Question

The practical nurse (PN) is caring for a toddler during a follow-up visit after corticosteroid treatment for minimal change nephrotic syndrome (MCNS). Which finding should the PN recognize as an early sign of relapse?

Answer 1

Correct Answers:

Albuminuria

Rationale :

🔷 Albuminuria is an early hallmark sign of relapse in minimal change nephrotic syndrome (MCNS) because the glomerular membrane again becomes abnormally permeable to protein.

🔷 When relapse begins, protein leaks into the urine before more obvious manifestations such as significant edema become severe.

🔷 Monitoring the urine for protein or albumin is one of the most important ways to detect recurrence early in a child with nephrotic syndrome.

🔷 Early identification of albuminuria allows prompt treatment and may help reduce complications related to worsening hypoalbuminemia and fluid shifts.

🔷 For this reason, albumin in the urine is the key early finding the PN should recognize as a sign of relapse.

Increased thirst

🔷 Increased thirst is not a classic early indicator of relapse in minimal change nephrotic syndrome.

🔷 The more specific early warning sign is protein loss in the urine, not thirst.

Rounded face

🔷 A rounded face is more commonly associated with corticosteroid therapy, often described as a cushingoid appearance.

🔷 This finding reflects a medication effect rather than an early relapse of the nephrotic syndrome itself.

Tachypnea

🔷 Tachypnea is not an early, specific sign of relapse in MCNS.

🔷 It may occur later if complications such as severe edema or pleural effusion develop, but it is not the earliest expected indicator.

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Answer 2

Correct Answers:

Flaring of the nares

Rationale :

💠 Flaring of the nares is a significant sign of increased work of breathing in an infant and should alert the PN to acute respiratory distress.

💠 Infants use nasal flaring as a compensatory mechanism to decrease airway resistance and improve airflow when breathing becomes difficult.

💠 In bronchiolitis, airway inflammation and mucus obstruction can quickly increase respiratory effort, making nasal flaring an important clinical warning sign.

💠 This finding often occurs along with other signs of distress such as retractions, grunting, or cyanosis, and it requires prompt assessment.

💠 Because it reflects active respiratory compromise, flaring of the nares is the most concerning finding in this child.

Bilateral bronchial breath sounds

💠 Bronchial breath sounds are not the classic key finding that best identifies acute respiratory distress in bronchiolitis.

💠 The nurse should be more concerned about visible signs of increased respiratory effort, such as nasal flaring.

A resting respiratory rate of 35 breaths/minute

💠 A respiratory rate of 35 breaths/minute is generally within the expected range for a 3-month-old infant.

💠 By itself, this finding does not indicate acute respiratory distress.

Diaphragmatic respirations

💠 Infants normally rely heavily on the diaphragm for breathing, so diaphragmatic respirations are expected.

💠 This finding alone is not a specific sign of acute respiratory distress.

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Answer 3

Correct Answers:

Dry mucous membranes
Rebound tenderness
Temperature of 100.8° F (38.2° C)
Hypoactive bowel sounds
Vomiting prior to arrival

Rationale :

Dry mucous membranes

🔷 Dry mucous membranes suggest mild dehydration, which is important in this child because there has been vomiting and no oral intake since dinner the night before.

🔷 A client who is NPO and already showing signs of fluid loss requires close monitoring of hydration status and response to IV fluids.

🔷 In a child with suspected appendicitis, dehydration can worsen quickly and may affect circulation, comfort, and surgical readiness.

🔷 This finding also supports the need to monitor intake and output, laboratory values, and overall perfusion.

🔷 Because it reflects possible fluid volume deficit, dry mucous membranes require follow-up.

Rebound tenderness

🔷 Rebound tenderness is a significant sign of peritoneal irritation and is highly concerning in a child with suspected acute appendicitis.

🔷 Pain that worsens when pressure is released suggests inflammation may be extending to the peritoneum, which can indicate progression of the condition.

🔷 This finding raises concern for complications such as worsening inflammation or possible perforation if not addressed promptly.

