Nokea
What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?
- A. Low specific gravity
- B. Decreased hemoglobin
- C. Normal platelet count
- D. Reduced serum albumin
Correct Answer: D
Rationale: Reduced serum albumin, due to significant proteinuria, is a hallmark of minimal change nephrotic syndrome (MCNS). Specific gravity is high due to protein loss, hemoglobin is normal or elevated, and platelet counts are elevated from hemoconcentration, not normal.
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Urinary tract anomalies are frequently associated with what irregularities in fetal development?
- A. Myelomeningocele
- B. Cardiovascular anomalies
- C. Malformed or low-set ears
- D. Defects in lower extremities
Correct Answer: C
Rationale: Malformed or low-set ears are frequently associated with urinary tract anomalies, prompting heightened suspicion during newborn exams. Myelomeningocele may impair urinary function due to neural defects, but it?s less directly linked. Cardiac and extremity defects have weaker associations with renal anomalies.
What recommendation should the nurse make to prevent urinary tract infections (UTIs) in young girls?
- A. Avoid public toilet facilities.
- B. Limit long baths as much as possible.
- C. Cleanse the perineum with water after voiding.
- D. Ensure clear liquid intake of 2 L/day.
Correct Answer: D
Rationale: Adequate fluid intake (e.g., 2 L/day for a 5-6-year-old) minimizes urinary stasis, reducing UTI risk. Public toilets and long baths aren?t directly linked to UTIs, and perineal cleansing with water lacks evidence as a primary preventive measure.
The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurses reply?
- A. The antibiotic therapy contributes to labile blood pressure values.
- B. Hypotension leading to sudden shock can develop at any time.
- C. Acute hypertension is a concern that requires monitoring.
- D. Blood pressure fluctuations indicate that the condition has become chronic.
Correct Answer: C
Rationale: Frequent blood pressure monitoring is critical in acute glomerulonephritis to detect acute hypertension, which requires aggressive management to prevent renal damage. Antibiotics aren?t typically used, hypotension is not a primary concern, and fluctuations don?t indicate chronicity.
The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?
- A. Consuming a regular diet
- B. Increasing protein
- C. Restricting fluids
- D. Decreasing calories
Correct Answer: C
Rationale: Restricting fluids and sodium during severe edema in MCNS helps manage fluid retention. A regular diet isn?t advised, high protein doesn?t alter disease course, and adequate calories are needed for growth, despite appetite challenges.
What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?
- A. Infarction of renal vessels
- B. Immune complex formation and glomerular deposition
- C. Bacterial endotoxin deposition on and destruction of glomeruli
- D. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation
Correct Answer: B
Rationale: Postinfectious glomerulonephritis results from immune complexes formed after streptococcal infection, depositing in glomerular capillaries. Renal vessel infarction occurs in sickle cell disease, bacterial endotoxins aren?t involved, and embolization is linked to bacterial endocarditis.