Of the following, the MOST common solid mass seen in adolescent girls is

Correct Answer: B

Rationale: The correct answer is B) fibroadenoma. In adolescent girls, fibroadenomas are the most common solid breast masses. Fibroadenomas are benign tumors composed of glandular and connective tissue. They are hormone-responsive and often present as painless, well-defined masses that are mobile and smooth. A) Lipomas are benign fatty tumors and are not commonly seen in the breast tissue of adolescent girls. C) Lymphangiomas are malformations of the lymphatic system and are typically found in areas other than the breast. D) Hamartomas are disorganized benign growths of normal tissues and are not typically seen as the most common solid mass in adolescent girls. Educationally, understanding the common types of breast masses in adolescent girls is crucial for nurses and healthcare providers working with this population. Recognizing fibroadenomas helps in providing appropriate care, reassurance, and guidance to young patients and their families. This knowledge is also essential for passing exams like the NCLEX, where clinical reasoning and diagnostic skills are tested.

Correct Answer: D

Rationale: In the context of pediatric genitourinary health, understanding hemihematometra is crucial for nursing students preparing for the NCLEX exam. Hemihematometra refers to the accumulation of menstrual blood in one horn of the uterus due to the failure of one müllerian duct to descend properly. This condition can lead to significant complications if not diagnosed and treated promptly. Option A, the accumulation of mucus or nonsanguineous fluid in the vagina, is incorrect as it describes a different condition known as mucocolpos. Option B, atretic segment of the vagina with menstrual fluid accumulation, is incorrect as it describes hematocolpos, where the vaginal opening is obstructed. Option C, the accumulation of serous fluid in the fallopian tube, is incorrect as it describes hydrosalpinx, not hemihematometra. Educationally, understanding these terms is essential for nurses caring for pediatric patients with genitourinary issues. By knowing the specific definitions and characteristics of each condition, nurses can provide appropriate care, educate patients and families, and collaborate effectively with other healthcare professionals to ensure optimal outcomes. This knowledge is vital in the clinical setting to promote early recognition and intervention for pediatric genitourinary conditions.

Correct Answer: D

Rationale: The correct answer is D) obstruction at the ureteropelvic junction. In this scenario, the infant's presentation of vomiting, lethargy, failure to thrive, abdominal mass, and positive blood and urinary cultures for Escherichia coli suggests a urinary tract infection (UTI) secondary to obstruction at the ureteropelvic junction. This obstruction can lead to stasis of urine, providing a medium for bacterial growth, hence the positive cultures. Option A) mesenteric cyst is incorrect because it typically presents with abdominal pain, not the symptoms described in the case. Option B) Wilms tumor is unlikely in this case as it usually presents with painless abdominal swelling, not the symptoms of UTI. Option C) adrenal hemorrhage would present with different symptoms such as shock or abdominal pain, not consistent with the infant's presentation. Understanding genitourinary disorders in pediatric patients is crucial for nurses and healthcare professionals. Recognizing the signs and symptoms of UTIs, obstructive uropathy, and other genitourinary conditions in children is vital for prompt diagnosis and treatment to prevent complications. This case highlights the importance of clinical assessment, diagnostic reasoning, and knowledge of pediatric genitourinary disorders in providing optimal care for pediatric patients.

Correct Answer: D

Rationale: Membranoproliferative glomerulonephritis (MPGN) is a type of glomerulonephritis that involves inflammation and changes in the structure of the glomeruli in the kidney. In the context of pediatric genitourinary practice, understanding the key characteristics of MPGN is crucial for nurses and other healthcare professionals caring for pediatric patients. Option A states that the age of onset for MPGN is 15-30 years, which is true. MPGN is more commonly seen in adolescents and young adults. Option B mentions a rare presentation with nephrotic syndrome, which is incorrect. MPGN can indeed present with nephrotic syndrome, characterized by proteinuria, hypoalbuminemia, and edema. Option C highlights that MPGN commonly has asymptomatic hematuria, which is true. Hematuria is a common finding in MPGN and can even be the presenting symptom in some cases. The correct answer, option D, states that MPGN is positive for antiglomerular basement membrane antibodies, which is false. MPGN is not associated with antiglomerular basement membrane antibodies. This differentiation is important for healthcare providers to make an accurate diagnosis and provide appropriate treatment for pediatric patients with MPGN. Educationally, understanding the nuances of different types of glomerulonephritis, including their clinical presentations, age of onset, and diagnostic features, is essential for nurses preparing for exams like the NCLEX. This knowledge helps in early recognition, prompt management, and improved outcomes for pediatric patients with renal disorders.

Correct Answer: B

Rationale: In this scenario, the most likely diagnosis for the 7-year-old with periorbital edema, tea-colored urine, high blood pressure, and low serum complement level is Poststreptococcal glomerulonephritis (PSGN). The rationale for choosing B) Poststreptococcal glomerulonephritis: - PSGN often presents with these symptoms 1-3 weeks after a streptococcal infection. - Edema, tea-colored urine (hematuria), hypertension, and low complement levels are characteristic of PSGN. - The history of a sore throat 10 days ago fits the timeline for a post-streptococcal complication. Explanation for why the other options are incorrect: - A) Lupus nephritis: Unlikely in the absence of other systemic symptoms typical of lupus. - C) Berger syndrome: Typically presents with episodes of visible blood in the urine (hematuria) rather than tea-colored urine and periorbital edema. - D) Thin basement membrane disease: Presents with microscopic hematuria without other systemic symptoms like edema, hypertension, or low complement levels. Educational context: Understanding the unique clinical manifestations and timelines of different pediatric genitourinary conditions is crucial for nurses and healthcare professionals. Recognizing the signs and symptoms of PSGN can lead to prompt diagnosis and appropriate management to prevent complications and promote positive outcomes for pediatric patients.