Rhabdomyolysis is always clinically significant as it may lead to acute renal injury. It can occur secondary to

Correct Answer: A

Rationale: Rhabdomyolysis is a condition characterized by the breakdown of muscle tissue leading to the release of muscle cell contents, such as myoglobin, into the bloodstream. This can result in acute renal injury due to the deposition of myoglobin in the renal tubules, causing renal tubular obstruction and subsequent damage. Severe electrolyte abnormalities, such as hyperkalemia and hyperphosphatemia, commonly accompany rhabdomyolysis and can contribute to renal injury. Therefore, option A is correct as electrolyte abnormalities are a common secondary factor in rhabdomyolysis-related acute renal injury. Option B, bacterial endocarditis, is not directly linked to rhabdomyolysis and acute renal injury. While infections can potentially lead to muscle breakdown and rhabdomyolysis, bacterial endocarditis is not a direct cause. Option C, transfusion reactions, can lead to hemolysis of red blood cells but is not a common cause of rhabdomyolysis. Hemolysis-related rhabdomyolysis is usually due to factors like sickle cell disease or autoimmune hemolytic anemia, rather than transfusion reactions. Option D, mycoplasma infection, can cause pneumonia and other respiratory symptoms, but it is not a common cause of rhabdomyolysis. Rhabdomyolysis is more commonly associated with factors such as trauma, muscle compression, drug-induced muscle injury, or metabolic disorders. Educationally, understanding the secondary causes of rhabdomyolysis and their implications for renal function is crucial for healthcare professionals, especially in pediatric settings. Recognizing the signs and symptoms of rhabdomyolysis, along with its potential complications like acute renal injury, enables timely intervention and appropriate management to prevent further harm to pediatric patients.

Correct Answer: A

Rationale: The correct answer is A) acute nephritic syndrome. In this scenario, the clinical presentation and laboratory findings are consistent with acute nephritic syndrome. This condition is characterized by inflammation of the glomeruli in the kidneys, leading to hematuria, proteinuria, hypertension, and decreased renal function. The presence of RBC casts, albuminuria, low C3 levels, and normal C4 levels are typical findings in acute nephritic syndrome. Option B) nephrotic syndrome is incorrect because this condition is characterized by massive proteinuria, hypoalbuminemia, edema, and hyperlipidemia, which are not the predominant features described in the case. Option C) acute renal failure is not the best choice as the clinical presentation in the question does not primarily suggest renal failure but rather an inflammatory process affecting the glomeruli. Option D) hypertension is a symptom commonly associated with acute nephritic syndrome due to fluid overload and renin-angiotensin system activation, but it is not the primary defining feature of the condition. In an educational context, understanding the differences between various renal conditions is crucial for nurses and healthcare providers. Recognizing the specific clinical manifestations, laboratory findings, and pathophysiology of each condition is essential for accurate diagnosis and appropriate management. This case highlights the importance of differentiating between acute nephritic syndrome and other renal disorders based on clinical presentation and laboratory results.

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.