Comprehensive Professional Nursing
Examination: Pediatric Nephrotic Syndrome
Total Questions: 200 | Format: Multiple Choice Questions (MCQs)
with Detailed Clinical Rationales
Target Audience: Registered Nurses, Pediatric Nursing Specialists,
NCLEX-RN Candidates
Domain 1: Laboratory Findings & Diagnostics (Questions 1-
30)
Question 1: A nurse is reviewing the laboratory results of a
school-age child who has nephrotic syndrome. Which of the
following findings should the nurse expect?
A. Serum albumin of 4.5 g/dL
B. Massive proteinuria (3+ to 4+ on dipstick)
C. Hypernatremia
D. Decreased serum cholesterol
Correct Answer: B
Rationale: Massive proteinuria is the hallmark of nephrotic
syndrome, resulting from increased glomerular permeability to
plasma proteins (particularly albumin). Serum albumin is typically
decreased (hypoalbuminemia), sodium may be normal or low (due
to fluid retention/dilutional hyponatremia), and serum cholesterol
and triglycerides are characteristically elevated (hyperlipidemia).
Question 2: A child with minimal change nephrotic syndrome
(MCNS) has a urinalysis ordered. Which finding confirms the
diagnosis?
A. Hematuria with red blood cell casts
B. 3+ or 4+ protein with absence of significant hematuria
, C. Glucosuria and ketonuria
D. Pyuria and bacteriuria
Correct Answer: B
Rationale: Minimal change nephrotic syndrome is characterized by
heavy proteinuria (3+ to 4+) without significant hematuria or
hypertension, distinguishing it from acute glomerulonephritis.
Question 3: Which of the following lipid abnormalities is most
commonly associated with nephrotic syndrome in children?
A. Hypocholesterolemia
B. Hypercholesterolemia and hypertriglyceridemia
C. Isolated hypetriglyceridemia with normal cholesterol
D. Normal lipid profile
Correct Answer: B
Rationale: Hyperlipidemia (elevated serum cholesterol and
triglycerides) is a classic feature of nephrotic syndrome, stimulated
by hepatic synthesis of lipoproteins in response to
hypoalbuminemia and decreased oncotic pressure.
Question 4: A nurse is reviewing the complete blood count
(CBC) of a school-age child with severe nephrotic syndrome.
Which electrolyte or hematologic value is frequently altered?
A. Hemoglobin and hematocrit may be elevated due to
hemoconcentration
B. Platelet count is typically severely decreased
C. White blood cell count is always zero
D. Potassium is dangerously low
Correct Answer: A
Rationale: Due to intravascular fluid shift into the interstitial
,spaces (third spacing), children with nephrotic syndrome often
exhibit hemoconcentration, leading to elevated hemoglobin and
hematocrit levels, as well as an increased risk for
thromboembolism due to hemoconcentration and loss of anti-
thrombin III in the urine.
Question 5: Clinical Case / Question 5: A school-age child with
nephrotic syndrome presents with specific clinical parameters.
Which nursing action or assessment is priority?
A. Administering prescribed loop diuretics and monitoring strict
intake and output.
B. Encouraging vigorous physical activity to prevent venous
stasis.
C. Initiating a high-sodium diet to replace electrolyte losses.
D. Discontinuing urine protein monitoring at home.
Correct Answer: A
Rationale: Rationale for Question 5: Managing fluid overload in
nephrotic syndrome involves judicious administration of diuretics
(such as furosemide), monitoring daily weights, and measuring
precise intake and output. High sodium is contraindicated, activity
is balanced with rest, and urine monitoring is crucial.
Question 6: Clinical Case / Question 6: A school-age child with
nephrotic syndrome presents with specific clinical parameters.
Which nursing action or assessment is priority?
A. Administering prescribed loop diuretics and monitoring strict
intake and output.
B. Encouraging vigorous physical activity to prevent venous
stasis.
, C. Initiating a high-sodium diet to replace electrolyte losses.
D. Discontinuing urine protein monitoring at home.
Correct Answer: A
Rationale: Rationale for Question 6: Managing fluid overload in
nephrotic syndrome involves judicious administration of diuretics
(such as furosemide), monitoring daily weights, and measuring
precise intake and output. High sodium is contraindicated, activity
is balanced with rest, and urine monitoring is crucial.
Question 7: Clinical Case / Question 7: A school-age child with
nephrotic syndrome presents with specific clinical parameters.
Which nursing action or assessment is priority?
A. Administering prescribed loop diuretics and monitoring strict
intake and output.
B. Encouraging vigorous physical activity to prevent venous
stasis.
C. Initiating a high-sodium diet to replace electrolyte losses.
D. Discontinuing urine protein monitoring at home.
Correct Answer: A
Rationale: Rationale for Question 7: Managing fluid overload in
nephrotic syndrome involves judicious administration of diuretics
(such as furosemide), monitoring daily weights, and measuring
precise intake and output. High sodium is contraindicated, activity
is balanced with rest, and urine monitoring is crucial.
Question 8: Clinical Case / Question 8: A school-age child with
nephrotic syndrome presents with specific clinical parameters.
Which nursing action or assessment is priority?
