Nokea
The nurse is caring for a client with suspected colorectal cancer. Which of the following findings would support a diagnosis of colorectal cancer? Select all that apply.
- A. Fatigue
- B. Blood in the stool
- C. Change in bowel habits
- D. Unintentional weight loss
- E. Elevated hemoglobin level
Correct Answer: A,B,C,D
Rationale: Colorectal cancer often presents with fatigue (A) due to anemia or systemic effects, blood in the stool (B) from tumor bleeding, changes in bowel habits (C) like diarrhea or constipation, and unintentional weight loss (D) from malignancy-related cachexia. Elevated hemoglobin (E) is unlikely, as anemia is more common due to chronic blood loss.
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A mother noticed a large abdominal mass when helping her 3-year-old child bathe. The child is taken to the physician and admitted to the hospital after an intravenous pyelogram (IVP) confirms the diagnosis of Wilms' tumor. Which nursing action is essential to include in the nursing care plan?
- A. Strain all urine and save for analysis.
- B. Avoid palpating the abdomen.
- C. Prepare the child for permanent dialysis.
- D. Help the family understand the poor prognosis.
Correct Answer: B
Rationale: Avoiding abdominal palpation prevents potential tumor rupture or metastasis in Wilms' tumor, a critical precaution. Urine straining, dialysis, or poor prognosis are inappropriate.
The nurse measures the head and chest circumferences of a 20 month-old infant. After comparing the measurements, the nurse finds that they are approximately the same. What action should the nurse take?
- A. Notify the provider
- B. Palpate the anterior fontanel
- C. Examine the posterior fontanel
- D. Record these normal findings
Correct Answer: D
Rationale: Record these normal findings. Head and chest circumferences are typically equal by 1 to 2 years of age.
A 3 year-old child has tympanostomy tubes in place. The child's parent asks the nurse if he can swim in the family pool. The best response from the nurse is
- A. Your child should not swim at all while the tubes are in place.'
- B. Your child may swim in your own pool but not in a lake or ocean.'
- C. Your child may swim if he wears ear plugs.'
- D. Your child may swim anywhere.'
Correct Answer: C
Rationale: Water should not enter the ears. Children should use ear plugs when bathing or swimming and should not put their heads under the water.
The nurse is reviewing a depressed client's history from an earlier admission. Documentation of anhedonia is noted. The nurse understands that this finding refers to
- A. Reports of difficulty falling and staying asleep
- B. Expression of persistent suicidal thoughts
- C. Lack of enjoyment in usual pleasures
- D. Reduced senses of taste and smell
Correct Answer: C
Rationale: Lack of enjoyment in usual pleasures. Anhedonia, a common finding in depression, is the lack of enjoyment in usual pleasures.
A mother brings her 1-month-old son to the clinic for a well-baby visit. The child has a moderately severe hypospadias that was seen by a urologist in the newborn nursery. The mother is upset that the doctors would not circumcise her son before he was discharged. What information should the nurse include when responding to the mother?
- A. The foreskin should not be removed because it will be used in the repair of the hypospadias.
- B. The child's condition did not allow for elective surgery. It will be done at a later date when he is stronger.
- C. Circumcision is a surgical procedure. Because he will have surgery in the near future, it will be done at the same time to avoid two surgeries close together.
- D. The procedure was not done because circumcision is medically unnecessary, not because he has a hypospadias.
Correct Answer: A
Rationale: Hypospadias repair often uses foreskin tissue, so circumcision is avoided to preserve it for surgical correction, addressing the mother's concern.