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Although most relapses in children with Wilms tumor occur early (within 2 yr of diagnosis) and have a favorable outcome, about 15% suffer relapse. Relapse includes all the following EXCEPT
- A. low stage (I/II) at diagnosis
- B. no prior radiotherapy
- C. anaplastic histology
- D. more than 12 mo from nephrectomy
Correct Answer: C
Rationale: Anaplastic histology is associated with a poorer prognosis and is not typically associated with favorable relapse outcomes.
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A nurse needs to assess a client who is undergoing urinary diversion. Which of the ff assessment is essential for the client?
- A. The client's knowledge about the effects of the surgery on his sexual function
- B. The clients medical history of allergy to iodine or seafood
- C. The clients knowledge about the effects of the surgery on his nervous control
- D. The clients occupational and environmental health hazards
Correct Answer: C
Rationale: The essential assessment for a client undergoing urinary diversion is the client's knowledge about the effects of the surgery on his nervous control. Urinary diversion is a surgical procedure that involves redirecting urine flow from the bladder to a new exit point in the body due to bladder cancer, birth defects, or other medical conditions. Understanding the effects of the surgery on nervous control is crucial as it can impact the client's ability to control urination and bowel movements post-surgery. Educating the client about these effects will help in managing expectations and in planning for any necessary adjustments to their lifestyle and daily routine. It is important for the nurse to assess the client's level of understanding and provide appropriate education and support regarding nervous control changes that may result from the procedure.
During a routine health assessment, the nurse notes that an 8-month-old infant has significant head lag. Which is the nurse's most appropriate action?
- A. Teach parents appropriate exercises.
- B. Recheck head control at next visit.
- C. Refer child for further evaluation.
- D. Refer child for further evaluation if anterior fontanel is still open. TestBankWorld.org
Correct Answer: C
Rationale: Significant head lag in an 8-month-old infant can be a concerning sign indicating potential developmental delays or muscle weakness. The most appropriate action for the nurse in this situation is to refer the child for further evaluation by a healthcare provider, such as a pediatrician or developmental specialist, to assess and address the underlying cause of the head lag. It is important to rule out any potential developmental issues early on to provide the necessary interventions and support for the infant's optimal growth and development.
Which is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats?
- A. Social isolation
- B. Level of stress
- C. Degree of depression
- D. Desire to punish others
Correct Answer: D
Rationale: The most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats is the desire to punish others. Individuals who commit suicide often exhibit behaviors or thought patterns indicating a desire to cause harm or guilt to others. This desire to punish others may drive them to take their own lives as a way to make others feel responsible or suffer the consequences of their actions. On the other hand, individuals who make suicidal attempts or threats may not have the same level of intent to harm others through their actions, and their motivations may stem from different underlying issues such as social isolation, stress, or depression. Therefore, the desire to punish others is a crucial factor that sets those who commit suicide apart from those who make attempts or threats.
Burns are commonly seen in child abuse. Approximately 10% of children hospitalized with burns are victims of abuse. Of the following, inflicted burn can be MOST commonly the result of
- A. contact with hot iron
- B. contact with radiators
- C. cigarette application
- D. scalding injuries
Correct Answer: D
Rationale: Scalding injuries, often caused by hot liquids, are the most common type of inflicted burns in child abuse due to their accessibility and ease of use.
An appropriate nursing action to include in the care of an infant with congenital heart disease who has been admitted with heart failure is:
- A. Positioning flat on the back
- B. Encouraging nutritional fluids
- C. Offering small frequent feedings
- D. Measuring the head circumference
Correct Answer: C
Rationale: Infants with congenital heart disease who have been admitted with heart failure may have difficulty feeding due to increased work of breathing and poor energy reserves. Offering small, frequent feedings can help prevent fatigue and provide adequate nutrition to support the infant's growth and recovery. It also helps to prevent overloading the heart with a large volume of fluids at once. This approach allows the infant to receive enough calories while reducing the risk of aspiration and conserving energy for feeding and breathing. Positioning the infant flat on the back may worsen respiratory distress, encouraging nutritional fluids alone may not address the feeding challenges faced by the infant, and measuring the head circumference is important for growth monitoring but may not be the priority when managing heart failure in this case.