🔷 Rebound tenderness is not a minor discomfort finding; it is an important abdominal red flag that requires urgent clinical attention.

🔷 Because it signals possible serious intra-abdominal pathology, it requires immediate follow-up.

Temperature of 100.8° F (38.2° C)

🔷 A temperature of 100.8° F (38.2° C) is a low-grade fever, which is clinically relevant in this child with right lower quadrant pain and vomiting.

🔷 Fever supports the possibility of an inflammatory or infectious process, such as appendicitis.

🔷 In the context of abdominal guarding, decreased bowel sounds, and pain migration to the right lower quadrant, this temperature becomes more significant.

🔷 The nurse should follow up on fever because worsening temperature trends may suggest increasing inflammation or possible complications.

🔷 This is an important abnormal finding that contributes to the overall picture and requires continued assessment.

Hypoactive bowel sounds

🔷 Hypoactive bowel sounds are abnormal and may indicate decreased intestinal activity associated with abdominal inflammation.

🔷 In a child with suspected appendicitis, reduced bowel sounds can occur as the bowel responds to irritation and localized inflammation.

🔷 This finding should be monitored because it can help support the severity and progression of the abdominal condition.

🔷 Bowel sound changes, when combined with guarding, localized tenderness, and pain with movement, strengthen concern for an acute abdominal process.

🔷 Because hypoactive bowel sounds reflect an abnormal gastrointestinal assessment, they require follow-up.

Vomiting prior to arrival

🔷 Vomiting is a concerning symptom in this client because it commonly accompanies appendicitis and can contribute to dehydration.

🔷 The child has vomited twice and has had no appetite, which increases concern for worsening fluid imbalance and gastrointestinal distress.

🔷 Vomiting also supports the significance of the abdominal pain pattern, especially since the pain migrated from the periumbilical area to the right lower quadrant.

🔷 This symptom is important to trend because persistent or worsening vomiting may indicate progression of the illness and affects fluid management.

🔷 Because it is both clinically relevant and potentially destabilizing, vomiting requires follow-up.

Bilateral clear breath sounds

🔷 Bilateral clear breath sounds are a normal respiratory finding and do not suggest an immediate pulmonary complication.

🔷 This finding does not require specific follow-up in comparison with the abnormal abdominal and hydration findings.

Denies dysuria

🔷 Denying dysuria helps reduce suspicion for a urinary cause of abdominal pain, such as a urinary tract problem.

🔷 This statement is useful assessment information, but it is not an abnormal finding that requires follow-up.

Strong peripheral pulses

🔷 Strong peripheral pulses indicate adequate peripheral perfusion at this time.

🔷 This is a reassuring finding and does not require follow-up unless the client’s condition changes.

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Answer 4

Correct Answers

Pain from umbilicus to RLQ [ Acute Appendicitis ]
C-reactive protein elevation [ Acute Appendicitis ; Mesenteric Adenitis ]
Vomiting after pain onset [ Acute Appendicitis ]
White blood cell elevation [ Acute Appendicitis ; Mesenteric Adenitis ]
Rebound tenderness [ Acute Appendicitis ]

Rationale :

Pain from umbilicus to RLQ- Acute Appendicitis

✅ Pain that starts around the umbilicus and then migrates to the right lower quadrant is a classic pattern of acute appendicitis.

✅Early appendiceal irritation causes vague periumbilical pain, and as inflammation progresses to the parietal peritoneum, the pain localizes to the RLQ.

✅This migration pattern is one of the most important hallmark findings used to distinguish appendicitis from many other abdominal disorders.

✅In the client record, the pain began as a “stomachache” around the belly button and later became worse in the right lower side, which strongly supports appendicitis . ✅This makes pain from umbilicus to RLQ a highly specific finding for acute appendicitis.

C-reactive protein elevation- Acute Appendicitis and Mesenteric Adenitis

✅An elevated C-reactive protein (CRP) reflects an active inflammatory process in the body.

