The parents of a child with Wilms tumor ask the nurse why surgery is necessary before a biopsy is performed. Which information should the nurse provide?
Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread.
Metal clips are surgically applied at the tumor site for exact marking for radiation.
Surgery is necessary to stage the tumor and determine metastasis to other sites.
The surgery provides a visualization of other pathology and dysfunction of the kidney.
The Correct Answer is A
Answer: A. Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread.
Rationale:
A) Biopsy may rupture the encapsulated tumor and cause the cancer cells to spread: This is the primary reason why surgery is performed before a biopsy in cases of Wilms tumor. The tumor is usually encapsulated, and performing a biopsy could risk breaking the capsule, leading to the dissemination of cancer cells into surrounding tissues, which can worsen the prognosis.
B) Metal clips are surgically applied at the tumor site for exact marking for radiation: While marking the tumor site for radiation is important, it is not the primary reason for performing surgery before a biopsy. The main concern is about the potential for cancer cell spread during a biopsy procedure.
C) Surgery is necessary to stage the tumor and determine metastasis to other sites: Although staging is a critical aspect of cancer management, the urgency of avoiding tumor rupture and subsequent spread is more pressing in this context. The surgery may assist in staging, but that is not the primary reason for immediate surgical intervention.
D) The surgery provides a visualization of other pathology and dysfunction of the kidney: While the surgical procedure may provide additional information about the kidney's condition, the most significant concern regarding Wilms tumor is preventing tumor rupture and the consequent spread of cancer cells, making this option less relevant.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Answer: C. Red blood cell count of 2.3 cells/mcl or (2.3 x 10/L).
Rationale:
A. White blood cell count of 10,000/mm³ (10 x 10⁹/L): This is within the normal range for an infant, indicating no immediate concern for infection or immune response. It does not need to be urgently conveyed to the surgeon.
B. Weight gain of 2 pounds (0.91 kg) since birth: This is a positive sign indicating healthy growth and nutritional status, but it is not a critical concern that would affect the immediate surgical plan.
C. Red blood cell count of 2.3 cells/mcl or (2.3 x 10⁹/L): This low RBC count indicates anemia, which is critical information for the surgeon. Anemia can increase the risk of complications during and after surgery due to potential issues with oxygenation and healing, making it the most important information to convey.
D. Urine specific gravity is 1.011: This indicates normal hydration status and is not immediately relevant to the surgical procedure. It does not need to be urgently reported to the surgeon compared to the low RBC count.
Correct Answer is ["B","D","F"]
Explanation
Answer: B, D, F
Rationale:
A) Understanding that nonstimulant medications show little benefit in treatment: This is inaccurate, as nonstimulant medications like atomoxetine can be effective for ADHD, especially in children who may not tolerate stimulants. Nonstimulants are often considered a viable alternative or adjunctive treatment.
B) Designating an established area for study: Creating a dedicated study space can help a child with ADHD focus on tasks and minimize distractions, which is beneficial for completing homework and improving concentration in a structured environment.
C) Anticipating being automatically entered into a specialized education plan: An Individualized Education Plan (IEP) or 504 Plan for ADHD is not automatic and typically requires evaluation and recommendation from school staff. The plan is individualized based on the child’s specific needs.
D) Knowing that medication is not always the best approach to treatment: Recognizing that treatment can involve behavioral interventions, counseling, and environmental adjustments, in addition to or instead of medication, reflects a balanced understanding of ADHD management.
F) Maintaining a consistent home schedule: Consistent routines help children with ADHD manage expectations and reduce stress, enhancing their ability to focus and transition smoothly between activities.
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