A nurse is caring for a toddler whose parent states that while bathing the child, she noticed a mass in his abdominal area and that his urine is a pink color. Which of the following actions is the nurse's priority?

Determine if the child is having pain.

Instruct the parent to avoid pressing on the abdominal area.

Schedule the child for an abdominal ultrasound.

Obtain a urine specimen for analysis.

Answer and Explanation

The Correct Answer is B

The correct answer is: B

Choice A reason: Determining if the child is having pain is important, but it is not the immediate priority. Pain assessment will help in managing the child’s comfort and can provide additional information about the condition. However, in the case of Wilms tumor, which is a common kidney cancer in children, the priority is to prevent any action that could potentially cause tumor spillage or spread.

Choice B reason: Instructing the parent to avoid pressing on the abdominal area is the priority action. Wilms tumor can rupture with pressure, which can lead to the spread of cancer cells. It is crucial to minimize handling of the tumor to prevent tumor spillage into the abdominal cavity.

Choice C reason: Scheduling the child for an abdominal ultrasound is a necessary diagnostic step, but it is not the immediate priority. The ultrasound will help in assessing the size and extent of the tumor, but the first action should be to ensure that the tumor is not disturbed.

Choice D reason: Obtaining a urine specimen for analysis is important for diagnosing the cause of the hematuria (blood in the urine), which is a common symptom of Wilms tumor. However, this is not the immediate priority compared to preventing potential harm to the child by avoiding pressure on the abdominal area.

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Correct Answer is A

Explanation

Choice A reason: This statement is correct because patent ductus arteriosus is a condition where the ductus arteriosus, a fetal blood vessel that connects the pulmonary artery and the aorta, fails to close after birth. This allows blood to flow from the aorta to the pulmonary artery, increasing the blood flow to the lungs and causing pulmonary hypertension.

Choice B reason: This statement is incorrect because coarctation of the aorta is a condition where the aorta, the main artery that carries blood from the heart to the body, is narrowed. This causes increased pressure in the upper body and decreased pressure in the lower body, reducing the blood flow to the kidneys and other organs.

Choice C reason: This statement is incorrect because tricuspid atresia is a condition where the tricuspid valve, which separates the right atrium and the right ventricle, is missing or abnormally developed. This prevents blood from flowing from the right atrium to the right ventricle, decreasing the blood flow to the lungs and causing cyanosis.

Choice D reason: This statement is incorrect because tetralogy of Fallot is a condition that involves four defects: a large ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy. These defects cause blood to bypass the lungs and mix with oxygen-poor blood in the aorta, decreasing the blood flow to the lungs and causing cyanosis.

A. Recurrent epigastric pain B. Hyperactive bowel sounds C. Yellowish-red emesis D. Melena stool

Correct Answer is C

Explanation

Choice A reason: Recurrent epigastric pain is not a complication of peptic ulcer disease, but rather a common symptom of it. Peptic ulcer disease is the erosion of the mucosal lining of the stomach or duodenum, which can cause pain, burning, or discomfort in the upper abdomen.

Choice B reason: Hyperactive bowel sounds are not a complication of peptic ulcer disease, but rather a normal finding in a child who has not eaten for a while. Hyperactive bowel sounds indicate increased peristalsis, which can be caused by hunger, stress, or infection.

Choice C reason: Yellowish-red emesis is a complication of peptic ulcer disease, as it indicates bleeding from the ulcer. Bleeding can occur when the ulcer erodes the blood vessels or the protective layer of the mucosa. Yellowish-red emesis means that the blood has been partially digested by the stomach acid, giving it a coffee-ground appearance.

Choice D reason: Melena stool is a complication of peptic ulcer disease, as it indicates bleeding from the ulcer. Melena stool is black and tarry, and it has a foul odor. It means that the blood has passed through the entire digestive tract, and has been altered by the intestinal bacteria and enzymes.

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A nurse is caring for a toddler whose parent states that while bathing the child, she noticed a mass in his abdominal area and that his urine is a pink color. Which of the following actions is the nurse's priority?

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