✅In acute appendicitis, CRP often rises because the inflamed appendix triggers a measurable systemic inflammatory response.

✅In mesenteric adenitis, CRP can also be elevated because inflamed mesenteric lymph nodes are commonly caused by an infectious or inflammatory process.

✅The client’s CRP is 4.2 mg/dL, which is above the normal range and supports a significant inflammatory abdominal condition .

✅Because CRP is a marker of inflammation rather than a disease-specific test, it is appropriately associated with both acute appendicitis and mesenteric adenitis.

Vomiting after pain onset-Acute Appendicitis

✅ In acute appendicitis, the pain commonly begins first and is then followed by nausea or vomiting.

✅ This sequence is clinically important because it helps distinguish appendicitis from conditions like gastroenteritis, where vomiting often begins earlier or at the same time as abdominal discomfort.

✅ The record shows that the client’s abdominal pain started the prior evening, and vomiting occurred later the next morning, which matches the expected appendicitis pattern .

✅ Vomiting after the onset of pain supports worsening abdominal inflammation rather than a primary stomach or bowel infection.

✅ For this reason, vomiting after pain onset is most appropriately associated with acute appendicitis.

White blood cell elevation-Acute Appendicitis and Mesenteric Adenitis

✅White blood cell elevation suggests the presence of infection or inflammation.

✅In acute appendicitis, leukocytosis is common because the inflamed appendix triggers an immune response.

✅In mesenteric adenitis, the inflamed lymph nodes may also produce an elevated WBC count, especially when the condition is related to infection.

✅The client’s WBC is 15,600/mm³, which is clearly above the normal range and supports an acute inflammatory abdominal process .

✅Because leukocytosis is commonly seen in both conditions, white blood cell elevation is associated with acute appendicitis and mesenteric adenitis.

Rebound tenderness- Acute Appendicitis

✅Rebound tenderness indicates peritoneal irritation, which is a highly concerning sign in acute appendicitis.

✅When pain worsens after pressure is released, it suggests inflammation is irritating the peritoneal lining rather than being limited to a mild gastrointestinal upset.

✅Rebound tenderness is especially important when paired with RLQ pain, guarding, and pain with movement, all of which are present in this client’s assessment .

✅This finding increases concern for progression of appendiceal inflammation and possible complications if treatment is delayed.

✅Because it is a classic abdominal red-flag finding, rebound tenderness is most strongly associated with acute appendicitis.

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Answer 5

Correct Answers:

Perforated appendix

Rationale :

🔴 A perforated appendix is the most severe potential complication because it means the inflamed appendix has ruptured, allowing infected contents to spill into the abdominal cavity.

🔴 This can rapidly lead to peritonitis, sepsis, and widespread intra-abdominal infection, which are life-threatening complications.

🔴 The client already has findings that suggest worsening appendiceal inflammation, including right lower quadrant pain, guarding, rising fever, increasing pain, leukocytosis, elevated C-reactive protein, rigid abdomen, and ultrasound evidence of periappendiceal inflammatory changes with free fluid.

🔴 A rigid abdomen and increasing pain are especially concerning because they can indicate progression toward rupture and peritoneal irritation.

🔴 For these reasons, perforated appendix is the most serious complication the PN should anticipate in this client.

Abscess formation

🔴 Abscess formation is a serious complication of appendicitis, but it is generally more localized than a full perforation with diffuse contamination of the abdomen.

🔴 It is dangerous, yet perforation is considered more severe because it can cause rapid, generalized infection and hemodynamic deterioration.

Bowel obstruction

🔴 Bowel obstruction is not the most immediate or classic severe complication of acute appendicitis in this presentation.

🔴 The client’s assessment is much more consistent with concern for worsening inflammation and possible appendiceal rupture rather than mechanical intestinal blockage.

Dehydration

🔴 Dehydration is present as a possible concern because the child has been vomiting and has had poor intake, but it is not the most severe complication listed.

🔴 Compared with a perforated appendix, dehydration is generally more manageable and less immediately life-threatening.