A. Administering prescribed loop diuretics and monitoring strict
Examination: Pediatric Nephrotic Syndrome
Total Questions: 200 | Format: Multiple Choice Questions (MCQs)
with Detailed Clinical Rationales
Target Audience: Registered Nurses, Pediatric Nursing Specialists,
NCLEX-RN Candidates
Domain 1: Laboratory Findings & Diagnostics (Questions 1-
30)
Question 1: A nurse is reviewing the laboratory results of a
school-age child who has nephrotic syndrome. Which of the
following findings should the nurse expect?
A. Serum albumin of 4.5 g/dL
B. Massive proteinuria (3+ to 4+ on dipstick)
C. Hypernatremia
D. Decreased serum cholesterol
Correct Answer: B
Rationale: Massive proteinuria is the hallmark of nephrotic
syndrome, resulting from increased glomerular permeability to
plasma proteins (particularly albumin). Serum albumin is typically
decreased (hypoalbuminemia), sodium may be normal or low (due
to fluid retention/dilutional hyponatremia), and serum cholesterol
and triglycerides are characteristically elevated (hyperlipidemia).
Question 2: A child with minimal change nephrotic syndrome
(MCNS) has a urinalysis ordered. Which finding confirms the
diagnosis?
A. Hematuria with red blood cell casts
B. 3+ or 4+ protein with absence of significant hematuria
, C. Glucosuria and ketonuria
D. Pyuria and bacteriuria
Correct Answer: B
Rationale: Minimal change nephrotic syndrome is characterized by
heavy proteinuria (3+ to 4+) without significant hematuria or
hypertension, distinguishing it from acute glomerulonephritis.
Question 3: Which of the following lipid abnormalities is most
commonly associated with nephrotic syndrome in children?
A. Hypocholesterolemia
B. Hypercholesterolemia and hypertriglyceridemia
C. Isolated hypetriglyceridemia with normal cholesterol
D. Normal lipid profile
Correct Answer: B
Rationale: Hyperlipidemia (elevated serum cholesterol and
triglycerides) is a classic feature of nephrotic syndrome, stimulated
by hepatic synthesis of lipoproteins in response to
hypoalbuminemia and decreased oncotic pressure.
Question 4: A nurse is reviewing the complete blood count
(CBC) of a school-age child with severe nephrotic syndrome.
Which electrolyte or hematologic value is frequently altered?
A. Hemoglobin and hematocrit may be elevated due to
hemoconcentration
B. Platelet count is typically severely decreased
C. White blood cell count is always zero
D. Potassium is dangerously low
Correct Answer: A
Rationale: Due to intravascular fluid shift into the interstitial
,spaces (third spacing), children with nephrotic syndrome often
exhibit hemoconcentration, leading to elevated hemoglobin and
hematocrit levels, as well as an increased risk for
thromboembolism due to hemoconcentration and loss of anti-
thrombin III in the urine.
Question 5: Clinical Case / Question 5: A school-age child with
nephrotic syndrome presents with specific clinical parameters.
Which nursing action or assessment is priority?
A. Administering prescribed loop diuretics and monitoring strict
intake and output.
B. Encouraging vigorous physical activity to prevent venous
stasis.
C. Initiating a high-sodium diet to replace electrolyte losses.
D. Discontinuing urine protein monitoring at home.
Correct Answer: A
Rationale: Rationale for Question 5: Managing fluid overload in
nephrotic syndrome involves judicious administration of diuretics
(such as furosemide), monitoring daily weights, and measuring
precise intake and output. High sodium is contraindicated, activity
is balanced with rest, and urine monitoring is crucial.
Question 6: Clinical Case / Question 6: A school-age child with
nephrotic syndrome presents with specific clinical parameters.
Which nursing action or assessment is priority?
A. Administering prescribed loop diuretics and monitoring strict
intake and output.
B. Encouraging vigorous physical activity to prevent venous
stasis.
, C. Initiating a high-sodium diet to replace electrolyte losses.
D. Discontinuing urine protein monitoring at home.
Correct Answer: A
Rationale: Rationale for Question 6: Managing fluid overload in
nephrotic syndrome involves judicious administration of diuretics
(such as furosemide), monitoring daily weights, and measuring
precise intake and output. High sodium is contraindicated, activity
is balanced with rest, and urine monitoring is crucial.
Question 7: Clinical Case / Question 7: A school-age child with
nephrotic syndrome presents with specific clinical parameters.
Which nursing action or assessment is priority?
A. Administering prescribed loop diuretics and monitoring strict
intake and output.
B. Encouraging vigorous physical activity to prevent venous
stasis.
C. Initiating a high-sodium diet to replace electrolyte losses.
D. Discontinuing urine protein monitoring at home.
Correct Answer: A
Rationale: Rationale for Question 7: Managing fluid overload in
nephrotic syndrome involves judicious administration of diuretics
(such as furosemide), monitoring daily weights, and measuring
precise intake and output. High sodium is contraindicated, activity
is balanced with rest, and urine monitoring is crucial.
Question 8: Clinical Case / Question 8: A school-age child with
nephrotic syndrome presents with specific clinical parameters.
Which nursing action or assessment is priority?
A. Administering prescribed loop diuretics and monitoring strict
