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Which is true of a Wilms tumor? (Select all that apply.)
- A. It is also referred to as neuroblastoma.
- B. It is most commonly seen between the ages of 2 and 5 years.
- C. It can occur on its own or be associated with congenital anomalies.
- D. It is a slow-growing tumor.
Correct Answer: C
Rationale: Wilms tumor typically occurs in children aged 2-5 years and may be associated with congenital anomalies. It is not the same as neuroblastoma, and its prognosis is generally good with treatment.
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A 14-year-old boy and his parents are concerned about bilateral breast enlargement. The nurse's discussion of this should be based on which statement?
- A. This is usually benign and temporary.
- B. This is usually caused by Klinefelter syndrome.
- C. Administration of estrogen effectively reduces gynecomastia.
- D. Administration of testosterone effectively reduces gynecomastia.
Correct Answer: A
Rationale: The correct statement is that bilateral breast enlargement in a 14-year-old boy is usually benign and temporary. This condition, known as gynecomastia, is commonly seen during puberty due to hormonal changes. It typically resolves on its own without the need for intervention. It is important for the nurse to reassure the boy and his parents that this is a normal occurrence and should not be a cause for major concern. It is crucial to address any underlying anxieties and provide education on the natural course of puberty-related changes.
Which of the ff should the nurse identify as the earliest symptom of heart failure in many older clients?
- A. Increased urine output
- B. Dyspnea on exertion
- C. Swollen joints
- D. Nausea and vomiting
Correct Answer: B
Rationale: Dyspnea on exertion is often identified as the earliest symptom of heart failure in many older clients. This symptom occurs due to the heart's inability to pump blood efficiently, leading to a buildup of fluid in the lungs. As a result, individuals may experience shortness of breath when engaging in physical activity or even at rest. Monitoring for dyspnea on exertion can aid in the early detection and management of heart failure in older clients. Other symptoms, such as increased urine output, swollen joints, and nausea/vomiting, may also occur in heart failure, but dyspnea on exertion is typically considered one of the earliest signs to manifest.
Bryce is a child diagnosed with coarctation of aorta. While assessing him, Nurse Zach would expect to find which of the following?
- A. Squatting posture
- B. Absent or diminished femoral pulses
- C. Severe cyanosis at birth
- D. Cyanotic ("tet") episodes 46
Correct Answer: B
Rationale: Coarctation of the aorta is a congenital heart defect where there is a narrowing of the aorta, usually near the insertion of the ductus arteriosus. This narrowing can lead to decreased blood flow to the lower body. A common finding in a child with coarctation of the aorta is absent or diminished femoral pulses due to the obstruction of blood flow through the narrowed aorta. Other symptoms may include high blood pressure in the arms, weak lower body pulses, and heart murmur. Squatting posture, severe cyanosis at birth, and cyanotic ("tet") episodes are not typically associated with coarctation of the aorta.
Which would be best for the nurse to use when determining the temperature of a preterm infant under a radiant heater?
- A. Axillary sensor TestBankWorld.org
- B. Tympanic membrane sensor
- C. Rectal mercury glass thermometer
- D. Rectal electronic thermometer
Correct Answer: B
Rationale: A tympanic membrane sensor or tympanic thermometer is the best option for determining the temperature of a preterm infant under a radiant heater. Tympanic thermometers are quick and non-invasive, making them ideal for use in neonatal care. They provide accurate readings by measuring the infrared heat waves coming from the eardrum. This method is preferred over other options like axillary sensors, rectal mercury thermometers, and rectal electronic thermometers, which may not be as efficient or suitable for use with preterm infants.
A 52-year old female tells the nurse that she has found a painless lump in her right breast during her monthly self- examination. Which assessment finding would strongly suggest that this client's lump is cancerous?
- A. Eversion of the right nipple and mobile mass
- B. Mobile mass that is soft and easily
- C. Non-mobile mass with irregular edges delineated
- D. Non palpable right axillary lymph nodes
Correct Answer: C
Rationale: The assessment finding that strongly suggests that the client's lump is cancerous is a non-mobile mass with irregular edges delineated. Generally, cancerous breast lumps tend to have irregular shapes/edges and lack mobility. This finding is concerning for malignancy because it indicates that the lump is fixed in place and possibly invading nearby tissues, which are characteristics often associated with cancerous tumors. It's essential for the client to undergo further diagnostic tests, such as a biopsy, to confirm the presence of cancer and establish a proper treatment plan.