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A child with a Wilms tumor is scheduled for surgery. Which best describes the procedure?
- A. Only the affected kidney will be removed.
- B. Both kidneys will be removed.
- C. Only the tumor mass will be excised.
- D. The tumor is removed, and a biopsy of the unaffected kidney is done.
Correct Answer: A
Rationale: The standard treatment for Wilms tumor is a nephrectomy of the affected kidney while preserving the other kidney.
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Mr. and Mrs. Baker's only daughter is diagnosed with heart failure. Which of the following interventions would be appropriate to promote optimal nutrition for the infant?
- A. Replacing regular nipples with easy-to-suck ones
- B. Allowing the infant to feed for at least 1 hour
- C. Providing large feedings evenly spaced every 4 hours
- D. Offering formula that is high in sodium and calories 47
Correct Answer: A
Rationale: Replacing regular nipples with easy-to-suck ones would be appropriate to promote optimal nutrition for the infant with heart failure. Infants with heart failure may have difficulty feeding due to fatigue and respiratory distress. Using easy-to-suck nipples can help the infant conserve energy during feeding and promote adequate intake. This intervention aims to make feeding easier for the infant and improve overall nutrition status.
The nurse is aware that a healthy newborn's respirations are:
- A. Regular, abdominal, 40-50 per minute, deep
- B. Irregular, abdominal, 30-60 per minute, shallow
- C. Irregular, initiated by chest wall, 30-60 per minute, deep
- D. Regular, initiated by the chest wall, 40-60 per minute, shallow
Correct Answer: B
Rationale: A healthy newborn's respirations are typically irregular, abdominal, with a rate of 30-60 per minute, and tend to be shallow. Newborns have immature respiratory centers in their brain, leading to irregular breathing patterns compared to adults. Their breathing is usually abdominal due to their diaphragmatic breathing pattern. The normal respiratory rate for a newborn can fluctuate between 30-60 breaths per minute, with shallow breathing being characteristic of their physiology. Regular shallow breathing with occasional periods of apnea is considered normal in newborns and should not be a cause for concern.
Which of the following outcomes would indicate successful treatment of diabetes insipidus?
- A. Fluid intake of less than 2,500mL
- B. Blood pressure of 90/50mmHg
- C. Pulse rate of 126 beats/min
- D. Urine output of more than 200mL/hour
Correct Answer: A
Rationale: Successful treatment of diabetes insipidus is indicated when the patient's excessive urination (polyuria) and thirst (polydipsia) are controlled. One of the primary goals of treatment is to achieve fluid balance by reducing urine output and, consequently, decreasing the excessive thirst. When the fluid intake is less than 2,500mL, it suggests that the patient's excessive thirst has decreased, indicating successful management of the condition. Monitoring and managing fluid intake are crucial in the treatment of diabetes insipidus to prevent dehydration and electrolyte imbalances. A lower fluid intake is a positive indicator that the treatment is effectively addressing the increased urine output characteristic of diabetes insipidus.
A 12-month-old boy weighed 8 lb 2 oz at birth. What weight should the nurse expect him to be now?
- A. 16 lb 4 oz
- B. 20 lb 5 oz
- C. 24 lb 6 oz
- D. 32 lb 8 oz
Correct Answer: C
Rationale: Infants typically triple their birth weight by 12 months. For an 8-lb infant, that would be approximately 24 lb.
A 16-year-old mother complaining she feels unhappy living with her husband and his family. The most appropriate action is
- A. refer her to an obstetrician
- B. explain the way of milk expression
- C. apply Edinburgh postnatal depression scale
- D. advise her on milk engorgement
Correct Answer: C
Rationale: The Edinburgh Postnatal Depression Scale is a screening tool for postnatal depression which might address her unhappiness.