On routine checkup of three years old boy, his general urine examination show: nitrite test positive, you think this is false-positive result.

Correct Answer: D

Rationale: The correct answer is D) prolonged contact (uncircumcised boys). Nitrite in urine is a common indicator of urinary tract infection (UTI) in adults, but in young children, especially uncircumcised boys, it can be a false-positive result. This is because bacteria present on the skin can convert nitrates in urine to nitrites upon prolonged contact, leading to a positive nitrite test result. Option A) frequent voiding does not directly influence the nitrite test result. Option B) low urine bacterial count would not typically result in a positive nitrite test. Option C) urinary tract obstruction is not related to the conversion of nitrates to nitrites in the urine. In an educational context, understanding the factors that can lead to false-positive results in diagnostic tests is crucial for healthcare providers, especially when dealing with pediatric patients. Recognizing the limitations and potential sources of error in diagnostic testing can help in making accurate clinical judgments and providing appropriate interventions for young patients.

Correct Answer: D

Rationale: In the context of pediatric genitourinary nursing interventions, understanding the pathophysiology of hemolytic uremic syndrome (HUS) is crucial. HUS presents with a triad of microangiopathic hemolytic anemia, thrombocytopenia, and renal injury. The correct answer, "D) pyuria," is indicative of renal involvement in HUS. Pyuria refers to the presence of white blood cells in the urine, highlighting renal inflammation or infection, which is a common feature of HUS due to the renal injury component of the syndrome. Option A, "anemia," is a characteristic of HUS but does not specifically point to renal involvement. Thrombocytopenia is associated with HUS but does not directly relate to renal injury, making option B, "decreased haptoglobin," incorrect. Similarly, option C, "leukocytosis," is a nonspecific finding in HUS and does not directly indicate renal injury. In an educational context, nurses caring for pediatric patients with HUS need to recognize the signs and symptoms that indicate renal involvement to provide timely and appropriate interventions. Understanding the significance of pyuria in HUS helps nurses in early identification of renal complications, enabling prompt management and improving patient outcomes.

Correct Answer: D

Rationale: In the context of a 9-month-old patient diagnosed with hemolytic uremic syndrome (HUS) without active hemorrhage, the correct nursing intervention is D) platelet transfusion. Platelet transfusion is the correct choice because in HUS, there is a risk of thrombocytopenia due to platelet consumption and activation in the microvasculature. Platelet transfusion helps to maintain adequate platelet levels and prevent bleeding complications. Option A) volume repletion is not necessary in a patient without active hemorrhage and can potentially exacerbate hypertension, a common complication in HUS. Option B) control of hypertension is important in HUS, but it is not the immediate priority in a patient without active hemorrhage. Platelet transfusion takes precedence in this scenario. Option C) dialysis may be indicated in severe cases of HUS with renal failure, but it is not the first-line intervention in a patient without active hemorrhage. In an educational context, understanding the pathophysiology of HUS and its complications is crucial for nurses caring for pediatric patients. This knowledge helps prioritize interventions based on the patient's condition and prevent potential complications. By choosing the correct intervention, nurses can provide optimal care and improve patient outcomes.

Correct Answer: D

Rationale: In the context of treating hypertension in the setting of acute kidney injury (AKI), it is crucial to consider the impact of certain medications on renal function. Angiotensin-converting enzyme inhibitors (ACE inhibitors) are contraindicated in AKI due to their potential to further compromise renal perfusion and function by blocking the renin-angiotensin-aldosterone system. This can lead to a decline in glomerular filtration rate and worsen kidney function in AKI. Diuretics, calcium channel blockers, and vasodilators are commonly used in managing hypertension in AKI. Diuretics help reduce fluid overload, calcium channel blockers dilate blood vessels to lower blood pressure, and vasodilators relax and widen blood vessels. These agents can help manage hypertension without significantly impacting renal function, making them suitable choices in AKI patients with hypertension. Educationally, understanding the appropriate selection of antihypertensive agents in AKI is vital for nurses caring for pediatric patients with genitourinary issues. It emphasizes the importance of considering the nephrotoxic potential of certain medications and tailoring treatment to the individual patient's needs to prevent further harm to renal function. This knowledge enhances nursing practice by promoting safe and effective pharmacological interventions in pediatric patients with complex renal conditions.

Correct Answer: D

Rationale: In the case of a 10-year-old patient with end-stage renal disease (ESRD) presenting with short stature and bony deformities, the correct answer is D) dietary phosphorous restriction. Rationale for Correct Answer: - In ESRD, the kidneys are unable to properly regulate phosphorus levels, leading to elevated levels in the blood. This can result in bone deformities and growth retardation. - By restricting dietary phosphorus intake, the body's phosphorus levels can be better controlled, reducing the risk of skeletal abnormalities and promoting normal growth and development in children with ESRD. Rationale for Incorrect Options: - Option A) 1: This option is vague and does not address the underlying issue of phosphorus imbalance in ESRD. - Option B) 25-dihydroxy vitamin D supplementation: While vitamin D is important for bone health, in ESRD, the focus should be on managing phosphorus levels first before considering vitamin D supplementation. - Option C) Calcium supplementation: While calcium is important for bone health, in ESRD, the primary concern is elevated phosphorus levels, so managing phosphorus intake is more crucial than calcium supplementation. Educational Context: - Understanding the impact of ESRD on phosphorus metabolism and bone health is crucial in pediatric nursing practice. - Educating parents and caregivers about the importance of dietary phosphorus restriction can help improve outcomes and quality of life for children with ESRD. - This question highlights the importance of individualized nursing interventions tailored to the specific needs of pediatric patients with chronic conditions like ESRD.