Which clinical finding should the nurse expect in a child with nephrosis?

• A. Elevated blood pressure.
• B. Blood-tinged urine.
• C. Elevated temperature.
• D. Urine protein 3+ to 4+

Answer: (D)

Nephrosis (nephrotic syndrome) is defined by heavy loss of protein in the urine. When the kidney’s filtering barrier becomes more permeable to proteins, albumin spills into the urine, leading to low blood protein levels and a drop in oncotic pressure. This drives fluid into tissues, causing edema, and drives the body to conserve or alter lipids, but the key diagnostic signal in the urine is prominent protein loss. Therefore, seeing heavy proteinuria, such as urine protein 3+ to 4+ on dipstick, is the most expected finding in a child with nephrotic syndrome. Blood pressure can be normal or only mildly elevated, hematuria is not typical (that would suggest a nephritic process), and fever is not a defining feature. So the urine protein reading is the best indicator of nephrosis in this context.