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
The nurse should recognize that the statement "high-calorie formula encourages increased growth" is an appropriate understanding of interventions for an infant with FTT. High-calorie formula can help infants who are not gaining weight adequately to increase their calorie intake and promote growth.
Breast milk provides adequate nutrition for most infants, but in cases of FTT, the infant may require a higher calorie intake than breast milk can provide. Regular syringe feedings and fruit juice are not recommended interventions for FTT. Syringe feedings can cause aspiration and fruit juice does not provide the appropriate balance of nutrients needed for an infant's growth and development.
Correct Answer is A
Explanation
In a normal infant, T4 levels increase after birth due to stimulation by TSH from the pituitary gland. In this case, the T4 level is low and the TSH level is high, indicating that the thyroid gland is not producing enough T4 in response to TSH stimulation. This suggests that the infant may have congenital hypothyroidism, which requires prompt treatment to prevent developmental delays and other complications.
The low T4 level is not a direct cause of the high TSH level; rather, the high TSH level is a compensatory mechanism to increase T4 production. It is not normal for a breastfeeding infant to have high thyroxine levels. While the thyroid gland may take a few weeks to reach normal function after birth, the persistent low T4 and high TSH levels in this infant suggest a more serious issue.
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