The glomerular filtration rate (GFR) reaches adult levels by the age of

Correct Answer: A

Rationale: The correct answer is A) 1 to 2 years. Understanding the development of the glomerular filtration rate (GFR) in pediatric patients is crucial in pharmacology and nursing practice. The GFR is a key indicator of kidney function, reflecting the rate at which blood is filtered by the glomeruli per unit of time. In pediatric patients, the GFR increases as the kidneys mature. By the age of 1 to 2 years, the GFR in children reaches approximately 25% of adult levels and continues to increase gradually, reaching adult levels by around 2 years of age. Option B) 3 to 4 years is incorrect because the GFR reaches adult levels earlier, by 1 to 2 years of age. Option C) 5 to 6 years and Option D) 7 to 8 years are also incorrect as the GFR typically reaches adult levels well before these ages. Educationally, this question highlights the importance of understanding pediatric pharmacology and the physiological differences in children that impact drug dosing and pharmacokinetics. Nurses and healthcare providers need to be aware of these developmental milestones to ensure safe and effective medication administration in pediatric patients. Understanding the timeline for GFR maturation helps healthcare professionals make informed decisions regarding medication dosing and monitoring in children.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) membranoproliferative glomerulonephritis. Nephrotic syndrome (NS) in pediatric patients can have various underlying causes, one of which is hepatitis B infection. Membranoproliferative glomerulonephritis is the most common type of secondary NS associated with hepatitis B infection in pediatric patients. Membranoproliferative glomerulonephritis is characterized by thickening of the glomerular basement membrane, mesangial cell proliferation, and hypercellularity. This results in impaired filtration and protein loss, leading to the clinical presentation of nephrotic syndrome. The other options (A, C, D) are less likely in this specific case. Membranous nephropathy is more commonly associated with hepatitis B infection in adults rather than children. Focal segmental glomerulosclerosis is more commonly seen in primary nephrotic syndrome rather than secondary causes. While these conditions can occur in pediatric patients, membranoproliferative glomerulonephritis is the most common type in this particular scenario. Educationally, understanding the specific associations of nephrotic syndrome in pediatric patients is crucial for healthcare providers to provide accurate diagnosis and appropriate management. This knowledge helps in tailoring treatment plans and improving patient outcomes.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) send for urine examination. The most likely finding in a 5-month-old boy with Fanconi syndrome would be low-molecular-weight proteins in the urine. Fanconi syndrome is a rare disorder where the proximal renal tubules are unable to reabsorb electrolytes and other substances properly, leading to their excretion in the urine. This results in low-molecular-weight proteins being detected in the urine, indicating renal dysfunction. Option B) hexagonal crystals is incorrect because these are more commonly associated with cystinuria, a condition characterized by the formation of cystine stones in the urinary tract, not Fanconi syndrome. Option C) red blood cell casts is incorrect as these are typically seen in conditions like glomerulonephritis or vasculitis, where there is damage to the glomeruli leading to the presence of red blood cells in the urine along with casts. Educationally, understanding the specific urinary findings associated with different pediatric genitourinary disorders is crucial for accurate diagnosis and appropriate management. This question highlights the importance of recognizing the characteristic urinary abnormalities seen in Fanconi syndrome, emphasizing the need for thorough assessment and investigation in pediatric patients presenting with renal issues.

Correct Answer: A

Rationale: In pediatric genitourinary disorders, understanding the impact of Verotoxin (VT)-producing Escherichia coli is crucial. The correct answer is A) 5% to 15% of affected children. This bacterium can lead to hemolytic uremic syndrome in a subset of affected individuals. Hemolytic uremic syndrome is a severe condition characterized by hemolytic anemia, thrombocytopenia, and acute kidney injury. Option B) 25% to 35% of affected children is incorrect because the incidence of hemolytic uremic syndrome caused by VT-producing E. coli is lower than this range. Option C) 45% to 55% and Option D) 65% to 75% are also incorrect as they overestimate the percentage of affected children who develop hemolytic uremic syndrome. Educationally, this question highlights the importance of recognizing the potential complications of VT-producing E. coli infections in pediatric patients. Understanding the prevalence of hemolytic uremic syndrome in affected children is crucial for accurate diagnosis and management in clinical practice. This knowledge is essential for nurses, nurse practitioners, and other healthcare professionals caring for pediatric patients with genitourinary disorders.

Correct Answer: A

Rationale: In this scenario, the correct option is A) urine sodium (mEq/L) <15. The reason this is the correct answer is that in a 9-month-old patient presenting with severe dehydration, the urine sodium concentration is expected to be low (<15 mEq/L). This finding indicates the kidneys' ability to conserve sodium in response to dehydration, a physiological response to maintain fluid balance. Option B) fractional excretion of sodium (%) >2 would not be appropriate in this case as a high fractional excretion of sodium would suggest inappropriate renal sodium loss, which is not characteristic of dehydration. Option C) urine osmolality ∼ 300 may not be as helpful in this context as it is a more general measure of urine concentration and may not specifically indicate dehydration. Option D) increased echogenicity in renal ultrasound is not typically used as a primary diagnostic tool for evaluating dehydration and renal function in pediatric patients. Educationally, understanding how to interpret urine sodium levels in pediatric patients with dehydration is crucial for nurses and healthcare providers to make appropriate clinical decisions and provide effective treatment. This rationale highlights the importance of considering specific laboratory values in the context of a patient's clinical presentation to guide proper management.