Which of the following findings are commonly associated with nephrotic syndrome? (Select All that Apply.)
Abrupt onset.
Proteinuria.
Hypoalbuminemia in blood.
Fever.
Hyperlipidemia.
Positive Group A beta hemolytic streptococcal infection.
Anasarca.
Correct Answer : B,C,E,G
Choice A rationale
Nephrotic syndrome typically has a gradual onset of symptoms, developing over days to weeks, as protein loss in the urine accumulates. An abrupt onset is less characteristic.
Choice B rationale
Proteinuria, the presence of abnormally high levels of protein in the urine (normal range is less than 150 mg/24 hours), is a defining characteristic of nephrotic syndrome. Damage to the glomeruli in the kidneys leads to increased permeability and leakage of protein into the urine.
Choice C rationale
Hypoalbuminemia in the blood (normal range is 3.5 to 5.5 g/dL) is a key feature of nephrotic syndrome. The excessive loss of protein in the urine leads to a decrease in serum albumin levels.
Choice D rationale
Fever is not typically a primary symptom of nephrotic syndrome. While children with nephrotic syndrome can develop infections, fever is not a direct consequence of the underlying kidney dysfunction.
Choice E rationale
Hyperlipidemia, an elevated level of lipids (fats) in the blood (normal total cholesterol is less than 200 mg/dL), is commonly associated with nephrotic syndrome. The liver increases lipoprotein synthesis in response to the decreased serum albumin levels.
Choice F rationale
While a positive Group A beta-hemolytic streptococcal infection can lead to post-streptococcal glomerulonephritis, which can sometimes present with nephrotic features, it is not a common finding directly associated with the primary diagnosis of nephrotic syndrome itself.
Choice G rationale
Anasarca, which is severe generalized edema characterized by widespread swelling due to fluid retention, is a common finding in nephrotic syndrome. The low serum albumin levels reduce oncotic pressure in the blood vessels, leading to fluid shifting into the interstitial spaces. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Instructing the student to avoid all physical activity is not the priority intervention. While reducing friction and sweating can be beneficial, completely ceasing activity may not be necessary with appropriate treatment and hygiene measures. The rash is likely a fungal infection, not exacerbated by moderate activity if properly managed.
Choice B rationale
Advising the student to apply an over-the-counter topical antifungal cream is the most appropriate initial intervention. The presentation of a well-demarcated, erythematous, scaly rash in the groin, sparing the scrotum and penis, in a wrestler wearing tight athletic gear strongly suggests tinea cruris, a fungal infection. Topical antifungals are the first-line treatment for this condition.
Choice C rationale
Referring the student for oral antibiotic therapy is not indicated at this stage. The clinical presentation is highly suggestive of a fungal infection, for which antibiotics are ineffective. Antibiotics are used to treat bacterial infections, which typically present with different characteristics such as pus or systemic symptoms.
Choice D rationale
Recommending a topical corticosteroid is not the priority. While corticosteroids can reduce inflammation and itching, they do not treat the underlying fungal infection and can sometimes worsen it by suppressing the local immune response. Antifungal treatment should be initiated first to address the cause of the rash.
Correct Answer is A
Explanation
Choice A rationale
Impetigo is a highly contagious superficial skin infection commonly caused by *Staphylococcus aureus* or *Streptococcus pyogenes*. The typical presentation includes small red papules that rapidly evolve into vesicles or pustules, which then rupture, leaving behind characteristic honey-colored, crusted lesions, often around the nose and mouth, consistent with the image and the reported progression.
Choice B rationale
Herpes simplex is caused by the herpes simplex virus (HSV) and typically presents as clusters of small, painful vesicles on an erythematous base, often around the mouth (oral herpes or cold sores) or genitals. While it can cause blisters, the progression to honey-colored crusts is not characteristic of herpes simplex infections.
Choice C rationale
Ringworm, or tinea corporis or tinea faciei when on the face, is a fungal infection that typically presents as circular, scaly patches with a raised border and central clearing. It is not characterized by the formation of blisters that rupture and form honey-colored crusts.
Choice D rationale
Contact dermatitis is an inflammatory skin reaction caused by direct contact with an irritant or allergen. It can present with redness, itching, swelling, and sometimes blisters, but the lesions are typically more widespread and do not characteristically form the honey-colored crusts seen in impetigo.
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