A 3-year-old child is admitted with a Stage II Wilm's tumor. Which preoperative intervention(s) should the nurse implement? Choose all that apply.

Explain expected side effects of postoperative chemotherapy.

Monitor blood pressure every 2 hours for hypertension.

Provide parents with simple explanations and repeat often.

Attend all healthcare provider and parent conferences.

Measure the child's abdominal girth.

Answer and Explanation

Correct Answer : B,C,E

A. Explain expected side effects of postoperative chemotherapy: Chemotherapy and its side effects are typically discussed after surgery when the treatment plan is clearer. The focus before surgery should be on preparing the child and family for the surgery itself.

B. Monitor blood pressure every 2 hours for hypertension: Wilm's tumor can be associated with hypertension due to renin production from the tumor, so monitoring the child's blood pressure closely is essential to detect any signs of hypertension early.

C. Provide parents with simple explanations and repeat often: Simplified, repeated explanations are key to helping parents understand the diagnosis and surgical procedure. This approach supports emotional comfort and ensures informed decision-making.

D. Attend all healthcare provider and parent conferences: While it is important to support the family, the nurse’s role in attending all healthcare provider and parent conferences is not mandatory unless specifically needed for continuity of care.

E. Measure the child's abdominal girth: Measuring abdominal girth is essential preoperatively to monitor for any abdominal changes, such as swelling or distension, which could indicate tumor growth or other complications related to the Wilm's tumor.

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Correct Answer is B

Explanation

A. Morphine: Morphine is used to relieve chest pain and anxiety in acute coronary syndromes. It acts as a vasodilator and analgesic, and there are no direct contraindications with recent sildenafil use, although blood pressure should still be monitored.

B. Nitroglycerin: Nitroglycerin is absolutely contraindicated in clients who have taken sildenafil within the past 24–48 hours. Both drugs are vasodilators, and their combination can lead to severe, life-threatening hypotension due to additive effects on vascular smooth muscle relaxation.

C. Aspirin: Aspirin is recommended in acute chest pain cases as it reduces platelet aggregation and helps prevent clot extension. It has no interaction with sildenafil and should not be withheld when myocardial ischemia is suspected.

D. Heparin: Heparin is an anticoagulant used in suspected myocardial infarction to prevent further clot formation. It does not have any adverse interactions with sildenafil and remains safe and beneficial in this context.

A. Monitor collection container and replace when full. B. Encourage frequent use of the incentive spirometer. C. Assess area around chest tube for subcutaneous emphysema. D. Keep tubing loosely coiled below the level of the chest. E. Verify air bubbling present in the water seal chamber.

Correct Answer is ["A","B","C","D"]

Explanation

A. Monitor collection container and replace when full: The nurse should monitor the collection container to ensure it doesn't become full, as this could cause backflow into the pleural cavity. Replacing it when full is essential to maintain proper drainage.

B. Encourage frequent use of the incentive spirometer: Using the incentive spirometer helps prevent atelectasis and pneumonia by promoting lung expansion. It is important for postoperative recovery to maintain good respiratory function.

C. Assess area around chest tube for subcutaneous emphysema: Subcutaneous emphysema can occur if air leaks into the tissues around the chest tube. The nurse should check for this condition as it could indicate complications like an air leak or pneumothorax.

D. Keep tubing loosely coiled below the level of the chest: The tubing should be positioned below the chest to facilitate gravity drainage. Keeping it loosely coiled ensures that fluid and air drain efficiently without backflow.

E. Verify air bubbling present in the water seal chamber: Continuous bubbling in the water seal chamber is not expected and may indicate an air leak. Intermittent bubbling may be normal if the lung is still re-expanding, but ongoing bubbling should be reported, not simply verified.

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A 3-year-old child is admitted with a Stage II Wilm's tumor. Which preoperative intervention(s) should the nurse implement? Choose all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client arrives to the emergency department with chest pain after taking sildenafil. Based on the client's history, which medication should the nurse withhold?

Correct Answer is B

Explanation

The nurse is caring for a client who underwent a right lobectomy for lung cancer 24 hours ago and has a single chest tube on the right side. Which intervention(s) should the nurse plan to implement? Select all that apply.

Correct Answer is ["A","B","C","D"]

Explanation

The nurse completes percussion of the abdomen on an older adult client. Which finding is considered normal for this client?

Exhibits Drag from Word Choices to complete the sentence. According to the lab values, the client has dropdownrelated to dropdownordropdown.

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