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Answer 6

Correct Answers

Airway patency [ Can be Delayed ]
Acute pain [ Immediate Priority ]
Skin integrity [ Can be Delayed ]
Risk for infection [ Immediate Priority ]
Deficient knowledge [ Can be Delayed ]

Rationale :

Acute pain — Immediate Priority

🔷 The client’s abdominal pain is worsening, increasing from 6/10 to 9/10, and the pain is now described as constant, which indicates active clinical deterioration.

🔷 Severe pain in this child is linked to acute appendicitis with concerning findings such as rigid abdomen, guarding, fever, and increasing restlessness.

🔷 Uncontrolled pain can increase stress, tachycardia, and anxiety, and it may also signal progression of inflammation or possible perforation.

🔷 The healthcare team has already recognized this urgency because the client is scheduled for an appendectomy within the hour and morphine has been prescribed.

🔷 Because the pain is severe, escalating, and related to an acute surgical condition, acute pain is an immediate priority.

Risk for infection — Immediate Priority

🔷 The client has clear evidence of active infection and inflammation, including fever, elevated WBC count, elevated C-reactive protein, and ultrasound findings of periappendiceal inflammatory changes with free fluid.

🔷 The abdomen also became rigid on palpation, which raises concern for worsening appendiceal inflammation and possible peritoneal involvement or perforation.

🔷 A progressing abdominal infection can rapidly become life-threatening if it leads to rupture, peritonitis, or sepsis.

🔷 Since the child is awaiting surgery, preventing and monitoring for worsening infection is essential to protect physiologic stability.

🔷 For these reasons, risk for infection is an immediate priority and requires urgent nursing attention.

Airway patency — Can be Delayed

🔷 The client’s airway is currently patent, and there is no evidence of airway obstruction in the assessment data.

🔷 The child has clear bilateral breath sounds and an oxygen saturation of 98% to 99% on room air, so airway compromise is not the immediate concern right now.

🔷 Although airway is always assessed first in priority frameworks, this specific client does not currently show airway compromise.

🔷 The more urgent needs are related to the acute abdominal process, worsening pain, and infection risk.

🔷 Therefore, airway patency can be delayed as a focused intervention because it is stable at this time.

Skin integrity — Can be Delayed

🔷 The skin assessment shows the client’s skin is warm and dry with normal turgor, and there is no evidence of breakdown or tissue injury.

🔷 Skin care remains important, but there is no indication that impaired skin integrity is an urgent problem in this acute situation.

🔷 The client’s immediate threats are the worsening appendiceal inflammation and severe abdominal pain, not skin damage.

🔷 Preventive skin care can still be addressed, especially if immobility continues, but it does not take priority over the current surgical emergency.

🔷 Therefore, skin integrity can be delayed while more urgent problems are managed first.

Deficient knowledge — Can be Delayed

🔷 The parents are understandably anxious about the upcoming surgery, so teaching is important, but it is not the first priority during this acute phase.

🔷 The child is showing signs of a worsening surgical abdomen, including increasing pain, rising temperature, tachycardia, and abdominal rigidity, which must be addressed first.

🔷 Teaching is most effective when the client and family are more stable and better able to process information.

🔷 Once urgent physiologic needs are managed, the nurse should absolutely provide explanations about the procedure, recovery, and postoperative care.

🔷 For now, deficient knowledge can be delayed until immediate physical priorities are stabilized.

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Answer 7

Correct Answers

Blank 1 Correct Option: Verify signed surgical consent on chart
Blank 2 Correct Option: Give cefoxitin 700 mg IVPB once
Blank 3 Correct Option: Keep NPO

Rationale :

Verify signed surgical consent on chart

🟣 Verifying that the surgical consent is signed is a priority because the client is scheduled for an appendectomy within the next hour, so the chart must be complete before surgery proceeds.

🟣 A signed consent confirms that the provider has explained the procedure and that the parent or legal guardian has given permission for the operation.

🟣 In a 10-year-old child, the parent or guardian must provide legal consent, making this step especially important before transport to the operating room.

