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A child is diagnosed with Wilms' tumor. During assessment, the nurse in charge expects to detect:
- A. Gross hematuria
- B. Dysuria
- C. Nausea and vomiting
- D. An abdominal mass
Correct Answer: D
Rationale: In a child with Wilms' tumor, the nurse would expect to detect an abdominal mass upon assessment. Wilms' tumor, also known as nephroblastoma, is a type of kidney cancer that commonly presents as a firm, non-tender abdominal mass. This mass may be felt upon palpation of the abdomen. Gross hematuria (A) is not a typical finding associated with Wilms' tumor. Dysuria (B) is the term used to describe painful or difficult urination and is not a characteristic symptom of Wilms' tumor. Nausea and vomiting (C) are also not commonly associated with Wilms' tumor, unless the tumor is causing obstruction or compression of nearby structures in the abdomen.
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Which is true of a Wilms tumor? (Select all that apply.)
- A. It is also referred to as neuroblastoma.
- B. It is most commonly seen between the ages of 2 and 5 years.
- C. It can occur on its own or be associated with congenital anomalies.
- D. It is a slow-growing tumor.
Correct Answer: C
Rationale: Wilms tumor typically occurs in children aged 2-5 years and may be associated with congenital anomalies. It is not the same as neuroblastoma, and its prognosis is generally good with treatment.
The nurse is assessing a 3-day-old, breastfed newborn who weighed 7 pounds, 8 ounces at birth. The newborn's mother is now concerned that the newborn weighs 6 pounds, 15 ounces. Which is the most appropriate nursing intervention?
- A. Recommend supplemental feedings of formula.
- B. Explain that this weight loss is within normal limits.
- C. Assess child further to determine cause of excessive weight loss.
- D. Encourage mother to express breast milk for bottle feeding the newborn.
Correct Answer: B
Rationale: It is normal for newborns to lose weight in the first few days of life, typically up to 10% of their birth weight. In this case, the newborn's weight loss from 7 pounds, 8 ounces to 6 pounds, 15 ounces is within the expected range. It is important for the nurse to reassure the mother that this weight loss is normal and to encourage continued breastfeeding on demand to support newborn hydration and nutrition. There is no need for supplemental feedings at this point unless there are other signs of feeding issues or concerns.
The nurse needs to administer an IM injection of 2.4 million units of penicillin G. it is supplied in a vial of 5,000,000 units of powder for injection. Instructions state to dilute with 8 mL of sterile water. How manu mL should the nurse draw up?
- A. 2.6 mL
- B. 4.1 mL
- C. 3.8 mL
- D. 4.4 mL
Correct Answer: B
Rationale: To administer an IM injection of 2.4 million units of penicillin G, the nurse should first reconstitute the penicillin powder with sterile water as per the instructions. The vial contains 5,000,000 units of the powder and when diluted with 8 mL of sterile water, the resulting concentration would be:
Which would be best for the nurse to use when determining the temperature of a preterm infant under a radiant heater?
- A. Axillary sensor TestBankWorld.org
- B. Tympanic membrane sensor
- C. Rectal mercury glass thermometer
- D. Rectal electronic thermometer
Correct Answer: B
Rationale: A tympanic membrane sensor or tympanic thermometer is the best option for determining the temperature of a preterm infant under a radiant heater. Tympanic thermometers are quick and non-invasive, making them ideal for use in neonatal care. They provide accurate readings by measuring the infrared heat waves coming from the eardrum. This method is preferred over other options like axillary sensors, rectal mercury thermometers, and rectal electronic thermometers, which may not be as efficient or suitable for use with preterm infants.
After a 3- month trail of dietary therapy, a client with type2 diabetes mellitus still has blood glucose levels above 180 mg/dl. The physician adds glyburide (DiaBeta), 2.5 mg P.O. daily, to the treatment regimen. The nurse should instruct the client to take glyburide:
- A. 30 minutes before breakfast
- B. 30 minutes after dinner.
- C. in the midmorning
- D. at bedtime.
Correct Answer: D
Rationale: Glyburide (DiaBeta) is a sulfonylurea medication used to treat type 2 diabetes mellitus by stimulating the pancreas to release more insulin. Taking glyburide at bedtime is recommended because it helps to ensure that the medication's peak action aligns with the natural rise in blood glucose levels in the early morning hours, which can help control fasting blood glucose levels. Additionally, taking glyburide in the evening reduces the risk of hypoglycemia during the day when the client may be more active and less likely to monitor blood glucose levels closely.