A nurse is assessing a 1-year-old toddler who notices a large abdominal mass and pink-tinged urine on the diaper. Which of the following disorders should the nurse suspect?
Nephritic syndrome
Wilms tumor
Pyloric stenosis
Intussusception
The Correct Answer is B
Choice A reason: Nephritic syndrome is a kidney disorder that causes inflammation and damage to the glomeruli, the filtering units of the kidneys. It can cause hematuria (blood in the urine), proteinuria (protein in the urine), hypertension (high blood pressure), and edema (swelling). However, it does not cause a palpable abdominal mass, which is a characteristic sign of Wilms tumor.
Choice B reason: Wilms tumor is a malignant tumor of the kidney that occurs mainly in children under 5 years of age. It can cause a large, firm, and painless abdominal mass, hematuria, abdominal pain, fever, and hypertension. It is the most common renal tumor in children and requires prompt diagnosis and treatment.
Choice C reason: Pyloric stenosis is a condition that causes narrowing of the pylorus, the outlet of the stomach. It can cause projectile vomiting, dehydration, weight loss, and a palpable olive-shaped mass in the upper abdomen. However, it does not cause hematuria or a large abdominal mass.
Choice D reason: Intussusception is a condition that occurs when a part of the intestine slides into another part, causing a blockage. It can cause abdominal pain, vomiting, bloody stools, and a sausage-shaped mass in the abdomen. However, it does not cause hematuria or a large abdominal mass.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Intravenous immunoglobulin (IVIG) is the main treatment for Kawasaki disease, as it reduces the inflammation of the blood vessels and the risk of coronary artery aneurysms. IVIG is given as a single infusion over 10 to 12 hours, within the first 10 days of the onset of fever.
Choice B reason: Aspirin is also used to treat Kawasaki disease, as it reduces the fever, pain, and inflammation. However, it is not the first-line treatment, and it is given after IVIG to prevent thrombosis and platelet aggregation. Aspirin is given at a high dose during the acute phase, and then at a low dose until the inflammation subsides.
Choice C reason: Penicillin is not indicated for Kawasaki disease, as it is an antibiotic that treats bacterial infections. Kawasaki disease is not caused by bacteria, but by an unknown trigger that activates the immune system and causes systemic vasculitis.
Choice D reason: Acetaminophen is not effective for Kawasaki disease, as it does not reduce the inflammation or the risk of complications. Acetaminophen may be used to treat mild pain or fever, but it is not the main treatment. Moreover, acetaminophen may mask the fever and delay the diagnosis of Kawasaki disease.
Correct Answer is A
Explanation
Choice A reason: A soft diet is appropriate for a toddler who has a cleft palate repair, as it prevents trauma to the surgical site and promotes healing. The nurse should avoid foods that are hard, sticky, or spicy.
Choice B reason: Offering fluids through a straw is not an appropriate action, as it can create negative pressure in the mouth and disrupt the suture line. The nurse should offer fluids with a cup or a spoon.
Choice C reason: Administering opioids for pain is not an appropriate action, as opioids can cause respiratory depression and sedation in toddlers. The nurse should use non-opioid analgesics such as acetaminophen or ibuprofen, unless otherwise prescribed.
Choice D reason: Applying bilateral wrist restraints is not an appropriate action, as it can cause injury and distress to the toddler. The nurse should use other methods to prevent the toddler from touching the surgical site, such as distraction, toys, or mittens.
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