Nokea
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: Failed to generate a rationale of 500+ characters after 5 retries.
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The 6-year-old child scheduled for an orchiopexy shyly asks the nurse, 'What are they going to do to me 'down there'? What is the nurse's best response?
- A. They are going to fix you up 'down there'.
- B. They will move your testicle from your abdomen to your scrotum.
- C. What do you think your doctor is going to do?
- D. You shouldn't worry. Your doctor knows exactly what to do.
Correct Answer: C
Rationale: The nurse should encourage the child to express his thoughts and feelings about the upcoming surgery. This approach helps the child feel heard and understood while providing an opportunity to address any misconceptions or fears. By asking the child what he thinks the doctor will do, the nurse engages the child in a conversation that can help alleviate anxiety and build trust. School-age children often have fears related to bodily harm, and open communication can help alleviate such concerns.
A child is in the oliguric phase of acute kidney injury. Which of the following interventions should be included in the plan of care?
- A. Administer a loop diuretic.
- B. Provide a low-sodium diet.
- C. Weigh the child weekly.
- D. Provide a high-protein diet.
Correct Answer: A
Rationale: During the oliguric phase of acute kidney injury, the priority is to manage fluid balance. Administering a loop diuretic helps promote diuresis and reduce fluid retention, aiding in managing the condition effectively. Providing a low-sodium diet may be beneficial but is not the priority intervention during this phase. Weighing the child weekly may be important for monitoring overall health but does not directly address the oliguric phase. Providing a high-protein diet is not typically recommended in acute kidney injury, especially during the oliguric phase.
Which urinalysis result should the nurse anticipate for a child admitted with acute glomerulonephritis?
- A. Bacteriuria and increased specific gravity
- B. Hematuria and proteinuria
- C. Proteinuria and decreased specific gravity
- D. Bacteriuria and hematuria
Correct Answer: B
Rationale: In acute glomerulonephritis, the glomeruli become inflamed, leading to the leakage of red blood cells (hematuria) and proteins (proteinuria) into the urine. These are hallmark findings in this condition due to the damage to the glomerular filtration barrier. Bacteriuria, presence of bacteria in the urine, is not typically associated with acute glomerulonephritis unless there is a concurrent urinary tract infection. Specific gravity may be normal or decreased due to the loss of proteins in the urine, rather than increased. Therefore, the correct anticipated urinalysis result for a child with acute glomerulonephritis is hematuria and proteinuria.
A child with suspected bacterial meningitis is under the care of a nurse. Which action should the nurse prioritize?
- A. Administer antibiotics as prescribed.
- B. Maintain the child on NPO status.
- C. Monitor the child's intake and output.
- D. Implement seizure precautions.
Correct Answer: D
Rationale: The priority action for a child with suspected bacterial meningitis is to implement seizure precautions. Meningitis can lead to increased intracranial pressure, which may trigger seizures. By implementing seizure precautions, such as padding the side rails of the bed and ensuring a clear environment, the nurse aims to prevent injury during a potential seizure episode, prioritizing the child's safety.
Metabolic derangement secondary to tumor lysis syndrome in children includes all the following EXCEPT
- A. hyperuricemia
- B. hypernatremia
- C. hyperkalemia
- D. hyperphosphatemia
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.