therefore, the combination of RTA and lithium can worsen acidosis in the body. Explanation of other options: A) Nephrotic syndrome is a condition characterized by proteinuria and edema. Penicillin is not directly associated with worsening nephrotic syndrome. B) Nephrogenic diabetes insipidus is a condition where the kidneys are unable to concentrate urine properly. Cisplatin, a chemotherapy drug, can cause kidney damage but is not specifically linked to nephrogenic diabetes insipidus. C) Nephrolithiasis refers to the formation of kidney stones. Furosemide, a diuretic, can be used to help pass kidney stones but is not a causative factor for nephrolithiasis. Educational context: Understanding the interactions between medications and pediatric genitourinary disorders is crucial for nurses and healthcare professionals caring for pediatric patients. This knowledge ensures safe medication administration and helps prevent potential complications. It also underscores the importance of a comprehensive assessment and understanding of a child's medical history before prescribing medications to prevent adverse effects.