Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is reviewing the laboratory results of a client who has nephrotic syndrome.
Which of the following results should the nurse expect?
A. Proteinuria.
Proteinuria is the presence of excess protein in the urine, which is a hallmark of nephrotic syndrome. Nephrotic syndrome is a kidney disorder that causes increased permeability of the glomerular basement membrane, leading to loss of protein and other substances in the urine.
B. Hypolipidemia.
Choice B is wrong because hypolipidemia is a low level of lipids in the blood, which is not expected in nephrotic syndrome. On the contrary, nephrotic syndrome causes hyperlipidemia, which is a high level of lipids in the blood, due to increased synthesis and decreased clearance of lipoproteins.
C. Hyperalbuminemia.
Choice C is wrong because hyperalbuminemia is a high level of albumin in the blood, which is not expected in nephrotic syndrome. On the contrary, nephrotic syndrome causes hypoalbuminemia, which is a low level of albumin in the blood, due to loss of albumin in the urine and decreased synthesis by the liver.
D. Increased hemoglobin.
Choice D is wrong because increased hemoglobin is not expected in nephrotic syndrome. On the contrary, nephrotic syndrome can cause anemia, which is a low level of hemoglobin in the blood, due to loss of iron and erythropoietin in the urine and decreased production of red blood cells by the bone marrow.
This question is an excerpt from Nurse Dive's nursing test bank - ATI PN Capstone Proctored Comprehensive Assessment 2020 B. Take the full exam now
Full Explanation
Proteinuria is the presence of excess protein in the urine, which is a hallmark of nephrotic syndrome. Nephrotic syndrome is a kidney disorder that causes increased permeability of the glomerular basement membrane, leading to loss of protein and other substances in the urine.
Choice B is wrong because hypolipidemia is a low level of lipids in the blood, which is not expected in nephrotic syndrome. On the contrary, nephrotic syndrome causes hyperlipidemia, which is a high level of lipids in the blood, due to increased synthesis and decreased clearance of lipoproteins.
Choice C is wrong because hyperalbuminemia is a high level of albumin in the blood, which is not expected in nephrotic syndrome. On the contrary, nephrotic syndrome causes hypoalbuminemia, which is a low level of albumin in the blood, due to loss of albumin in the urine and decreased synthesis by the liver.
Choice D is wrong because increased hemoglobin is not expected in nephrotic syndrome. On the contrary, nephrotic syndrome can cause anemia, which is a low level of hemoglobin in the blood, due to loss of iron and erythropoietin in the urine and decreased production of red blood cells by the bone marrow.
Normal ranges for proteinuria are less than 150 mg per day or less than 10 mg per deciliter on a random urine sample. Normal ranges for serum lipids are total cholesterol less than 200 mg per deciliter, LDL cholesterol less than 100 mg per deciliter, HDL cholesterol more than 40 mg per deciliter for men and more than 50 mg per deciliter for women, and triglycerides less than 150 mg per
deciliter. Normal ranges for serum albumin are 3.5 to 5.0 grams per deciliter.
Similar Questions
A nurse is reviewing a client’s laboratory results prior to administering the client’s medications. The nurse notes that the client’s lithium level is 2.0 mEq/L.
Which of the following findings should the nurse expect?
A. Muscle irritability.
. A client with a lithium level of
B. Constipation.
Choice B is wrong because constipation is not a sign of lithium toxicity, but rather a possible side effect of lithium therapy at lower doses.
C. Hypoglycemia.
Choice C is wrong because hypoglycemia is not a sign of lithium toxicity, but rather a possible complication of diabetes or other conditions that affect blood sugar levels.
D. Increased BP.
Choice D is wrong because increased blood pressure is not a sign of lithium toxicity, but rather a possible risk factor for cardiovascular disease or other conditions that affect blood vessels.
Full Explanation
Muscle irritability. A client with a lithium level of
2.0 mEq/L has severe lithium toxicity, which can cause muscle irritability, tremors, seizures, and other neurological symptoms. The normal therapeutic range for lithium is 0.8-1.2 mEq/L.
