Pyelonephritits Nephrotic Syndrome Study Guide

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Sample questions from Pyelonephritits Nephrotic Syndrome Study Guide

This material has 15 questions with answers and rationales. Here are the first 5.

1. 1.A nurse compares the findings of a patient with acute pyelonephritis and a patient with nephrotic syndrome. Which statement correctly explains the major difference between these disorders?

   • A.Pyelonephritis primarily causes urinary protein loss, whereas nephrotic syndrome is an infection of the renal pelvis.
   • B.Pyelonephritis involves infection of the kidney, whereas nephrotic syndrome involves increased glomerular permeability and heavy urinary protein loss.
   • C.Pyelonephritis results from reduced albumin production, whereas nephrotic syndrome results from an ascending bacterial infection.
   • D.Pyelonephritis and nephrotic syndrome both primarily result from obstruction of urine flow.

   Rationale: Option 1 is correct: pyelonephritis infects the renal pelvis and kidney tissue, while nephrotic syndrome reflects glomerular injury that permits excessive protein loss. Option 0 reverses the disorders. Option 2 incorrectly attributes pyelonephritis to reduced albumin production and nephrotic syndrome to infection. Option 3 is wrong because obstruction increases infection risk but is not the primary mechanism of both disorders.

2. 2.A pregnant patient reports dysuria followed by fever, chills, nausea, and right-sided flank pain. Which interpretation and nursing action are most appropriate?

   • A.These are expected pregnancy changes; recommend discussing them at the next routine prenatal visit.
   • B.These findings indicate nephrotic syndrome; begin teaching about protein replacement.
   • C.These findings suggest an ascending urinary infection involving the kidney; arrange prompt medical evaluation.
   • D.These findings indicate uncomplicated bladder irritation; encourage fluids without further evaluation.

   Rationale: Option 2 is correct because lower urinary symptoms followed by fever and flank pain suggest ascending pyelonephritis. Pregnancy-related urinary stasis increases risk, and prompt evaluation is needed because maternal and fetal complications can occur. Option 0 delays care for abnormal findings. Option 1 does not explain the fever and urinary symptoms. Option 3 overlooks signs of upper urinary tract infection; fluids alone are inadequate treatment.

3. 3.An older adult admitted with pyelonephritis develops new confusion, a blood pressure of 84/48 mm Hg, a respiratory rate of 28/min, and urine output of 15 mL during the past hour. Which nursing action has the highest priority?

   • A.Activate the rapid response system or urgently notify the provider and prepare to implement the sepsis protocol.
   • B.Administer a prescribed antipyretic and reassess blood pressure in one hour.
   • C.Encourage oral fluids and assist the patient to walk to the bathroom.
   • D.Wait for the urine culture result before requesting further treatment.

   Rationale: Option 0 is correct because hypotension, altered mental status, tachypnea, and low urine output suggest sepsis with impaired organ perfusion. Urgent assessment, prescribed IV fluids, and timely antibiotics are needed; obtain ordered cultures without significantly delaying antibiotics. Option 1 treats fever but delays stabilization. Option 2 is unsafe with hypotension and confusion. Option 3 delays potentially lifesaving treatment while cultures are pending.

4. 4.A patient with nephrotic syndrome has generalized edema, heavy proteinuria, low serum albumin, and a prescription for a loop diuretic and a sodium-restricted diet. Which nursing plan best evaluates treatment and supports fluid management?

   • A.Use urine color as the main measure of fluid balance and encourage salty foods to replace urinary losses.
   • B.Measure weight once each week and provide a high-protein diet to replace all protein lost in urine.
   • C.Restrict all oral fluids and hold the diuretic whenever peripheral edema remains present.
   • D.Obtain daily weights using the same scale, record intake and output, and monitor blood pressure, creatinine, and electrolytes.

   Answer and rationale are in the full material.

5. 5.A parent is learning home care for a child with nephrotic syndrome who takes prednisone. Which statement shows correct understanding of complication prevention and when to seek help?

   • A.I will stop prednisone as soon as the swelling disappears and restart it if swelling returns.
   • B.I will give prednisone as prescribed, report fever promptly, and seek emergency care for sudden chest pain or difficulty breathing.
   • C.I will give extra salty snacks when urine protein increases and restrict activity whenever the child feels well.
   • D.I will arrange all scheduled live vaccines without checking with the care team because prednisone does not affect vaccine safety.

   Answer and rationale are in the full material.