A nurse is caring for a toddler whose parent states 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.
Obtain a urine specimen for a urinalysis.
Instruct the parent to avoid pressing on the abdominal area.
Schedule the child for an abdominal ultrasound.
The Correct Answer is C
A. While assessing for pain is important, it is not the priority in this situation. The presence of pink- colored urine and a palpable mass in the abdominal area are more concerning findings that warrant immediate investigation.
B. 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.
C. 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.
D. The decision to schedule additional diagnostic tests, such as an abdominal ultrasound, can be made based on the results of the urinalysis and further clinical assessment.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. A fall of a bike into the handlebars is unlikely to be directly associated with glomerulonephritis. Trauma from a fall could potentially cause hematuria, but it is not a common cause of glomerulonephritis.
B. Streptococcal throat infection 2 weeks ago is commonly associated factor with post-streptococcal glomerulonephritis (PSGN). PSGN can occur after an infection of the throat or skin by certain strains of streptococcal bacteria.
C. Nausea and vomiting for the last 24 hours can be present in a child with glomerulonephritis but are not specific to glomerulonephritis.
D. Urticaria and itching are not typically associated with glomerulonephritis. They can be symptoms of allergic reactions or other conditions, but they are not indicative of glomerulonephritis on their own.
Correct Answer is A
Explanation
A. Sealing non-washable items in airtight plastic bags is a recommended practice for items that cannot be washed. Sealing items such as stuffed animals, pillows, and other non-washable items in airtight bags for two weeks can help ensure that any lice or nits present are killed.
B. Spraying countertops and sinks with insecticide is not a recommended practice. Insecticides are not effective against head lice on surfaces and can be harmful if used improperly. It's important to focus on treating the infested individual and any items in direct contact with their head.
C. Pets do not need to be treated for head lice. Human head lice cannot live on pets and are not transmitted to or from animals.
D. Soaking all combs and hairbrushes in alcohol is not effective against lice and nits.
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