Regarding the treatment of IgA nephropathy, which of the following is TRUE?

Correct Answer: D

Rationale: In the treatment of IgA nephropathy, the correct answer is D) successful kidney transplantation. IgA nephropathy is a condition characterized by the deposition of IgA antibodies in the kidneys, leading to inflammation and damage. When conservative treatments like ACE inhibitors and corticosteroids fail to control the disease progression and manage symptoms such as proteinuria and hematuria, kidney transplantation becomes a viable option for end-stage renal disease due to IgA nephropathy. Option A) ACE inhibitors are actually effective in reducing proteinuria in IgA nephropathy by decreasing intraglomerular pressure and protein leakage. Option B) Corticosteroids can help reduce inflammation and slow the progression of IgA nephropathy, although they may not always improve renal function in all cases. Option C) Tonsillectomy was previously considered as a treatment option for IgA nephropathy due to the association between tonsil inflammation and the disease, but its current recommendation is not widely accepted or established in clinical practice. Educationally, understanding the treatment options for IgA nephropathy is crucial for nursing students preparing for the NCLEX exam. It highlights the importance of knowing when conservative treatments are ineffective, and when more aggressive interventions like kidney transplantation may be necessary for managing this chronic kidney disease.

Correct Answer: D

Rationale: Type I membranoproliferative glomerulonephritis is characterized by the deposition of dense, ribbon-like electron-dense material within the glomerular basement membrane. This is why option D, "called dense deposit disease," is the correct answer. In contrast, type II membranoproliferative glomerulonephritis is characterized by the presence of immune complexes within the glomerulus, making option B incorrect. Option A is also incorrect as type I MPGN is actually more common than type II. Option C is not associated with type I MPGN; rather, it is associated with type IV collagen nephropathies. From an educational perspective, understanding the differences between the types of membranoproliferative glomerulonephritis is crucial for nurses and healthcare professionals caring for pediatric patients with renal disorders. Being able to differentiate between the types based on their underlying pathophysiology and clinical manifestations is essential for accurate diagnosis and appropriate management of these conditions. This knowledge is particularly important for those preparing for the NCLEX exam as it tests their ability to apply pharmacological principles in complex pediatric cases.

Correct Answer: D

Rationale: Plasmapheresis is a therapeutic procedure that involves removing blood plasma from the body and replacing it with fluids such as saline or albumin. In the context of pediatric genitourinary conditions, the correct answer, D) Goodpasture disease, is the most appropriate option for the use of plasmapheresis. Goodpasture disease is an autoimmune disorder characterized by the production of antibodies against the basement membrane in the lungs and kidneys, leading to glomerulonephritis and pulmonary hemorrhage. Plasmapheresis is beneficial in Goodpasture disease as it helps remove circulating autoantibodies and inflammatory mediators from the blood, thereby reducing the immune-mediated damage to the kidneys and lungs. Option A) post-infectious glomerulonephritis is typically managed with supportive care and treatment of the underlying infection, rather than plasmapheresis. Option B) immunoglobulin A nephropathy and Option C) Henoch-Schönlein purpura are immune complex-mediated renal diseases where plasmapheresis has not shown significant benefit compared to other treatment modalities like corticosteroids and immunosuppressants. Educationally, understanding the appropriate use of plasmapheresis in different pediatric genitourinary conditions is crucial for nurses and healthcare providers working in pediatric settings. This knowledge ensures that interventions are evidence-based and tailored to each specific condition, ultimately improving patient outcomes and safety.

Correct Answer: D

Rationale: In the treatment of diarrhea-associated hemolytic-uremic syndrome, the option that has no beneficial role is red cell transfusions (Option D). The correct answer is D because red cell transfusions do not address the underlying cause of hemolytic-uremic syndrome, which is primarily related to kidney damage secondary to the release of toxins from certain strains of E. coli bacteria. Transfusions do not remove these toxins or treat the kidney damage. Option A, dialysis, is beneficial in managing the complications of kidney failure that can occur in hemolytic-uremic syndrome. Option B, early intravenous volume expansion, helps maintain adequate renal perfusion and prevent further kidney damage. Option C, controlling hypertension, is important as high blood pressure can worsen kidney function. In an educational context, understanding the rationale behind each treatment option is crucial for nurses and healthcare providers caring for pediatric patients with hemolytic-uremic syndrome. This knowledge can guide appropriate interventions, improve patient outcomes, and prevent potential complications. It also highlights the importance of evidence-based practice in pharmacological management.

Correct Answer: C

Rationale: Rationale: Correct Answer: C) Hemolytic-uremic syndrome Sickle cell nephropathy refers to kidney damage in individuals with sickle cell disease. Clinical manifestations of sickle cell nephropathy can include hematuria (blood in the urine), renal tubular acidosis (a condition where the kidneys are unable to maintain the correct balance of acids in the body), and polyuria (excessive urination). Option A: Hematuria is a common clinical manifestation of sickle cell nephropathy due to the damage to the kidney's blood vessels. Option B: Polyuria can occur in sickle cell nephropathy as the kidneys may struggle to concentrate urine properly. Option D: Renal tubular acidosis is seen in sickle cell nephropathy due to the impaired acid-base regulation by the kidneys. Option C: Hemolytic-uremic syndrome, while a serious condition involving abnormal destruction of red blood cells, is not typically a direct clinical manifestation of sickle cell nephropathy. It is more commonly associated with bacterial infections or certain genetic factors. Educational Context: Understanding the clinical manifestations of sickle cell nephropathy is crucial for healthcare providers caring for pediatric patients with sickle cell disease. Recognizing these signs and symptoms can aid in early detection and management of kidney complications in these individuals, ultimately improving patient outcomes. It is important for nurses, nurse practitioners, and other healthcare professionals to be knowledgeable about the various complications associated with sickle cell disease to provide comprehensive care to pediatric patients.