A child is diagnosed with Wilms' tumor. During assessment, the nurse in charge expects to detect:
Gross hematuria
Dysuria
An abdominal mass
Nausea and Vomiting
The Correct Answer is C
A. Gross hematuria: Gross hematuria refers to visible blood in the urine, which can present as pink, red, or cola-colored urine. While hematuria can be associated with various kidney conditions, including Wilms' tumor, it is not a consistent or defining symptom of this specific tumor. Additionally, because the tumor is typically confined within the kidney and does not usually invade the urinary tract, gross hematuria might not always be present.
B. Dysuria: Dysuria is the medical term for painful or difficult urination. It is not a typical symptom of Wilms' tumor, as this tumor primarily affects the kidney and may not directly affect the urinary tract in a way that causes painful urination.
C. An abdominal mass: This is the correct answer. Wilms' tumor often presents as a palpable abdominal mass, which may be felt during physical examination. The mass is usually firm, non-tender, and confined to one side of the abdomen. Detection of an abdominal mass should prompt further diagnostic evaluation to confirm the diagnosis and plan appropriate treatment.
D. Nausea and vomiting: While some children with Wilms' tumor may experience nausea and vomiting, these symptoms are nonspecific and can be caused by various conditions. They are not considered characteristic or defining features of Wilms' tumor. The presence of nausea and vomiting would prompt further assessment to determine the underlying cause
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
A. Bed in highest position:
The height of the bed is not directly related to seizure precautions.
B. Remove restrictive objects or clothing from patients’ body:
This is important to prevent injury during a seizure episode.
C. Remove all pillows from the patient's head:
While it's generally a good practice to remove pillows to prevent suffocation or obstruction, it's not specifically related to seizure precautions.
D. Oxygen and suction at bedside:
Oxygen and suction should be readily available to support the patient's respiratory status and clear any secretions or vomit during or after a seizure.
E. Padded bed rails:
Padded bed rails can help prevent injury if the patient thrashes or moves violently during a seizure.
Correct Answer is A
Explanation
A. "My belly doesn't hurt anymore."
- This statement is concerning because sudden relief from severe right lower quadrant pain in a child with a history of nausea, vomiting, and suspected appendicitis may indicate a rupture or perforation of the appendix. When the appendix ruptures, there may be a temporary alleviation of pain due to the release of pressure. However, this situation is critical and requires immediate medical attention to prevent further complications such as peritonitis or sepsis.
B. "I am hungry and thirsty."
- While it's normal for a child to feel hungry and thirsty, especially if they have been experiencing nausea and vomiting, this statement is not necessarily concerning on its own. However, in the context of suspected appendicitis and severe right lower quadrant pain, it's important for the child to remain NPO (nothing by mouth) to prevent complications in case surgery is needed.
C. "I'm tired and want to take a nap."
- Feeling tired and wanting to rest is not uncommon, especially if the child has been experiencing discomfort or pain for a prolonged period. While this statement may indicate fatigue, it's not inherently concerning in the context of suspected appendicitis. However, it's important for the nurse to monitor the child's energy level and overall condition.
D. "I am scared and I want to go home."
- It's understandable for a child to feel scared or anxious, particularly when facing a medical procedure such as surgery. While this statement reflects the child's emotions, it doesn't necessarily indicate a change in their medical condition. However, it's important for the nurse to address the child's fears and provide emotional support while ensuring that the child receives appropriate medical care.
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