A child is admitted with a suspected diagnosis of Wilms tumor.
The nurse should place a sign with which of the following warnings over the child’s bed?
Do not palpate abdomen.
No venipuncture or blood pressure in left arm.
Collect all urine.
Contact precautions.
The Correct Answer is A
The correct answer is Choice A.
Choice A rationale
Wilms tumor, also known as nephroblastoma, is a type of kidney cancer that primarily affects children. It is crucial not to palpate the abdomen of a child with a suspected Wilms tumor because this can cause the tumor to rupture and spread cancerous cells to other parts of the body.
Choice B rationale
This choice is incorrect because there is no specific restriction on venipuncture or blood pressure measurements in the left arm for children with Wilms tumor. This precaution is typically associated with conditions like lymphedema or after a mastectomy.
Choice C rationale
Collecting all urine is not a specific precaution for Wilms tumor. While monitoring urine output can be important in various conditions, it is not a primary concern for Wilms tumor.
Choice D rationale
Contact precautions are not necessary for Wilms tumor as it is not an infectious disease. Contact precautions are typically used for conditions that are contagious or spread through direct contact.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is Choice A.
Choice A rationale
The apex of the heart (apical pulse) is the preferred site for assessing the heart rate in infants. It is located at the point of maximal impulse (PMI) and provides the most accurate measurement of the heart rate in this age group.
Choice B rationale
The brachial artery is not the preferred site for assessing the heart rate in infants. While it can be used for blood pressure measurement, it is not as accurate as the apical pulse for heart rate assessment.
Choice C rationale
The radial artery is not typically used for assessing the heart rate in infants. It is more commonly used in older children and adults.
Choice D rationale
The carotid artery is not recommended for assessing the heart rate in infants due to the risk of compressing the airway and causing discomfort.
Correct Answer is A,B,C,D,E
Explanation
A. Trust vs. mistrust: This stage occurs from birth to 18 months. Infants learn to trust their caregivers to meet their needs. If caregivers are consistent and reliable, infants develop a sense of trust.
B. Autonomy vs. shame and doubt: This stage occurs from 18 months to 3 years. Toddlers learn to do things independently. Success leads to autonomy, while failure results in feelings of shame and doubt.
C. Initiative vs. guilt: This stage occurs from 3 to 5 years. Children begin to assert control and power over their environment. Success leads to a sense of initiative, while failure results in guilt.
D. Industry vs. inferiority: This stage occurs from 6 to 11 years. Children learn to cope with new social and academic demands. Success leads to a sense of competence, while failure results in feelings of inferiority.
E. Identity vs. role confusion: This stage occurs from 12 to 18 years. Adolescents explore their independence and develop a sense of self. Success leads to a strong identity, while failure results in role confusion.
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