🟣 The record shows the surgeon has already discussed the surgery plan with the parents, so confirming the signed form is an essential immediate nursing action.

🟣 Because surgery is imminent, verifying the signed consent is one of the top three priorities.

Give cefoxitin 700 mg IVPB once

🟣 Administering cefoxitin is a priority because the client has findings of acute appendicitis with worsening abdominal findings, fever, elevated WBC, elevated C-reactive protein, and ultrasound evidence of periappendiceal inflammatory changes with free fluid.

🟣 A preoperative antibiotic helps reduce the bacterial load and lowers the risk of postoperative infection, peritonitis, and surgical site complications.

🟣 Appendicitis is an infectious and inflammatory condition, so timely antibiotic therapy is part of appropriate preoperative preparation.

🟣 Since the client is moving quickly to surgery, this medication should be given promptly as part of immediate readiness.

🟣 For these reasons, giving cefoxitin IVPB is a top priority action.

Keep NPO

🟣 Keeping the client NPO is a critical priority because surgery is scheduled for 1000, and anesthesia is expected.

🟣 Food or fluids in the stomach increase the risk for aspiration during induction of anesthesia, which can lead to serious respiratory complications.

🟣 The nurse should not allow oral intake even though the mother asked if the client could have sips of water for dry mouth.

🟣 Maintaining strict NPO status protects the client’s airway and supports safe perioperative care.

🟣 Because the child is about to undergo immediate surgery, keeping NPO is one of the top three priority actions.

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Answer 8

Correct Highlights :

Three small abdominal incisions present, dressings intact with scant serosanguineous drainage.
Abdomen soft with hypoactive sounds.
Client afebrile.
Oxygen saturation 99% on room air.

Rationale :

Three small abdominal incisions present, dressings intact with scant serosanguineous drainage

🟢 Intact dressings indicate that the surgical sites are protected and there is no evidence of major disruption of the incision areas.

🟢 Scant serosanguineous drainage is an expected early postoperative finding because a small amount of blood-tinged drainage can occur after surgery.

🟢 The description of three small abdominal incisions is also consistent with a routine laparoscopic appendectomy, which generally uses small incision sites.

🟢 There is no mention of excessive bleeding, purulent drainage, or dressing saturation, which supports normal postoperative healing.

🟢 For these reasons, this finding reflects positive progress toward recovery goals.

Abdomen soft with hypoactive sounds

🟢 A soft abdomen is a reassuring postoperative finding because it suggests there is no rigid abdominal guarding or severe distention at this time.

🟢 Hypoactive bowel sounds can be expected after abdominal surgery because anesthesia and bowel handling often temporarily slow intestinal motility.

🟢 This is more favorable than absent bowel sounds or a rigid abdomen, which would raise greater concern for complications.

🟢 Early after surgery, bowel activity does not have to be fully normal immediately to still represent acceptable progress.

🟢 Because the abdomen is soft and the bowel sounds are present, even if decreased, this finding supports postoperative improvement.

Client afebrile

🟢 Being afebrile is a positive sign because it suggests there is no current evidence of worsening postoperative infection or persistent inflammatory escalation.

🟢 Before surgery, this client had elevated temperatures, so the absence of fever afterward is an encouraging change.

🟢 A normal temperature supports the goal of maintaining physiologic stability during the recovery period.

🟢 Although temperature alone does not rule out all complications, it is still an important marker of postoperative progress.

🟢 Therefore, afebrile status is a finding that shows movement in the right direction after surgery.

Oxygen saturation 99% on room air

🟢 An oxygen saturation of 99% on room air shows that the client is oxygenating well without needing supplemental oxygen.

🟢 This indicates effective respiratory function, which is an important postoperative recovery goal, especially after anesthesia and opioid pain medication.

🟢 Adequate oxygenation helps support tissue healing and overall physiologic stability.

🟢 There is no sign here of hypoxemia, respiratory depression, or immediate airway compromise.

🟢 For these reasons, this is a clear indicator of positive postoperative progress.

