A 4-year-old child is diagnosed with nephrotic syndrome. Which of the following findings would the nurse expect to observe?

Massive proteinuria and generalized edema

Hematuria and flank pain

Polyuria and polydipsia

Hyperactive reflexes and muscle spasms

Answer and Explanation

The Correct Answer is A

A. Massive proteinuria and generalized edema is correct because nephrotic syndrome results from increased permeability of the glomerular membrane. This allows large amounts of protein, especially albumin, to be lost in the urine (proteinuria). The loss of albumin leads to hypoalbuminemia, which reduces plasma oncotic pressure. As a result, fluid shifts from the intravascular space into the interstitial tissues, causing generalized edema. Edema is often most noticeable around the eyes (periorbital edema), abdomen (ascites), and lower extremities. Additional associated findings may include hyperlipidemia and lipiduria due to the liver’s increased production of lipids in response to protein loss.

B. Hematuria and flank pain is incorrect because these findings are more characteristic of nephritic syndromes such as acute poststreptococcal glomerulonephritis. Nephrotic syndrome typically does not present with significant hematuria or flank pain; instead, protein loss and edema are the dominant features.

C. Polyuria and polydipsia is incorrect because these symptoms are commonly associated with endocrine disorders such as diabetes mellitus or diabetes insipidus. In nephrotic syndrome, urine output may actually decrease due to fluid shifting into tissues and activation of fluid-retaining mechanisms.

D. Hyperactive reflexes and muscle spasms is incorrect because these signs are indicative of electrolyte imbalances such as hypocalcemia. While electrolyte disturbances can occur in kidney disorders, they are not defining or expected hallmark findings of nephrotic syndrome.

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Correct Answer is D

Explanation

A. Quickening experienced by the patient is incorrect because quickening (the first perception of fetal movement by the mother) is considered a presumptive sign of pregnancy, not a positive sign. While it suggests pregnancy, it can be mistaken for gastrointestinal activity.

B. Patient reports of a positive pregnancy test is incorrect because this is a probable sign of pregnancy. Laboratory tests detecting human chorionic gonadotropin (hCG) are more reliable than presumptive signs, but they can occasionally give false positives (e.g., due to certain medications or medical conditions).

C. Braxton Hicks contractions felt by the patient is incorrect because these are also presumptive or possible signs of pregnancy. They indicate uterine activity, but they do not confirm the presence of a fetus.

D. Fetal movement palpated by the provider is correct. This is considered a positive sign of pregnancy, as only a developing fetus can cause these movements to be felt by an examiner. Other positive signs include visualization of the fetus on ultrasound and auscultation of the fetal heartbeat. Positive signs provide definitive confirmation of pregnancy, distinguishing them from presumptive or probable signs.

A. Recommend increasing the child's caloric intake significantly to accelerate growth and catch up with peers quickly. B. Advise that the child's growth should match exactly the rate of their peers to ensure proper development. C. Suggest delaying further growth assessments until the child reaches school age, as preschool growth is too variable to interpret D. Explain that preschool growth is typically steady but slower compared to infancy, with average gains of 4 to 5 pounds and 2 to 3 inches per year, which is normal for this stage.

Correct Answer is D

Explanation

A. Recommending a significant increase in caloric intake is incorrect because forced or excessive caloric intake can lead to unhealthy weight gain and does not appropriately address normal developmental growth patterns. Preschool growth slows naturally compared to infancy, and nutritional changes should only be made if growth is outside expected ranges.

B. Advising that a child’s growth should exactly match peers is incorrect because normal growth varies among children. Genetics, body type, and overall health influence growth, and children do not grow at identical rates. Comparing strictly to peers can cause unnecessary anxiety for parents.

C. Suggesting delaying further growth assessments is incorrect because regular monitoring of growth is essential during all developmental stages. Preschool growth patterns are well understood and can be accurately evaluated using standardized growth charts.

D. Explaining that preschool growth is typically steady but slower compared to infancy is correct because preschool-aged children usually gain about 4 to 5 pounds and grow 2 to 3 inches per year. The child’s growth of 2.5 inches and 5 pounds falls squarely within expected norms, making this a reassuring and educational response that supports parental understanding.

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A 4-year-old child is diagnosed with nephrotic syndrome. Which of the following findings would the nurse expect to observe?

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Explanation

Correct Answer is D

Explanation

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