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
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Correct Answer is C
Explanation
The nurse should reassure the parents that febrile seizures typically decrease in frequency as the child grows older. Most children outgrow febrile seizures by the age of 5 years.
Ibuprofen is not typically used prophylactically to prevent febrile seizures.
Providing the child with a sponge bath for temperatures over 100.6°F (38.1° C) can help to lower the fever, but it will not necessarily prevent febrile seizures.
Avoiding excessive visual stimuli is not necessary for children with febrile seizures, as this type of seizure is triggered by a fever rather than visual stimuli.
Correct Answer is A
Explanation
The nurse should report a positive rapid strep test of the oropharynx to the healthcare provider. Acute glomerulonephritis is often caused by a recent streptococcal infection, and a positive rapid strep test would confirm this as the underlying cause
A blood pressure of 88/50 mmHg is within the normal range for a child and would not need to be reported.
A maculopapular rash over the trunk of the body is not typically associated with acute glomerulonephritis and would not need to be reported.
Weight loss may occur with acute glomerulonephritis due to decreased appetite, but it is not an urgent finding that needs to be reported immediately.
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