A nurse is caring for a toddler whose parent states while bathing the child she noticed a mass in his abdominal area and that his urine is a pink color. Which of the following actions is the nurse's priority?
Determine if the child is having pain.
Obtain a urine specimen for a urinalysis.
Instruct the parent to avoid pressing on the abdominal area.
Schedule the child for an abdominal ultrasound.
The Correct Answer is C
A. While assessing for pain is important, it is not the priority in this situation. The presence of pink- colored urine and a palpable mass in the abdominal area are more concerning findings that warrant immediate investigation.
B. Obtaining a urine specimen for analysis is important for diagnosing the cause of the hematuria (blood in the urine), which is a common symptom of Wilms tumor. However, this is not the immediate priority compared to preventing potential harm to the child by avoiding pressure on the abdominal area.
C. Instructing the parent to avoid pressing on the abdominal area is the priority action. Wilms tumor can rupture with pressure, which can lead to the spread of cancer cells. It is crucial to minimize handling of the tumor to prevent tumor spillage into the abdominal cavity.
D. The decision to schedule additional diagnostic tests, such as an abdominal ultrasound, can be made based on the results of the urinalysis and further clinical assessment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
To calculate the appropriate dosage of amoxicillin for the toddler; Given:
Weight of the toddler = 20 kg
Recommended dosage range = 20 to 25 mg/kg/day Calculate the total daily dose:
Minimum recommended dosage = 20 mg/kg/day Maximum recommended dosage = 25 mg/kg/day
Minimum total daily dose = 20 mg/kg/day × 20 kg = 400 mg/day Maximum total daily dose = 25 mg/kg/day × 20 kg = 500 mg/day
The prescribed dosage is 100 mg every 8 hours, which means 300 mg per day (100 mg × 3 times a day). As 300 mg is below the minimum recommended total daily dose (400 mg) for a toddler weighing 20 kg, the nurse should determine that the prescribed dosage is insufficient to achieve the desired effect.
Correct Answer is B
Explanation
A. Application of antibiotic ointment to the pin sites is not necessary as pins drilled into the bone are not used in buck extension traction.
B. Traction can be removed briefly during baths in cases where a pre-made boot is being used
C. Adequate hydration is essential for overall health and well-being, and fluid restriction could lead to dehydration, especially in a child with increased metabolic demands due to illness or injury.
D. Repositioning every 2 hours may not be necessary, as the child's position is generally stable with the traction device in place.
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