A client is to receive Levothyroxine 25 mcg PO daily.

Levothyroxine unit dose available is 0.05 mg/tablet.

What would the nurse administer?

Choice A rationale

Brain death is a clinical diagnosis characterized by irreversible cessation of all functions of the entire brain, including the brainstem. If the client's heart is still beating and they can breathe on their own, it indicates preserved brainstem function, which is inconsistent with brain death criteria.

Choice B rationale

Brain death is defined as irreversible cessation of all brain functions. When a client is on life support, but their brain has sustained irreversible damage with complete loss of brainstem reflexes, they meet the criteria for brain death, allowing for organ donation consideration.

Choice C rationale

A client able to respond to stimuli and communicate with others exhibits clear signs of brain activity and consciousness. This directly contradicts the definition of brain death, which requires complete and irreversible loss of all brain function, including higher cortical functions.

Choice D rationale

While vital organs may eventually cease functioning after brain death, the initial and primary criterion for brain death is the irreversible cessation of brain function. The vital organs can often be maintained on life support for a period to facilitate organ donation, so they are not necessarily non-functioning.

Choice A rationale

Biopsy of the tumor is the definitive diagnostic procedure for Wilms tumor. This involves the surgical removal of a tissue sample from the suspected mass, which is then examined microscopically by a pathologist. Histopathological analysis confirms the presence of malignant cells characteristic of nephroblastoma, differentiating it from other renal masses and guiding subsequent treatment protocols. Normal renal tissue structure is preserved in healthy kidneys.

Choice B rationale

Bone marrow aspiration is primarily used to diagnose hematological malignancies or assess for metastatic disease in certain cancers. While Wilms tumor can metastasize, particularly to the lungs, bone marrow involvement is uncommon and not the primary diagnostic method for confirming the initial diagnosis of the tumor itself. Normal bone marrow contains hematopoietic stem cells and a balanced cellularity.

Choice C rationale

A CT scan of the abdomen and chest provides detailed anatomical information about the tumor's size, location, and extent of involvement within the kidney and surrounding structures, as well as checking for metastasis to the lungs. While crucial for staging and surgical planning, a CT scan is an imaging modality and does not provide a definitive tissue diagnosis. Normal abdominal organs appear with distinct densities.

Choice D rationale

Abdominal ultrasonography is often the initial imaging modality used to evaluate a suspected abdominal mass in children due to its non-invasive nature and lack of radiation exposure. It can identify the presence of a renal mass and distinguish between solid and cystic lesions, but like CT, it cannot definitively diagnose Wilms tumor without tissue sampling. Normal kidneys appear as solid, homogeneous organs.