The nurse evaluates post-operative teaching for repair of testicular torsion. The parent says, 'I will make sure he does testicular self-examination monthly.' Which is the best response?

Correct Answer: D

Rationale: The best response is option D: "I will ensure he learns testicular self-examination monthly to monitor his health." This response promotes patient education and empowerment in monitoring his health post-operatively. Testicular self-examination is crucial in detecting any changes or abnormalities early, which is particularly important after testicular torsion repair to monitor for recurrence or other issues. Option A is incorrect as it does not address the importance of testicular self-examination and wrongly emphasizes a timeline for returning to sports. Option B is also incorrect as it focuses solely on physical activity rather than long-term monitoring of testicular health. Option C is incorrect and misleading as testicular torsion repair does not automatically lead to infertility, and seeking therapy based on this assumption is inappropriate. In an educational context, it is essential for nurses to emphasize the importance of self-care practices such as testicular self-examination to pediatric patients and their parents. By teaching them how to monitor for changes and abnormalities, nurses empower patients to take an active role in their health management, promoting early detection and intervention when needed. This approach fosters a sense of autonomy and responsibility for one's health, leading to better health outcomes.

Correct Answer: C

Rationale: The correct response, option C, is the most appropriate choice for the parent of a 7-year-old experiencing persistent bed-wetting. Limiting fluids in the evening can help reduce the likelihood of bed-wetting episodes by decreasing urine production overnight. Additionally, implementing a reward system for dry nights can positively reinforce the child's efforts and progress, promoting a sense of achievement and motivation to stay dry. Option A, suggesting the use of DDAVP, may be a viable treatment in some cases of bed-wetting, but it is typically reserved for specific situations and should be prescribed by a healthcare provider after a thorough evaluation. Option B, advocating a punitive approach by showing the child the work involved in changing sheets, is not recommended as it can lead to emotional distress and does not address the underlying cause of bed-wetting. Option D, mentioning bed-wetting alarms, is a valid intervention that can be effective in helping children recognize and respond to the sensation of a full bladder during sleep. However, in this scenario, focusing on fluid management and positive reinforcement through a reward system aligns better with addressing the issue of persistent bed-wetting in a 7-year-old. In an educational context, it is essential to emphasize a holistic approach to managing pediatric genitourinary issues, including bed-wetting. Educating parents about practical strategies like fluid restriction and positive reinforcement can empower them to support their child effectively while also promoting a positive and nurturing environment for the child to address this common concern.

Correct Answer: B

Rationale: In chronic renal failure (CRF), the correct answer is B) Depletion of calcium and phosphorus from the bones due to hypocalcemia. In CRF, the kidneys are unable to regulate electrolyte balance effectively, leading to impaired excretion of phosphorus and decreased activation of vitamin D, which in turn causes hypocalcemia. This results in the body attempting to maintain normal serum calcium levels by leaching calcium and phosphorus from the bones, leading to bone demineralization and osteoporosis. Option A is incorrect because in CRF, there is typically an increase in serum phosphorus levels due to decreased excretion by the kidneys. Option C is incorrect as calcium does not remain in the bones due to a structural change; rather, the bones are depleted of calcium and phosphorus. Option D is incorrect as poor nutritional intake does not directly lead to decreased electrolytes in CRF; the primary issue lies in the kidney's inability to regulate electrolyte balance efficiently. Understanding the electrolyte imbalances in CRF is crucial for pediatric genitourinary nursing interventions as these imbalances can have significant effects on a child's growth, development, and overall health. Nurses need to closely monitor and manage these electrolyte abnormalities to prevent complications such as bone disease and metabolic disturbances in pediatric patients with CRF.

Correct Answer: C

Rationale: In pediatric genitourinary nursing, understanding the signs associated with glomerulonephritis is crucial for providing effective care. The correct answer, option C, is commonly associated with glomerulonephritis due to the presence of mild proteinuria, hematuria, decreased urine output, and lethargy. Massive proteinuria, hematuria, decreased output, and lethargy (option A) are indicative of a more severe presentation, typically seen in conditions like nephrotic syndrome rather than glomerulonephritis. Mild proteinuria, increased output, and lethargy (option B) are not typical signs of glomerulonephritis, as increased urine output is not a common feature. Massive proteinuria, decreased urine output, and hypotension (option D) present with hypotension, which is not commonly associated with glomerulonephritis. Educationally, understanding the specific signs and symptoms of glomerulonephritis is essential for early identification and intervention in pediatric patients. By recognizing the combination of mild proteinuria, hematuria, decreased urine output, and lethargy, nurses can promptly initiate appropriate treatments and prevent potential complications associated with glomerulonephritis.

Correct Answer: C

Rationale: In the context of pediatric genitourinary nursing interventions, understanding the laboratory results associated with hemolytic uremic syndrome (HUS) is crucial for timely and effective management. The correct answer is option C: Mild proteinuria, increased BUN and creatinine. The presence of mild proteinuria in HUS is due to the damage caused to the glomerular filtration barrier, allowing some proteins to pass through into the urine. Elevated blood urea nitrogen (BUN) and creatinine levels indicate impaired kidney function, which is a hallmark of HUS due to the systemic effects of the condition on the kidneys. Option A (Massive proteinuria, elevated BUN and creatinine) is incorrect because massive proteinuria is not typically seen in HUS. Option B (Mild proteinuria, decreased BUN and creatinine) is also incorrect as HUS leads to increased, not decreased, BUN and creatinine levels. Option D (Massive proteinuria, decreased BUN and creatinine) is incorrect as well due to the reasons mentioned above. Educationally, this question highlights the importance of recognizing the specific pattern of laboratory abnormalities in HUS, enabling nurses to promptly identify and intervene in the care of pediatric patients with this condition. Understanding these nuances can lead to improved patient outcomes and effective nursing interventions.