Renal involvement in childhood systemic lupus erythematosis (SLE) is present in

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) 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.

Correct Answer: D

Rationale: In this question, option D, "right-sided valvular heart disease," is the correct answer because it is NOT associated with autosomal dominant polycystic kidney disease (ADPKD). The presence of valvular heart disease is not a typical feature of ADPKD. Option A, "gross or microscopic hematuria," is a common manifestation of ADPKD due to the development of cysts in the kidneys leading to bleeding within the urinary tract. Option B, "may be seen in neonates," is true because ADPKD can be diagnosed at any age, including in neonates if there is a family history of the disease. Option C, "abnormal renal sonography in the absence of symptoms," is also true as ADPKD can be detected through imaging studies like renal sonography even before symptoms manifest, making it a valuable diagnostic tool. In an educational context, understanding the clinical manifestations and diagnostic methods for pediatric genitourinary disorders like ADPKD is crucial for nurses and healthcare professionals caring for pediatric patients. This knowledge helps in early identification, appropriate management, and improving patient outcomes. By reviewing and understanding these concepts, nurses can provide better care and support to children with genitourinary disorders and their families.

Correct Answer: D

Rationale: In pediatric genitourinary disorders, accurate assessment of urine protein excretion is crucial for diagnosis and monitoring of conditions like nephrotic syndrome or other renal conditions. The most precise method among the options provided is option D, which is the 24-hour urine for protein and creatinine excretion. Option A, frothy urine, is a subjective observation and not a reliable method for quantifying protein excretion. Dipstick testing (option B) provides a semi-quantitative assessment and may not be as accurate as a 24-hour urine collection. Microalbuminuria (option C) is a specific test for detecting small amounts of albumin in the urine, often used in diabetic patients, but may not provide the comprehensive data obtained from a 24-hour urine collection. Understanding the importance of accurate urine protein excretion assessment is essential in managing pediatric patients with genitourinary disorders. The 24-hour urine collection allows for a more precise measurement of protein excretion over an extended period, offering valuable information for diagnosis and treatment decisions. Educating healthcare providers on the significance of using the most accurate methods for assessing urine protein can lead to improved patient outcomes and better management of pediatric genitourinary conditions.

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.