The diet for a child with chronic renal failure (CRF) should be high in calories and include:

Correct Answer: C

Rationale: In the context of pediatric chronic renal failure (CRF), it is crucial to provide a diet that supports proper growth and development while managing the condition. The correct answer, option C, states that the diet should be high in protein and calcium while being low in potassium and phosphorus. High protein intake is important in CRF to prevent malnutrition and support growth, but it should be carefully controlled to avoid excess waste products that the kidneys may struggle to eliminate. Calcium is essential for bone health, which can be compromised in children with CRF. Limiting potassium and phosphorus is necessary in CRF to prevent electrolyte imbalances and further stress on the kidneys. Option A is incorrect because it suggests excluding all minerals and electrolytes, which would be harmful to a child with CRF. Option B is incorrect as it suggests low protein intake, which is not ideal for ensuring proper growth and development in these children. Option D is incorrect as it recommends high intake of phosphorus and sodium, which can be detrimental in CRF due to difficulties in filtering these electrolytes by the compromised kidneys. Educationally, understanding the specific dietary needs of children with CRF is crucial for nurses and healthcare providers caring for these patients. It is essential to balance nutritional requirements with the limitations imposed by the renal condition to optimize the child's health outcomes. By grasping these principles, healthcare professionals can effectively manage the dietary aspect of pediatric CRF and contribute to improved patient outcomes.

Correct Answer: C

Rationale: The best response for the nurse to provide to the parents of a newborn with hypospadias who inquire about circumcision is option C: Circumcision is an option, but it should be delayed because the foreskin may be needed for surgical repair. This response is correct because in cases of hypospadias, where the opening of the urethra is on the underside of the penis, the foreskin tissue may be required for reconstructive surgery to correct the condition. Delaying circumcision preserves this tissue and allows for potential future surgical interventions to be more effective. Option A is incorrect as circumcision is not contraindicated but rather may need to be delayed in this specific situation. Option B is incorrect because circumcision does not specifically prevent infection in the context of hypospadias. Option D is also incorrect as circumcision can be performed in children with hypospadias but may need to be timed appropriately based on the individual case. Educationally, it is important for nurses to understand the implications of different treatment options in pediatric genitourinary conditions like hypospadias. Providing accurate information to parents empowers them to make informed decisions regarding their child's care and fosters a trusting relationship between healthcare providers and families.

Correct Answer: B

Rationale: The correct answer is B) There is blood in your child’s urine, which causes it to be tea-colored. In glomerulonephritis, the glomeruli in the kidneys become inflamed and damaged, leading to the leakage of blood cells into the urine, causing it to appear discolored. This tea-colored urine is a classic symptom of glomerulonephritis and indicates the presence of blood in the urine, known as hematuria. Option A) It is not uncommon when children receive steroids and blood pressure medications, is incorrect because the discoloration of urine in glomerulonephritis is primarily due to the presence of blood, not medications. Option C) Your child’s urine is concentrated, is incorrect because concentrated urine would typically appear darker yellow, not tea-colored. Option D) A ketogenic diet can cause tea-colored urine, is incorrect because a ketogenic diet is not known to cause tea-colored urine; this is more likely related to the presence of blood in the urine from glomerulonephritis. Educationally, understanding the causes of urine discoloration in pediatric patients is crucial for nurses and healthcare providers caring for children with genitourinary conditions. Recognizing the significance of tea-colored urine in the context of glomerulonephritis can aid in prompt diagnosis and appropriate management to prevent complications and promote the child's health and well-being.

Correct Answer: A

Rationale: In testicular torsion, the correct answer is A) Twisting of the spermatic cord interrupts the blood supply. This is because testicular torsion involves the twisting of the spermatic cord, leading to a reduction or complete cessation of blood flow to the testicle. This lack of blood flow results in severe pain, swelling, and potential ischemic damage to the testicle. Option B) Swelling of the scrotum leads to displacement is incorrect because the swelling of the scrotum is a consequence of testicular torsion due to the interrupted blood supply, not the cause of the symptoms. Option C) Unmanaged undescended testes cause displacement is incorrect as undescended testes (cryptorchidism) refer to a condition where the testes fail to descend into the scrotum during development and are not directly related to testicular torsion. Option D) Microthrombi in the spermatic cord cause blockage is incorrect because testicular torsion is primarily a mechanical issue involving the twisting of the spermatic cord, not the formation of microthrombi. From an educational perspective, understanding the pathophysiology of testicular torsion is crucial for healthcare professionals, especially when dealing with pediatric patients. Recognizing the signs and symptoms of testicular torsion and understanding the urgent need for surgical intervention are essential to prevent testicular damage and preserve fertility in affected individuals.

Correct Answer: D

Rationale: The correct answer is D) Cluster care to allow the child uninterrupted sleep for healing before surgical repair. In the case of a newborn with bladder exstrophy and a malformed pelvis, the priority is to provide optimal conditions for healing before surgical intervention. Clustering care minimizes disruptions, allowing the newborn to rest and heal effectively. This approach promotes better outcomes and reduces the risk of complications associated with the condition. Option A is incorrect as simply changing the diaper frequently and assessing for skin breakdown does not address the primary concern of providing an optimal environment for healing. Option B is incorrect because keeping the exposed bladder open in a warm, dry environment can increase the risk of infection and does not prioritize the newborn's need for rest and healing. Option C is incorrect as offering formula for growth and fluid management is important but not the priority in this situation. The immediate focus should be on creating conditions that support healing and preparing the newborn for surgical repair. In an educational context, understanding the care priorities for newborns with genitourinary abnormalities is crucial for nursing practice, especially when preparing for the NCLEX exam. It highlights the importance of effective time management, prioritization, and providing holistic care to pediatric patients with complex health needs.