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Answer 9

Correct Answers:

Deliver oxygen and keep the child in a knee-chest position.

Rationale :

🔵 A knee-chest position is a priority intervention during a cyanotic (hypoxic) spell because it increases systemic vascular resistance and helps reduce the right-to-left shunting of blood.

🔵 This position improves pulmonary blood flow, allowing more blood to reach the lungs for oxygenation.

🔵 Oxygen administration is also essential because it helps correct hypoxemia and decreases the severity of the spell.

🔵 Children with cyanotic heart defects, such as tetralogy of Fallot, often squat instinctively for this same reason, so the knee-chest position mimics that protective action.

🔵 This makes oxygen with knee-chest positioning the most appropriate immediate intervention for tachypnea and tachycardia caused by a hypoxic spell.

Take the vital signs after putting the child in a prone position.

🔵 A prone position does not help relieve a cyanotic spell and does not improve oxygenation in the same therapeutic way as the knee-chest position.

🔵 Taking vital signs is important, but treating the hypoxic episode comes before routine measurement.

Place the child in bed and elevate the head with two pillows.

🔵 Elevating the head may promote comfort, but it does not directly reduce the right-to-left shunt that occurs during a cyanotic spell.

🔵 This intervention is less effective than placing the child in the knee-chest position and giving oxygen immediately.

Have the child blow up balloons to increase gas exchange.

🔵 Asking the child to blow up balloons increases effort and can worsen fatigue and oxygen demand during a hypoxic spell.

🔵 This is not a safe or appropriate emergency intervention for a child with acute cyanosis.

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Answer 10

Correct Answers:

Observe the appearance of the eyelids.

Rationale :

🟣 Periorbital edema refers to swelling around the eyes, so observing the eyelids is the most direct way to assess changes in this finding.

🟣 In nephrotic syndrome, fluid shifts and hypoalbuminemia commonly cause swelling that is especially noticeable around the eyes, particularly in the morning.

🟣 Monitoring the eyelids helps the nurse evaluate whether the edema is improving, worsening, or remaining the same over time.

🟣 This is a focused and appropriate assessment because it directly matches the body area affected by periorbital swelling.

🟣 For this reason, observing the eyelids is the best action to monitor changes in periorbital edema.

Apply gentle pressure over the flank area.

🟣 The flank area may be assessed for generalized edema, but it does not specifically evaluate periorbital edema.

🟣 The question asks about swelling around the eyes, so the eyelids are the priority area to observe.

Measure the child's abdominal girth.

🟣 Measuring abdominal girth is useful for tracking ascites or abdominal fluid accumulation.

🟣 It does not directly assess changes in periorbital edema.

Compress the tissue over the ankles.

🟣 Pressing over the ankles helps assess for dependent edema in the lower extremities.

🟣 Although edema can occur there, it is not the best method for monitoring swelling around the eyes.

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Laboratory Test	Result	Reference Range
White blood cells (WBC)	15,600/mm³ (15.6 * 10 ^ 9 / L)	5,000 to 10,000/mm³ (5 to 10 * 10 ^ 9 / L )
Red blood cells (RBC)	(4.8 * 10 ^ 12 / L) 4.8 * 10 ^ 6 * mu*L	4 to 5.5 * 10 ^ 6 / mu * L (4.4 to 5.5 * 10 ^ 12 / L )
Hemoglobin (Hgb)	13.5 g/dL (135 g/L)	10 to 15.5 g/dL (100 to 155 g/L)
Hematocrit (Hct)	41% (0.41 volume fraction)	32% to 44% (0.32 to 0.44 volume fraction)
Platelet count	280,000/mm³ (280 * 10 ^ 9 / L)	150,000 to 400,000/mm³ (150 to 400 * 10 ^ 9 / L )

