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Urinary System

Glomerulonephritis and Nephrotic Syndrome Practice Questions

15 free Glomerulonephritis and Nephrotic Syndrome practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.

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Question 1 of 15 Medium

Which diagnosis fits best for a 10-year-old child presenting with periorbital edema, proteinuria (>3.5 g/day), hypoalbuminemia and hyperlipidemia?

  1. A Acute post-streptococcal glomerulonephritis
  2. B Nephrotic syndrome
  3. C IgA nephropathy
  4. D Rapidly progressive glomerulonephritis

Correct answer: Nephrotic syndrome

The heavy proteinuria, hypoalbuminemia and hyperlipidemia with edema are characteristic of nephrotic syndrome.

Question 2 of 15 Medium

In a patient with Acute Glomerulonephritis following streptococcal infection, what urine finding is most expected?

  1. A Massive proteinuria (>3.5 g/day) without hematuria
  2. B Tea-coloured (cola-coloured) urine with red blood cell casts
  3. C Clear urine with low specific gravity
  4. D Frothy urine with fat bodies (oval fat bodies)

Correct answer: Tea-coloured (cola-coloured) urine with red blood cell casts

Post-streptococcal glomerulonephritis typically causes hematuria, RBC casts and reduced GFR, not pure heavy proteinuria with fat bodies.

Question 3 of 15 Medium

A patient diagnosed with nephrotic syndrome is at highest risk for which of the following complications?

  1. A Presence of marked hyperlipidaemia
  2. B Urinary protein loss exceeding 3.5 g/day
  3. C Hematuria with red blood cell casts
  4. D Severe hypoalbuminaemia below 2 g/dL

Correct answer: Hematuria with red blood cell casts

In nephrotic syndrome, loss of proteins including antithrombin III leads to a hypercoagulable state and risk of DVT.

Question 4 of 15 Medium

Which of the following best differentiates nephritic-type glomerulonephritis from pure nephrotic syndrome?

  1. A Presence of hyperlipidaemia
  2. B Urinary protein loss >3.5 g/day
  3. C Significant hematuria and RBC casts
  4. D Severe hypoalbuminaemia (<2 g/dL)

Correct answer: Significant hematuria and RBC casts

Nephritic syndrome (in glomerulonephritis) is typified by hematuria and RBC casts; heavy proteinuria and hyperlipidaemia are more nephrotic features.

Question 5 of 15 Medium

A student asks why a patient with nephrotic syndrome develops generalized edema. The best explanation is?

  1. A Increased oncotic pressure from hypoalbuminaemia
  2. B Decreased plasma oncotic pressure increases capillary filtration
  3. C Decreased aldosterone causing renal sodium loss
  4. D Loss of free water producing dehydration and swelling

Correct answer: Decreased plasma oncotic pressure increases capillary filtration

Loss of albumin lowers plasma oncotic pressure, causing fluid to shift into interstitial space, thereby causing edema.

Question 6 of 15 Medium

In acute glomerulonephritis, which of the following vital-sign findings is most anticipated?

  1. A Hypotension with bradycardia
  2. B Hypertension with oliguria
  3. C Normal blood pressure with polyuria
  4. D Hypotension with polyuria

Correct answer: Hypertension with oliguria

In glomerulonephritis, reduced GFR and sodium/water retention lead to oliguria and hypertension.

Question 7 of 15 Medium

A biopsy in a patient shows “spike and dome” pattern on silver stain and immunoglobulin deposit along the basement membrane, consistent with a cause of nephrotic syndrome. Which is the likely diagnosis?

  1. A Minimal change disease
  2. B Focal segmental glomerulosclerosis
  3. C Membranous nephropathy
  4. D IgA nephropathy

Correct answer: Membranous nephropathy

The “spike and dome” pattern describes membranous glomerulopathy, a common adult cause of nephrotic syndrome.

Question 8 of 15 Medium

A nurse is caring for a child with minimal change disease causing nephrotic syndrome. Which treatment is expected as first-line?

