Nephrotic syndrome is a hypercoagulable state resulting from

Correct Answer: C

Rationale: Nephrotic syndrome is a kidney disorder characterized by increased glomerular permeability, leading to proteinuria, hypoalbuminemia, edema, and hyperlipidemia. One of the complications of nephrotic syndrome is a hypercoagulable state due to changes in coagulation factor levels. This alteration leads to an increased risk of thrombosis, especially venous thromboembolism, in affected individuals. Choice A, hemodilution, is not the correct answer because nephrotic syndrome causes hemoconcentration rather than hemodilution due to the loss of protein-rich fluid into the urine. This loss leads to an increase in blood viscosity, contributing to the hypercoagulable state. Choice B, decreased platelet number, is incorrect as nephrotic syndrome does not typically cause thrombocytopenia. Instead, it is associated with platelet dysfunction and an increased risk of thrombosis. Choice D, decrease in hepatic production of fibrinogen, is also incorrect. In nephrotic syndrome, there is actually an increase in the production of hepatic acute-phase proteins, including fibrinogen, contributing to the hypercoagulable state. Educationally, understanding the pathophysiology of nephrotic syndrome and its complications, such as hypercoagulability, is crucial for healthcare professionals managing pediatric patients with this condition. Recognizing the risk factors for thrombosis in nephrotic syndrome and implementing appropriate monitoring and preventive measures are essential in providing comprehensive care to these patients.

Correct Answer: D

Rationale: In the treatment of cystinosis, the correct answer is D) angiotensin-converting enzyme inhibitors. These medications are used to help manage hypertension that can develop as a complication of chronic renal failure, which is common in patients with cystinosis. Angiotensin-converting enzyme inhibitors work by dilating blood vessels, reducing blood pressure, and reducing the workload on the heart. Option A) cystine eye drops are not the appropriate treatment for correcting the metabolic abnormalities associated with Fanconi syndrome or chronic renal failure in cystinosis. These eye drops are used to treat eye manifestations of cystinosis, such as corneal cystine crystal deposits. Option B) oral cysteine is not the correct treatment either. While cysteine is a component of cystine, it is not the primary focus of treatment for the systemic metabolic abnormalities in cystinosis. Option C) prostaglandin synthesis inhibitors are not typically used in the treatment of cystinosis. These medications are more commonly used for conditions like arthritis or to manage certain types of glaucoma. Educationally, understanding the rationale behind the correct answer helps students grasp the importance of tailoring treatments to address specific aspects of a disease process. In pharmacology, it is crucial to select the most appropriate medication based on the underlying pathophysiology of the condition being treated. This question highlights the importance of considering comorbidities and complications when managing pediatric genitourinary disorders like cystinosis.

Correct Answer: D

Rationale: In pediatric genitourinary disorders, understanding urinary indices is crucial for proper diagnosis and management. In the context of type IV renal tubular acidosis (RTA), the correct answer, option D (aminoaciduria), is not typically seen. Type IV RTA is characterized by hyperkalemia, metabolic acidosis, and decreased urinary ammonium excretion. Aminoaciduria, the presence of amino acids in the urine, is not a classic feature of type IV RTA. Option A, urinary pH being alkaline or acidic, is a common finding in patients with type IV RTA due to impaired acid secretion in the distal tubules. Elevated sodium levels, as in option B, can be seen in type IV RTA due to the impaired sodium reabsorption in the distal nephron. Inappropriately low potassium levels, as in option C, are also a characteristic feature of type IV RTA due to impaired potassium secretion in the distal nephron. Educationally, understanding these urinary indices and their implications in pediatric patients with genitourinary disorders is essential for nurses and healthcare providers to recognize and manage these conditions effectively. It is vital for nurses preparing for the NCLEX exam to grasp these concepts to provide safe and competent care to pediatric patients with renal disorders.

Correct Answer: C

Rationale: In pediatric pharmacology, understanding genitourinary disorders is crucial for providing safe and effective care to pediatric patients. Posterior urethral valves are a congenital anomaly that occurs exclusively in male infants. The correct answer, option C, "boys with lower urinary tract symptoms," is the most appropriate choice because posterior urethral valves commonly present with symptoms such as urinary hesitancy, weak stream, dribbling, and recurrent urinary tract infections. Option A, "newborns with oligohydramnios," is incorrect because while oligohydramnios may be a finding associated with posterior urethral valves due to renal impairment, it is not the most common presentation for diagnosis. Option B, "infants with urinary tract infections," is not the most common presentation either, as urinary tract infections may occur secondary to the obstruction caused by the valves. Option D, "adolescents with recurrent UTIs," is also incorrect as posterior urethral valves are typically diagnosed in infancy due to the early presentation of symptoms. Educationally, understanding the typical presentation of posterior urethral valves in pediatric patients is essential for early recognition and intervention. This knowledge can help healthcare providers initiate prompt treatment to prevent complications such as renal damage and urinary tract infections. By grasping the key clinical manifestations associated with this condition, nurses and other healthcare professionals can advocate for timely diagnostic testing and appropriate management strategies, ultimately improving patient outcomes.

Correct Answer: D

Rationale: In the context of pediatric genitourinary disorders, understanding the Doppler ultrasound findings in testicular torsion is crucial for clinical practice. The hallmark finding on Doppler ultrasound in testicular torsion is the absence of blood flow (Option D). This is because testicular torsion involves the twisting of the spermatic cord, leading to compromised blood flow to the testicle. As a result, Doppler ultrasound will show a lack of perfusion to the affected testicle. Option A, increased blood flow, is incorrect because testicular torsion results in vascular compromise rather than increased blood flow. Option B, decreased blood flow, may seem plausible, but the significant characteristic in torsion is the absence of blood flow, not just a decrease. Option C, normal blood flow, is also incorrect in the context of testicular torsion where a lack of blood flow is expected. Educationally, this question highlights the importance of recognizing the specific imaging findings associated with testicular torsion. Understanding this concept is essential for nurses and healthcare professionals caring for pediatric patients with genitourinary issues, as prompt recognition and intervention are critical in preserving testicular viability and preventing long-term complications.