Laboratory Test	Result	Reference Range
Sodium	138 mEq/L (138 mmol/L)	136 to 145 mEq/L (136 to 145 mmol/L)
Potassium	3.8 mEq/L (3.8 mmol/L)	3.4 to 4.7 mEq/L (3.4 to 4.7 mmol/L)
Chloride	102 mEq/L (102 mmol/L)	90 to 110 mEq/L (90 to 110 mmol/L)
CO2 (carbon dioxide)	24 mEq/L (24 mmol/L)	20 to 28 mEq/L (20 to 28 mmol/L)
Glucose	74 mg/dL (4.1 mmol/L)	70 to 110 mg/dL (3.9 to 6.1 mmol/L)
Blood urea nitrogen (BUN)	18 mg/dL (6.4 mmol/L)	5 to 18 mg/dL (1.8 to 6.4 mmol/L)
Creatinine	1.1 mg/dL (97 µmol/L)	0.3 to 0.7 mg/dL (26.5 to 61.9 µmol/L)

Laboratory Test	Result	Reference Range
C-reactive protein	4.2 mg/dL (42 mg/L)	Less than 1.0 mg/dL (less than 10 mg/L)

Laboratory Test	Result	Reference Range
Appearance	Clear	Clear
Color	Amber Yellow	Amber yellow
White blood cells (WBC)	0	0 to 4 per Ipf
Red blood cells (RBC)	Less than 2	Less than or equal to 2
Protein	0 mg/dL	0 to 8 mg/dL
Specific gravity	1.020	1.005 to 1.03 (usually 1.01 to 1.025)
Leukocyte esterase	Negative	Negative
Nitrites	Negative	Negative
Ketones	Negative	Negative
Crystals	Negative	Negative
Casts	None	None
Red blood cell casts	None	None
Glucose	Negative	Fresh specimen: negative
Bilirubin	None	None
Osmolality, Urine	800 mOsm/kg	Random specimen: 50 to 1,200 mOsm/kg

Assessment Finding	Acute Appendicitis	Mesenteric Adenitis	Gastroenteritis
Pain from umbilicus to RLQ
C-reactive protein elevation
Vomiting after pain onset
White blood cell elevation
Rebound tenderness

Hesi RN pediatrics 2026

No.

1 :
The practical nurse (PN) is caring for a toddler during a follow-up visit after corticosteroid treatment for minimal change nephrotic syndrome (MCNS). Which finding should the PN recognize as an early sign of relapse?

2 :
A 3-month-old with bronchiolitis is brought to the clinic experiencing irritability and poor oral intake. Which finding should alert the practical nurse (PN) that the child is in acute respiratory distress?

Answer Options

Correct Answers

Answer Options

Correct Answers

Correct Answers

Correct Highlights :

10 :
To monitor changes in the periorbital edema of a child with nephrotic syndrome, which action should the practical nurse (PN) take?

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Nursing Problem	Immediate Priority	Can be Delayed
Airway patency
Acute pain
Skin integrity
Risk for infection
Deficient knowledge

Hesi RN pediatrics 2026

No.

1 : The practical nurse (PN) is caring for a toddler during a follow-up visit after corticosteroid treatment for minimal change nephrotic syndrome (MCNS). Which finding should the PN recognize as an early sign of relapse?

2 : A 3-month-old with bronchiolitis is brought to the clinic experiencing irritability and poor oral intake. Which finding should alert the practical nurse (PN) that the child is in acute respiratory distress?

Answer Options

Correct Answers

Answer Options

Correct Answers

Correct Answers

Correct Highlights :

10 : To monitor changes in the periorbital edema of a child with nephrotic syndrome, which action should the practical nurse (PN) take?

1 :
The practical nurse (PN) is caring for a toddler during a follow-up visit after corticosteroid treatment for minimal change nephrotic syndrome (MCNS). Which finding should the PN recognize as an early sign of relapse?

2 :
A 3-month-old with bronchiolitis is brought to the clinic experiencing irritability and poor oral intake. Which finding should alert the practical nurse (PN) that the child is in acute respiratory distress?

10 :
To monitor changes in the periorbital edema of a child with nephrotic syndrome, which action should the practical nurse (PN) take?