Which physical assessment technique will the nurse omit when caring for a 2-year-old child diagnosed with Wilms' tumor?
Percussing ankle and knee reflexes
Assessing for bowel sounds
Performing range-of-motion exercises on low extremities
Palpating the abdomen
The Correct Answer is D
A. Percussing ankle and knee reflexes. Safe and non-invasive, and does not risk disturbing the tumor.
B. Assessing for bowel sounds. Routine part of assessment and does not involve manipulating the tumor.
C. Performing range-of-motion exercises on lower extremities. Safe and non-invasive, unrelated to the abdominal tumor.
D. Palpating the abdomen. Palpating the abdomen in a child with Wilms' tumor is avoided to prevent the risk of tumor rupture and subsequent metastasis.
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Related Questions
Correct Answer is D
Explanation
A. Regular diet, no added salt: A regular diet with no added salt does not adequately address the sodium restriction needed to manage edema in acute glomerulonephritis.
B. Low-carbohydrate, low-protein diet: Restricting carbohydrates and proteins is not typically necessary in acute glomerulonephritis unless there are specific complications.
C. Low-protein, low-potassium diet: While protein restriction may be necessary in chronic kidney disease, it is not typically the primary focus in managing acute glomerulonephritis.
D. Low-sodium, fluid-restricted: A low-sodium diet helps to reduce fluid retention and manage edema in acute glomerulonephritis. Fluid restriction may also be necessary to manage fluid balance.
Correct Answer is A
Explanation
A. Reports of scalp itchiness: Itchiness of the scalp is a common symptom of pediculosis capitis (head lice), caused by the allergic reaction to lice bites. This should alert the nurse to the possibility of head lice and warrant further examination.
B. Patches of baldness: While bald patches can be seen in certain conditions like alopecia areata, they are not typically associated with pediculosis capitis.
C. Dry patches on the scalp: Dry patches may indicate a condition like seborrheic dermatitis or psoriasis, but they are not indicative of pediculosis capitis.
D. Blisters on the scalp: Blisters are more likely associated with skin infections or conditions like impetigo, not pediculosis capitis.
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