Testicular torsion is most commonly seen in

Correct Answer: C

Rationale: Testicular torsion is most commonly seen in adolescents (Option C) because this condition often occurs during puberty when the testes undergo significant growth and increased mobility within the scrotum. The rapid growth and development during adolescence can lead to an increased risk of testicular torsion due to the long spermatic cord and the increased potential for twisting. Neonates (Option A) are less likely to experience testicular torsion due to the underdeveloped nature of their reproductive system. Prepubertal boys (Option B) are also at a lower risk compared to adolescents because their testes are not as large and do not have the same degree of mobility. Elderly men (Option D) are unlikely to develop testicular torsion as this condition is more commonly associated with younger age groups. In an educational context, understanding the age groups most at risk for testicular torsion is crucial for healthcare professionals, especially those working with pediatric populations. Recognizing the signs and symptoms of testicular torsion in adolescents can lead to prompt diagnosis and treatment, which is essential to preserving testicular function and preventing complications. This knowledge is not only important for passing exams like the NCLEX but also for providing quality care to patients in clinical practice.

Correct Answer: A

Rationale: The correct answer is A) Wilm's tumor. Wilm's tumor is the most likely diagnosis in this case due to the classic presentation of a palpable abdominal mass, hypertension, and imaging findings of a renal mass with calcifications in a 2-year-old child. Wilm's tumor is the most common primary renal malignancy in children and typically presents in early childhood. Option B) renal cell carcinoma is incorrect because it is extremely rare in children, and the presentation in this case is more consistent with Wilm's tumor. Option C) angiomatosis is not a common renal tumor in pediatric patients and does not match the presentation described. Option D) neuroblastoma is a solid tumor that arises from neural crest cells and typically presents with symptoms such as abdominal distension, weight loss, and bone pain. It is not typically associated with hypertension or renal calcifications. Educationally, understanding the typical presentations and characteristics of different pediatric genitourinary tumors is crucial for healthcare providers caring for children. Recognizing the signs and symptoms can lead to early diagnosis and appropriate management, improving outcomes for pediatric patients with these conditions. This question highlights the importance of clinical knowledge and imaging interpretation in diagnosing and managing pediatric genitourinary conditions.

Correct Answer: A

Rationale: Rationale: The correct answer is A) peritonitis. Peritonitis is the most common complication of peritoneal dialysis in children. This is due to the direct contact between the dialysate solution and the peritoneal cavity, which can lead to infection and inflammation of the peritoneum. Signs and symptoms of peritonitis include abdominal pain, cloudy dialysate effluent, fever, and general malaise. Option B) fluid overload is incorrect because peritoneal dialysis is actually used to remove excess fluid from the body, making fluid overload less likely as a complication. Option C) hypotension is less common in peritoneal dialysis compared to hemodialysis, as peritoneal dialysis allows for more gradual fluid and solute removal, reducing the risk of sudden fluid shifts and hypotension. Option D) hemoconcentration is not a common complication of peritoneal dialysis. Hemoconcentration refers to an increase in the concentration of blood cells and proteins due to a decrease in plasma volume, which is not typically associated with peritoneal dialysis. Educationally, understanding the complications of peritoneal dialysis in children is crucial for nurses and healthcare providers caring for pediatric patients requiring this treatment. Recognizing and managing complications such as peritonitis promptly is essential to prevent further complications and improve patient outcomes.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) 350 mL of oral and intravenous fluids. For a 10-kg toddler with acute renal failure, the daily fluid maintenance requirement is typically calculated as 100 mL/kg for the first 10 kg, 50 mL/kg for the next 10 kg, and 20 mL/kg for each kg above 20. Therefore, for a 10-kg toddler, the total daily fluid requirement would be 1000 mL + 0 (as there are no additional kgs) = 1000 mL. Since the toddler already has a 24-hour urine output of 110 mL, the nurse would expect the toddler's daily allotment of fluids to be 1000 mL - 110 mL = 890 mL. Option B) providing 350 mL of oral and intravenous fluids is appropriate to ensure hydration without overwhelming the compromised kidneys. Option A) Sips of clear fluids and ice chips only would not provide an adequate amount of fluids to meet the toddler's daily maintenance requirements and could lead to dehydration. Option C) 1000 mL of oral and intravenous fluids would exceed the toddler's calculated daily allotment by 110 mL, potentially causing fluid overload and worsening the renal condition. Option D) 2000 mL of oral and intravenous fluids would significantly exceed the toddler's calculated daily allotment, posing a risk of fluid overload and further compromising renal function. In an educational context, understanding the principles of calculating fluid requirements based on weight and condition is crucial in pediatric pharmacology and nursing practice. It is essential for nurses to accurately assess and manage fluid balance in pediatric patients, especially those with renal issues, to prevent complications and promote optimal outcomes.

Correct Answer: B

Rationale: The correct answer is B) Prerenal failure due to dehydration. In this scenario, the child's post-operative hemorrhage has led to significant blood loss, causing hypotension (BP 84/48) and tachycardia (HR 124). These vital sign changes indicate poor perfusion to the kidneys, leading to prerenal failure. Dehydration exacerbates this condition by reducing circulating blood volume, further compromising renal perfusion. Option A is incorrect because Chronic Renal Failure (CRF) is a long-term, progressive condition not related to the acute situation described. Option C is incorrect as primary kidney damage due to a lack of urine flow (possibly from obstruction) is not supported by the scenario. Option D is incorrect as postrenal failure is typically caused by urinary tract obstruction, not hypotension. Educationally, understanding the different types of renal failure is crucial for nurses to assess and intervene appropriately in pediatric patients experiencing post-operative complications. Prerenal failure highlights the importance of recognizing and addressing dehydration promptly to prevent renal compromise in vulnerable populations like children.