The most common histological subtype of renal cell carcinoma in children is

Correct Answer: D

Rationale: In pediatric genitourinary disorders, understanding the histological subtypes of renal cell carcinoma is crucial for accurate diagnosis and treatment. The correct answer, D) Xp11 translocation renal cell carcinoma, is the most common histological subtype in children. This type is characterized by a translocation involving the TFE3 gene on the X chromosome, leading to overexpression of TFE3 protein. Option A) clear cell carcinoma is more common in adults and is not typically seen in pediatric cases. Option B) papillary carcinoma is another common subtype in adults but less frequently observed in children. Option C) chromophobe carcinoma is rare in pediatric cases and is more commonly found in adults. Educationally, knowing the specific histological subtypes of renal cell carcinoma in children helps healthcare providers make informed decisions regarding treatment and prognosis. By understanding these distinctions, practitioners can tailor management strategies to each child's unique histopathological profile, ultimately improving patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) If a mucous plug forms in the urinary drainage tube, we will irrigate it gently to prevent a blockage. This statement indicates the parents understand the importance of maintaining the patency of the urinary drainage tube to prevent obstruction and complications following their child's epispadias repair surgery. By irrigating the tube gently, they can ensure proper drainage and prevent blockages. Option B is incorrect because allowing a mucous plug to pass on its own can lead to blockage and potential complications. Option C is incorrect as a loose dressing can increase the risk of infection and compromise wound healing. Option D is incorrect because yellow drainage can indicate infection rather than healing. In the context of pediatric genitourinary disorders, it is crucial for parents to understand postoperative care instructions to ensure the child's recovery and prevent complications. Teaching parents how to care for urinary drainage tubes post-epispadias repair is essential for the child's well-being. Education should focus on promoting parental confidence and competence in managing their child's postoperative care effectively.

Correct Answer: A

Rationale: The most appropriate plan for a child diagnosed with another UTI after a recent episode is to choose option A, which includes urinalysis, urine culture, and a voiding cystourethrogram (VCUG). The rationale for choosing option A is that urinalysis and urine culture will help confirm the presence of infection and identify the causative organism. The VCUG is essential to evaluate for any underlying structural abnormalities in the genitourinary tract that may be predisposing the child to recurrent UTIs. This diagnostic approach is crucial in pediatric patients to prevent long-term complications like renal scarring and reflux nephropathy. Option B, evaluating for renal failure, is not the most appropriate initial step in the management of a child with a recurrent UTI. UTIs are more commonly due to bacterial infections rather than renal failure, so this step would not be the primary focus at this stage. Option C, admitting to the pediatric unit, may not be necessary unless the child shows signs of severe illness, such as sepsis or dehydration. In uncomplicated cases of UTI, outpatient management is often appropriate. Option D, discharging home on an antibiotic, without further investigation, would be premature as it does not address the underlying cause of recurrent UTIs or evaluate for potential complications. In an educational context, understanding the rationale behind each diagnostic step is crucial for nurses and healthcare providers caring for pediatric patients with genitourinary disorders. Proper assessment and management can prevent complications and improve outcomes for children with UTIs.

Correct Answer: C

Rationale: The correct answer is C) A treatment option that will free the child from dialysis. In pediatric genitourinary disorders, renal transplantation is a well-established treatment for end-stage renal disease. It is considered a definitive treatment that eliminates the need for ongoing dialysis. This option is correct because a successful renal transplant can restore kidney function, allowing the child to live without the burden of regular dialysis sessions. Option A is incorrect because while renal transplantation can significantly improve the child's quality of life and eliminate the need for dialysis, it may not necessarily be a curative procedure in all cases. Option B is incorrect because a history of dialysis noncompliance would not make renal transplantation an ideal option. Compliance with post-transplant care, including medication regimens and follow-up appointments, is crucial for a successful outcome. Option D is incorrect because renal transplantation has been performed in pediatric patients for many years and is not a very new treatment option for this population. Educationally, understanding the role of renal transplantation in pediatric genitourinary disorders is essential for nursing students preparing for the NCLEX exam. It highlights the importance of this intervention in improving the quality of life for children with end-stage renal disease and the need for ongoing monitoring and support post-transplant.

Correct Answer: D

Rationale: In pediatric genitourinary disorders, hydronephrosis is characterized by the dilation of the renal pelvis and calyces due to an obstruction in the urinary tract. The correct answer, option D, includes metabolic acidosis, polydipsia (excessive thirst), and polyuria (excessive urination), which are commonly associated with hydronephrosis. Metabolic acidosis can occur due to impaired kidney function in hydronephrosis, leading to an accumulation of acid in the body. Polydipsia and polyuria are common symptoms seen in hydronephrosis due to the kidneys' inability to concentrate urine properly. Option A (metabolic alkalosis, polydipsia, and polyuria) is incorrect because metabolic alkalosis is not typically associated with hydronephrosis. Option B (metabolic acidosis and bacterial growth in the urine) is incorrect as bacterial growth in the urine is not a direct consequence of hydronephrosis. Option C (metabolic alkalosis and bacterial growth in the urine) is also incorrect because metabolic alkalosis is not a usual finding in hydronephrosis. Understanding the specific clinical manifestations of pediatric genitourinary disorders like hydronephrosis is crucial for nurses, nurse practitioners, and other healthcare professionals caring for pediatric patients. Recognizing the signs and symptoms allows for early identification, appropriate intervention, and optimal management to prevent complications and improve outcomes.