  1. A High-dose loop diuretics alone
  2. B Corticosteroids such as prednisone
  3. C Immediate renal transplantation
  4. D Plasmapheresis to remove immune complexes

Correct answer: Corticosteroids such as prednisone

Minimal change disease often responds to corticosteroids as first-line therapy; other options are not initial first-line.

Question 9 of 15 Medium

A patient with glomerulonephritis shows increasing BUN, creatinine, oliguria and crescent formation on biopsy. What term best describes this scenario?

  1. A Serum albumin of 4.0 g/dL
  2. B Urinary protein of 1 g/day
  3. C Serum cholesterol of 320 mg/dL
  4. D Absence of peripheral edema

Correct answer: Serum cholesterol of 320 mg/dL

Rapidly progressive glomerulonephritis is characterized by rapid loss of renal function, crescent formation and oliguria.

Question 10 of 15 Medium

In nephrotic syndrome, which laboratory finding is most consistent?

  1. A Serum albumin 4.0 g/dL
  2. B Urinary protein 1 g/day
  3. C Serum cholesterol elevated
  4. D No edema present

Correct answer: Serum cholesterol elevated

Hyperlipidaemia (elevated cholesterol) is common in nephrotic syndrome due to liver response to hypoalbuminaemia.

Question 11 of 15 Medium

A nurse monitors a patient with acute post-streptococcal glomerulonephritis. Which of the following is the priority nursing focus?

  1. A Monitoring for development of thrombosis
  2. B Promoting high-protein diet to replace losses
  3. C Monitoring and managing hypertension and fluid overload
  4. D Encouraging bed-rest until urine clears completely

Correct answer: Monitoring and managing hypertension and fluid overload

Hypertension and fluid overload are common complications in acute glomerulonephritis and require prompt monitoring and management.

Question 12 of 15 Medium

Which dietary instruction is appropriate for a patient with nephrotic syndrome?

  1. A High-sodium diet to prevent hypotension and shock
  2. B Low-fat, moderate-protein diet with sodium and fluid restriction
  3. C Unlimited protein intake to compensate for urinary losses
  4. D High-cholesterol diet to raise circulating lipid levels

Correct answer: Low-fat, moderate-protein diet with sodium and fluid restriction

In nephrotic syndrome, moderate protein (not excessive), low fat (because of hyperlipidaemia), and sodium/fluid restriction for edema are appropriate.

Question 13 of 15 Medium

A patient with glomerulonephritis develops hematuria, oliguria, nausea, vomiting and malaise. Which underlying pathophysiologic mechanism best explains these symptoms?

  1. A Increased glomerular capillary permeability to albumin alone
  2. B Immune complex deposition causing inflammation and reduced GFR
  3. C Primary tubular cell necrosis without glomerular involvement
  4. D Podocyte foot-process effacement causing massive protein loss

Correct answer: Immune complex deposition causing inflammation and reduced GFR

In glomerulonephritis, immune complex deposition causes inflammation of glomeruli, decreasing GFR, generating oliguria and uremic symptoms.

Question 14 of 15 Medium

When teaching a patient with nephrotic syndrome, what should the nurse emphasize monitoring at home for relapse?

  1. A Morning hematuria
  2. B Increase in foaminess of the urine
  3. C Gradual weight loss
  4. D A drop in blood pressure to 90/50 mmHg

Correct answer: Increase in foaminess of the urine

Foaminess of urine reflects increased proteinuria and is a useful home sign of relapse in nephrotic syndrome.

Question 15 of 15 Medium

Which of the following medications is used to reduce proteinuria and progression in glomerular disease by lowering intra-glomerular pressure?

  1. A ACE inhibitor (e.g., lisinopril)
  2. B Loop diuretic (e.g., furosemide) only
  3. C High-dose corticosteroid alone
  4. D Beta-blocker (e.g., metoprolol) only

Correct answer: ACE inhibitor (e.g., lisinopril)

ACE inhibitors reduce glomerular capillary pressure and proteinuria and are used in glomerular disease management.

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