Choice B is wrong because constipation is not a sign of lithium toxicity, but rather a possible side effect of lithium therapy at lower doses.
Choice C is wrong because hypoglycemia is not a sign of lithium toxicity, but rather a possible complication of diabetes or other conditions that affect blood sugar levels.
Choice D is wrong because increased blood pressure is not a sign of lithium toxicity, but rather a possible risk factor for cardiovascular disease or other conditions that affect blood vessels.
A nurse is collecting data from a client who is at 29 weeks of gestation.
Which of the following findings should the nurse identify as a potential indication of a prenatal complication?
A. Leg cramps.
Choice A is wrong because leg cramps are a common discomfort during pregnancy and are not usually a sign of a complication.
B. Ptyalism.
Choice B is wrong because ptyalism, or excessive salivation, is a normal physiological change during pregnancy and does not indicate a problem.
C. Blurred vision.
This can be a sign of preeclampsia, a serious complication of pregnancy that causes high blood pressure and proteinuria.
D. Melasma.
Choice D is wrong because melasma, or darkening of the skin on the face, is also a normal physiological change during pregnancy and does not pose a risk to the mother or the fetus.
Full Explanation
This can be a sign of preeclampsia, a serious complication of pregnancy that causes high blood pressure and proteinuria.
The nurse should report this finding to the provider and monitor the client’s blood pressure, urine protein, and reflexes.
Choice A is wrong because leg cramps are a common discomfort during pregnancy and are not usually a sign of a complication.
Choice B is wrong because ptyalism, or excessive salivation, is a normal physiological change during pregnancy and does not indicate a problem.
Choice D is wrong because melasma, or darkening of the skin on the face, is also a normal physiological change during pregnancy and does not pose a risk to the mother or the fetus.
A nurse is reinforcing teaching with a newly licensed nurse about discharge planning.
Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?
A. The nurse is responsible for providing a written prescription for a client home care referral.
Choice A is wrong because the nurse is not responsible for providing a written prescription for a client home care referral. This is the role of the provider or another authorised prescriber.
B. The nurse should begin discharge planning upon the client’s admission.
The nurse should begin discharge planning upon the client’s admission. This is because discharge planning is a key aspect of effective care that reduces the length of stay, emergency readmissions and pressure on hospital beds. Discharge planning involves considering what support might be required by the client in the community, referring the client to these services, and liaising with these services to manage the client’s discharge.
C. A home hazard appraisal includes an assessment of the client’s financial resources.
Choice C is wrong because a home hazard appraisal does not include an assessment of the client’s financial resources. A home hazard appraisal is an evaluation of the safety and accessibility of the client’s home environment.
D. A medication reconciliation is required 24 hours prior to the client’s discharge.
Choice D is wrong because a medication reconciliation is not required 24 hours prior to the client’s discharge. A medication reconciliation is a process of comparing the medications a client is taking with those prescribed for them to avoid errors or discrepancies. A medication reconciliation should be done at every transition of care, including admission, transfer and discharge.
Full Explanation
The nurse should begin discharge planning upon the client’s admission. This is because discharge planning is a key aspect of effective care that reduces the length of stay, emergency readmissions and pressure on hospital beds. Discharge planning involves considering what support might be required by the client in the community, referring the client to these services, and liaising with these services to manage the client’s discharge.
Choice A is wrong because the nurse is not responsible for providing a written prescription for a client home care referral. This is the role of the provider or another authorised prescriber.
Choice C is wrong because a home hazard appraisal does not include an assessment of the client’s financial resources. A home hazard appraisal is an evaluation of the safety and accessibility of the client’s home environment.
Choice D is wrong because a medication reconciliation is not required 24 hours prior to the client’s discharge. A medication reconciliation is a process of comparing the medications a client is taking with those prescribed for them to avoid errors or discrepancies. A medication reconciliation should be done at every transition of care, including admission, transfer and discharge.