The labs of a hospitalized child indicate protein in the urine, decreased serum albumin, and increased serum cholesterol. Upon assessment, the child presents with generalized edema. Which of the following diagnoses does the nurse anticipate given the clinical presentation?
Nephrotic syndrome
Acute glomerulonephritis
Chronic kidney disease
Urinary tract infection
The Correct Answer is A
Choice A reason: Nephrotic syndrome is characterized by proteinuria, hypoalbuminemia, hyperlipidemia, and generalized edema due to glomerular damage, leading to protein loss in urine. This reduces serum albumin, causing fluid shifts into tissues (edema) and elevated cholesterol due to liver compensation. The described lab and clinical findings align perfectly with this diagnosis.
Choice B reason: Acute glomerulonephritis typically presents with hematuria, hypertension, and mild edema, not significant proteinuria or hyperlipidemia. It is often post-infectious (e.g., streptococcal) and involves immune-mediated glomerular inflammation. The described findings of low albumin and high cholesterol are more specific to nephrotic syndrome, making glomerulonephritis less likely.
Choice C reason: Chronic kidney disease may cause proteinuria and edema in advanced stages, but it typically involves elevated creatinine, reduced glomerular filtration rate, and systemic symptoms like fatigue. Hyperlipidemia and hypoalbuminemia are less prominent compared to nephrotic syndrome, making this diagnosis less consistent with the described clinical presentation.
Choice D reason: Urinary tract infections cause dysuria, frequency, and sometimes hematuria, but not significant proteinuria, hypoalbuminemia, hyperlipidemia, or generalized edema. These infections are bacterial and localized, without the systemic protein and lipid imbalances seen in the described case, making this an incorrect diagnosis for the presentation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Barium or air enema is both diagnostic and therapeutic for intussusception. It visualizes the telescoped bowel segment (diagnostic) and applies pressure to reduce the invagination (therapeutic), resolving most cases non-surgically. This dual role makes it the standard approach, aligning with the correct answer.
Choice B reason: Abdominal x-ray can suggest intussusception by showing air-fluid levels or obstruction but is not therapeutic. It lacks the specificity to confirm the diagnosis and cannot reduce the telescoped bowel, making it an incorrect choice for a test that serves both diagnostic and therapeutic purposes.
Choice C reason: Abdominal ultrasound is highly sensitive for diagnosing intussusception, showing the “target sign” of telescoped bowel. However, it is not therapeutic, as it cannot reduce the invagination. It is used for confirmation, not treatment, making it incorrect for a dual-purpose test in this context.
Choice D reason: CT scans can diagnose intussusception by visualizing bowel obstruction but are not therapeutic. They involve radiation exposure, making them less preferred in children, and do not reduce the telescoped bowel, making this an incorrect choice for a test with both diagnostic and therapeutic roles.
Correct Answer is ["230"]
Explanation
Step 1: Convert 1/2 cup of juice to milliliters.
1 cup = 240 mL
1/2 cup = 240 mL ÷ 2 = 120 mL
Result at step 1 = 120 mL
Step 2: Convert 3 ounces of gelatin to milliliters.
1 ounce = 30 mL
3 ounces × 30 mL = 90 mL
Result at step 2 = 90 mL
Step 3: Convert 1 ounce of ice pop to milliliters.
1 ounce = 30 mL
Result at step 3 = 30 mL
Step 4: Note the ginger ale intake.
The child consumed 20 mL of ginger ale, which is already in milliliters.
Result at step 4 = 20 mL
Step 5: Sum the fluid intake from all items.
120 mL + 90 mL + 30 mL + 20 mL = 260 mL
Result at step 5 = 260 mL
Final answer 230 mL
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