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 D
Explanation
Choice A rationale
Monitoring for signs of infection is crucial in children with spina bifida due to the potential for meningitis and urinary tract infections related to neurological deficits and potential openings in the spinal cord. Normal white blood cell count ranges from 4,500 to 11,000 per microliter, and fever, redness, swelling, or purulent drainage would indicate infection.
Choice B rationale
Encouraging mobility is important to promote development and prevent complications like contractures. However, in the immediate postoperative period or with significant neurological impairment, maintaining skin integrity takes precedence to prevent infection and further complications.
Choice C rationale
Providing nutritional support is essential for growth and development in children with spina bifida, who may have feeding difficulties or increased metabolic needs. Adequate nutrition supports overall health, but preventing skin breakdown in areas prone to pressure is a more immediate concern.
Choice D rationale
Maintaining skin integrity is the most important intervention because children with spina bifida often have sensory and motor deficits that make them susceptible to pressure ulcers, especially over bony prominences and the surgical site if a myelomeningocele repair has occurred. Skin breakdown can lead to serious infections and complications.
Correct Answer is C
Explanation
Choice A rationale
Washing bedding and recently worn clothing in hot water (above 54°C or 130°F) helps to kill lice and their nits (eggs) that may be present on these items, preventing re-infestation or spread to others. The heat denatures the proteins essential for the lice's survival.
Choice B rationale
Sealing non-washable items in a plastic bag for 2 weeks suffocates any lice and allows any hatched nymphs to die due to lack of a blood meal. Lice cannot survive for extended periods away from a human host.
Choice C rationale
Both washing bedding and clothing in hot water and sealing non-washable items are crucial steps in eliminating head lice and preventing recurrence or transmission. Therefore, all of the above instructions should be provided to parents.
Choice D rationale
Notifying the school allows for screening of other children and implementation of appropriate measures to prevent further spread of the head lice within the school environment. While important for public health, it is an action separate from the direct treatment and environmental control measures that parents should undertake at home.
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