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 ["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.
Correct Answer is D
Explanation
Hypoparathyroidism is a disorder in which the parathyroid glands produce insufficient amounts of parathyroid hormone, which regulates calcium and phosphorus levels in the body. In hypoparathyroidism, there is a decreased level of calcium in the blood, which can result in carpal spasm or tetany when pressure is applied to the upper arm.
Therefore, the nurse should review the child's calcium level (D) to determine if it is within the normal range. Low calcium levels can cause muscle spasms, seizures, and cardiac arrhythmias. Hypocalcemia may also result in other symptoms such as numbness, tingling, and muscle cramps.
Potassium (A), chloride (B), and sodium (C) are electrolytes that play important roles in various physiological processes in the body, but they are not directly related to the development of carpal spasm in a child with hypoparathyroidism. While hypokalemia (low potassium) or hyponatremia (low sodium) can cause muscle weakness or cramps, these conditions are not typically associated with carpal spasm in hypoparathyroidism.
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