A nurse is caring for a school-age child in the pediatric unit.

Exhibits

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Answer and Explanation

The Correct Answer is []

Nephrotic Syndrome: The child presents with periorbital and abdominal edema, foamy dark-colored urine, significant proteinuria (24 mg/dL), hypoalbuminemia (1.4 g/dL), and hyperlipidemia (cholesterol 465 mg/dL), all of which are classic indicators of nephrotic syndrome. The elevated ESR and low sodium further support an inflammatory renal process with fluid retention.
Chronic Kidney Disease: CKD is a long-term progressive decline in kidney function. This child shows acute findings with severe proteinuria and low albumin, consistent with nephrotic syndrome, not CKD.
Acute Glomerulonephritis: Usually presents with hematuria (cola-colored urine), hypertension, and mild proteinuria. This client has severe proteinuria, hypoalbuminemia, and edema, which are more typical of nephrotic syndrome.
Hemolytic Uremic Syndrome: Commonly follows a gastrointestinal illness and includes anemia, thrombocytopenia, and acute kidney injury. This child’s platelets are elevated, not low, and there's no history of diarrheal illness, making HUS unlikely.
Encourage a low sodium diet: Sodium restriction helps manage fluid retention and edema which are key concerns in nephrotic syndrome. It also prevents worsening of ascites and periorbital swelling.
Administer oral corticosteroids: This is the first-line treatment for idiopathic nephrotic syndrome, especially in children. Corticosteroids reduce glomerular permeability, limiting protein loss in the urine and promoting remission.
Initiate peritoneal dialysis: Dialysis is only indicated in severe renal failure, which this child does not have. There’s no indication of uremia or electrolyte crisis, so dialysis is not appropriate at this stage.

Intake and output: Essential for assessing fluid balance. Children with nephrotic syndrome may retain fluid or have decreased urine output, making I&O a crucial measure.
Daily weight: This is the most accurate way to track fluid retention or loss. Daily weight is important for evaluating response to treatment, especially as edema resolves.

Head circumference: This is monitored in infants and toddlers, especially to assess for hydrocephalus or growth delays. It is not relevant for a school-age child with kidney issues.

HbA1C: A measure of long-term blood glucose control, used for diagnosing and managing diabetes. Has no relevance in the diagnosis or management of nephrotic syndrome.
Urine specific gravity: While useful in initial diagnosis (and already elevated), it is not the best indicator of ongoing progress. Daily weight and I&O are more practical and reliable for assessing edema and treatment response.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is C

Explanation

A. 1+ pedal edema. Mild pedal edema is typically not associated with instability or falls, unless it progresses to severe swelling that affects mobility or balance. It is a sign of fluid retention but not a direct fall risk indicator on its own.
B. Bruises on the lower extremities. Bruising can be a sign of previous falls or trauma, but it is not itself a cause or indicator of fall risk. While it may prompt further investigation, it does not confirm fall risk independently.
C. Impaired vision. Visual impairment is a significant risk factor for falls because it affects depth perception, ability to detect hazards, and overall spatial awareness. Clients with impaired vision are more likely to trip, misjudge steps, or bump into obstacles.
D. Coarse rhonchi auscultated over the trachea. Coarse rhonchi are respiratory findings typically related to mucus in the airways and do not directly contribute to fall risk unless accompanied by severe respiratory distress or fatigue.

A. Administer packed RBCS. B. Obtain a specimen for ABG analysis. C. Place a large-bore IV catheter in an upper extremity. D. Insert an indwelling urinary catheter.

Correct Answer is C

Explanation

A. Administer packed RBCs. While blood transfusion may be urgently needed for hemorrhagic shock, it cannot be initiated until vascular access is established. It is important, but not the first step.
B. Obtain a specimen for ABG analysis. Arterial blood gases can provide valuable information about respiratory and metabolic status, but they are not the top priority in an unstable trauma patient.
C. Place a large-bore IV catheter in an upper extremity. Establishing IV access is the priority in trauma care, as it allows for rapid fluid resuscitation and medication administration. This intervention supports all subsequent emergency treatments.
D. Insert an indwelling urinary catheter. A catheter may be necessary for monitoring urine output as a sign of perfusion, but this is not the first action in a trauma situation where immediate stabilization is the priority.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client to determine their fall risk. Which of the following findings should alert the nurse that the client is at risk for falls?

Correct Answer is C

Explanation

A nurse in an emergency department is planning care for a client who has abdominal trauma from a motor-vehicle crash. Which of the following provider prescriptions should the nurse implement first?

Correct Answer is C

Explanation

A nurse is preparing to administer a blood transfusion to a client, which of the following actions should the nurse take?

A nurse is caring for a client whose partner recently died. The nurse sits with the client to provide comfort. Which of the following ethical principles is the nurse demonstrating?

A nurse is caring for a client who is experiencing status epilepticus. Which of the following medications should the nurse expect to administer?

A nurse and an assistive personnel (AP) are assigned a group of clients on the unit. Which of the following clients should the nurse instruct the AP to report to the nurse?

A nurse is teaching a group of parents about expected development of gross motor skills during infancy. The nurse should teach that the following developmental tasks are expected to occur in what order? (Move the steps into the box, placing them in the order of performance. Use all the steps.)

A nurse is documenting at a computer when a second nurse asks to use the computer to quickly document data before taking a break. Which of the following actions should the first nurse take?

A charge nurse is observing a conflict between two nurses who both insist that the charge nurse favors the other when making assignments. Which of the following conflict-resolution strategies should the charge nurse use?

A nurse is caring for a client who is newly diagnosed with diabetes mellitus and is prescribed an 1800 calorie ADA diet. The client is refusing to eat the provided meals. Which of the following actions should the nurse take?