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A nurse is gathering information from a 1-year-old child who has been diagnosed with Wilms' tumor. Which of the following symptoms should the nurse anticipate?
- A. Jaundice
- B. Abdominal mass
- C. Swollen joints
- D. Diarrhea
Correct Answer: B
Rationale: Jaundice, a yellowing of the skin and eyes, is not typically a symptom of Wilms' tumor. It is more commonly associated with conditions that cause liver dysfunction. An abdominal mass is one of the most common symptoms of Wilms' tumor. Parents or healthcare providers may feel a lump or swelling in the child's abdomen. Swollen joints are not a typical symptom of Wilms' tumor. They are more commonly associated with conditions that affect the joints, such as juvenile arthritis. Diarrhea is not a typical symptom of Wilms' tumor. It is more commonly a symptom of gastrointestinal illnesses.
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A nurse is planning to monitor a client for dehydration following several episodes of vomiting and an increase in the client's temperature. Which of the following findings should the nurse identify as an indication that the client is dehydrated?
- A. Urine specific gravity 1.034.
- B. Bounding pulse.
- C. BP 46/94 mm Hg.
- D. Distended neck veins.
Correct Answer: A
Rationale: A urine specific gravity of 1.034 is higher than the normal range (1.002-1.030), indicating that the urine is more concentrated due to a lack of hydration. A bounding pulse is not typically associated with dehydration. Dehydration more commonly results in a weak, rapid pulse. A blood pressure reading of 46/94 mm Hg is not indicative of dehydration. Dehydration often leads to low blood pressure. Distended neck veins are not a typical sign of dehydration. Dehydration can lead to decreased blood volume, which would not cause distension of the neck veins.
The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?
- A. Abdominal rigidity and pain on palpation.
- B. Rounded abdomen and hypoactive bowel sounds.
- C. Visible peristalsis and weight loss.
- D. Distention of the lower abdomen and constipation.
Correct Answer: B
Rationale: Abdominal rigidity and pain on palpation are not typical signs of pyloric stenosis. Pyloric stenosis usually presents with non-bilious projectile vomiting, a palpable olive-shaped mass in the upper abdomen, and signs of dehydration. A rounded abdomen and hypoactive bowel sounds are characteristic signs of pyloric stenosis. The hypertrophied pyloric muscle obstructs the passage of food from the stomach to the duodenum, leading to gastric distention, visible peristalsis, and vomiting. The infant may appear hungry after vomiting and will continue to feed, leading to weight loss. Visible peristalsis and weight loss are consistent with pyloric stenosis. The visible peristalsis occurs as the infant tries to force the stomach contents through the narrowed pyloric sphincter. Weight loss is a result of poor feeding and vomiting. Distention of the lower abdomen and constipation are not typical findings in pyloric stenosis. Constipation suggests a lower gastrointestinal issue, while pyloric stenosis primarily affects the upper gastrointestinal tract.
A nurse is caring for a client who is postoperative immediately following a tonsillectomy. Which of the following snacks should the nurse offer the client?
- A. Lime ice pop
- B. Cranberry juice
- C. Ice cream
- D. Apple juice
Correct Answer: A
Rationale: An orange ice pop is a good choice because it is cold and soothing for the throat, and it is also clear liquid which is usually recommended after tonsillectomy. Cranberry juice is not the best choice because it is acidic and can cause discomfort to the surgical site. Ice cream is not recommended immediately after surgery because dairy products can increase mucus production which can lead to coughing and discomfort. Apple juice is not the best choice because it is acidic and can cause discomfort to the surgical site.
What is the mode of transmission for Tinea Capitis (ringworm)?
- A. Direct contact with infected personal items such as towels, combs, or hats.
- B. Exposure to worm eggs through bare feet.
- C. Sitting on worm eggs.
- D. Airborne droplet transmission.
Correct Answer: A
Rationale: Tinea Capitis, also known as scalp ringworm, is primarily transmitted through direct contact with infected personal items such as towels, combs, or hats. Exposure to worm eggs through bare feet is not a mode of transmission for Tinea Capitis. This is more commonly associated with a different type of parasitic infection known as hookworm. Sitting on worm eggs is not a mode of transmission for Tinea Capitis. This is a misconception and there is no scientific evidence to support this claim. Airborne droplet transmission is not a mode of transmission for Tinea Capitis. Tinea Capitis is caused by a type of fungus, not a virus or bacteria, and it does not spread through the air via droplets.
A nurse is planning care for a child who has severe diarrhea. Which of the following actions is the nurse's priority?
- A. Assess fluid balance.
- B. Maintain fluid therapy.
- C. Rehydrate.
- D. Introduce a regular diet.
Correct Answer: A
Rationale: Assessing fluid balance is the priority action when caring for a child with severe diarrhea. Diarrhea can lead to significant fluid and electrolyte loss, which can result in dehydration. Early recognition and treatment of dehydration are crucial to prevent further complications. While maintaining fluid therapy is an important part of managing severe diarrhea, the first step should be to assess the child's fluid balance. Rehydration is a key part of the treatment for severe diarrhea, but it should be done after assessing the child's fluid balance. Introducing a regular diet is usually done after the acute phase of diarrhea has resolved and the child's fluid balance has been restored.