A nurse is assessing a 1-year-old toddler who notices a large abdominal mass and pink-tinged urine on the diaper. Which of the following disorders should the nurse suspect?
Nephritic syndrome
Wilms tumor
Pyloric stenosis
Intussusception
The Correct Answer is B
Choice A reason: Nephritic syndrome is a kidney disorder that causes inflammation and damage to the glomeruli, the filtering units of the kidneys. It can cause hematuria (blood in the urine), proteinuria (protein in the urine), hypertension (high blood pressure), and edema (swelling). However, it does not cause a palpable abdominal mass, which is a characteristic sign of Wilms tumor.
Choice B reason: Wilms tumor is a malignant tumor of the kidney that occurs mainly in children under 5 years of age. It can cause a large, firm, and painless abdominal mass, hematuria, abdominal pain, fever, and hypertension. It is the most common renal tumor in children and requires prompt diagnosis and treatment.
Choice C reason: Pyloric stenosis is a condition that causes narrowing of the pylorus, the outlet of the stomach. It can cause projectile vomiting, dehydration, weight loss, and a palpable olive-shaped mass in the upper abdomen. However, it does not cause hematuria or a large abdominal mass.
Choice D reason: Intussusception is a condition that occurs when a part of the intestine slides into another part, causing a blockage. It can cause abdominal pain, vomiting, bloody stools, and a sausage-shaped mass in the abdomen. However, it does not cause hematuria or a large abdominal mass.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: A 13% weight loss is not a finding of severe dehydration, but rather of moderate dehydration. Severe dehydration is characterized by a weight loss of more than 15%.
Choice B reason: A rapid pulse is a finding of severe dehydration, as the body tries to compensate for the fluid loss and maintain the blood pressure.
Choice C reason: A bulging anterior fontanel is not a finding of severe dehydration, but rather of increased intracranial pressure. A sunken anterior fontanel is a sign of severe dehydration, as the brain tissue loses water and shrinks.
Choice D reason: Moist mucous membranes are not a finding of severe dehydration, but rather of normal hydration. Dry mucous membranes are a sign of severe dehydration, as the body loses water and electrolytes.
Choice E reason: Decreased urine output is a finding of severe dehydration, as the kidneys try to conserve water and produce less urine. This can lead to renal failure if not corrected.
Correct Answer is A
Explanation
Choice A reason: A soft diet is appropriate for a toddler who has a cleft palate repair, as it prevents trauma to the surgical site and promotes healing. The nurse should avoid foods that are hard, sticky, or spicy.
Choice B reason: Offering fluids through a straw is not an appropriate action, as it can create negative pressure in the mouth and disrupt the suture line. The nurse should offer fluids with a cup or a spoon.
Choice C reason: Administering opioids for pain is not an appropriate action, as opioids can cause respiratory depression and sedation in toddlers. The nurse should use non-opioid analgesics such as acetaminophen or ibuprofen, unless otherwise prescribed.
Choice D reason: Applying bilateral wrist restraints is not an appropriate action, as it can cause injury and distress to the toddler. The nurse should use other methods to prevent the toddler from touching the surgical site, such as distraction, toys, or mittens.
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