A child is admitted with a suspected diagnosis of Wilms tumor.
The nurse should place a sign with which of the following warnings over the child’s bed?

Do not palpate abdomen.

No venipuncture or blood pressure in left arm.

Collect all urine.

Contact precautions.

Answer and Explanation

The Correct Answer is A

The correct answer is Choice A.

Choice A rationale

Wilms tumor, also known as nephroblastoma, is a type of kidney cancer that primarily affects children. It is crucial not to palpate the abdomen of a child with a suspected Wilms tumor because this can cause the tumor to rupture and spread cancerous cells to other parts of the body.

Choice B rationale

This choice is incorrect because there is no specific restriction on venipuncture or blood pressure measurements in the left arm for children with Wilms tumor. This precaution is typically associated with conditions like lymphedema or after a mastectomy.

Choice C rationale

Collecting all urine is not a specific precaution for Wilms tumor. While monitoring urine output can be important in various conditions, it is not a primary concern for Wilms tumor.

Choice D rationale

Contact precautions are not necessary for Wilms tumor as it is not an infectious disease. Contact precautions are typically used for conditions that are contagious or spread through direct contact.

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Correct Answer is C

Explanation

The correct answer is Choice C.

Choice A rationale

The conjunctivae, the mucous membranes that cover the front of the eye and line the inside of the eyelids, can show signs of cyanosis. However, they are not the most reliable indicator of central cyanosis. Central cyanosis is best observed in areas with a rich blood supply and thin skin, where the bluish discoloration due to low oxygen levels in the blood is more apparent.

Choice B rationale

The soles of the feet are not a reliable indicator of central cyanosis. Peripheral cyanosis, which affects the extremities, can occur due to poor circulation or cold temperatures and does not necessarily indicate central cyanosis. Central cyanosis is more accurately assessed in areas with a high concentration of blood vessels and thin skin.

Choice C rationale

The oral mucosa, including the lips and tongue, is the most reliable indicator of central cyanosis. This area has a rich blood supply and thin skin, making it easier to observe the bluish discoloration caused by low oxygen levels in the blood. Central cyanosis is a sign of significant hypoxemia and requires prompt medical attention.

Choice D rationale

The ear lobes are not the most reliable indicator of central cyanosis. While they can show signs of cyanosis, they are not as accurate as the oral mucosa. The ear lobes may be affected by peripheral cyanosis, which can occur due to factors like cold temperatures or poor circulation, rather than central cyanosis.

A. Influenza vaccine. B. Pneumococcal polysaccharide vaccine. C. Bacille Calmette-Guérin (BCG) vaccine. D. Meningococcal polysaccharide vaccine.

Correct Answer is D

Explanation

The correct answer is Choice D.

Choice A rationale

The influenza vaccine is recommended annually for all individuals, including adolescents, to protect against the flu. However, it is not specifically required for pre-college physical assessments.

Choice B rationale

The pneumococcal polysaccharide vaccine is typically administered to older adults and individuals with certain medical conditions. It is not a standard requirement for adolescents.

Choice C rationale

The Bacille Calmette-Guérin (BCG) vaccine is used in countries with a high prevalence of tuberculosis. It is not commonly administered in the United States or required for pre-college physical assessments.

Choice D rationale

The meningococcal polysaccharide vaccine is recommended for adolescents, especially those entering college, to protect against meningococcal disease, which can spread in close living quarters.

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A child is admitted with a suspected diagnosis of Wilms tumor.The nurse should place a sign with which of the following warnings over the child’s bed?

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A child is admitted with a suspected diagnosis of Wilms tumor.
The nurse should place a sign with which of the following warnings over the child’s bed?