The parent of a 3-year-old with suspected Wilms tumor says, 'How could I have missed a lump this big?' Which is the best response?
- A. Don't be hard on yourself; it's easy to miss something growing slowly.
- B. I understand you're upset; earlier detection might have improved prognosis.
- C. It takes a trained professional to notice such a lump.
- D. This tumor grows rapidly and may not have been noticeable just a few days ago.
Correct Answer: D
Rationale: Wilms tumor can grow very quickly, so a lump that was not evident previously may become noticeable in a short period.
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The LEAST important advice for a 2-month-old baby with excessive crying is
- A. master the situation in relaxed manner
- B. adhere to precry cues
- C. change milk formula
- D. avoid sensory overstimulation
Correct Answer: C
Rationale: Changing formula may not address refusal due to developmental factors.
When monitoring for hypernatremia, the nurse should assess the client for:
- A. Dry skin
- B. Tachycardia
- C. Confusion
- D. Pale coloring
Correct Answer: C
Rationale: Hypernatremia is a condition characterized by high levels of sodium in the blood. When monitoring for hypernatremia, the nurse should assess the client for signs of neurologic impairment, such as confusion. This is because hypernatremia can lead to changes in mental status due to the hyperosmolarity of the blood affecting brain function. Assessing for confusion is crucial in identifying and managing hypernatremia promptly to prevent further complications. Dry skin, tachycardia, and pale coloring are not specific manifestations of hypernatremia and are less likely to be directly related to this electrolyte imbalance.
Why is heart biopsy performed throughout a clients lifetime after heart transplantation?
- A. To detect rejection
- B. To check the heart functionality
- C. To check rate of the heartbeat
- D. To check for heart tumor CARING FOR CLIENTS WITH HYPERTENSION
Correct Answer: A
Rationale: Heart biopsy is performed throughout a client's lifetime after heart transplantation mainly to detect rejection. Rejection is a common complication following a heart transplant where the recipient's immune system recognizes the transplanted heart as foreign tissue and attacks it. By conducting heart biopsies, healthcare providers can monitor the health of the transplanted heart and detect signs of rejection early on. This allows for prompt intervention and adjustment of the client's immunosuppressive therapy to prevent further damage to the transplanted heart. Monitoring for rejection through heart biopsies is crucial in ensuring the long-term success of heart transplants and the overall well-being of the recipient.
Hepatoblastoma is a neoplasm of undifferentiated precursors of hepatocytes. It is of different histological classification; which type predict the MOST favorable outcome?
- A. mixed type of pure epithelial and mesenchymal elements
- B. type of pure epithelial histology
- C. type of mixed fetal and embryonal histology
- D. type of undifferentiated histology
Correct Answer: B
Rationale: Pure epithelial histology, particularly fetal type, is associated with the best prognosis.
The nurse is conducting teaching for an adolescent being discharged to home after a renal transplant. The adolescent needs further teaching if which statement is made?
- A. "I will report any fever to my primary health care provider."
- B. "I am glad I only have to take the immunosuppressant medication for two weeks."
- C. "I will observe my incision for any redness or swelling."
- D. "I won't miss doing kidney dialysis every week."
Correct Answer: B
Rationale: The statement "I am glad I only have to take the immunosuppressant medication for two weeks" indicates a misunderstanding about the long-term nature of immunosuppressant therapy following a renal transplant. In reality, individuals who undergo a renal transplant need to take immunosuppressant medications for the rest of their lives to prevent rejection of the donor kidney. Failure to adhere to this medication regimen can result in rejection of the transplanted kidney. Therefore, this statement indicates a need for further teaching to ensure the adolescent understands the importance of lifelong immunosuppressant therapy.