The mother of a 4-year-old client tells the pediatric nurse that the child's abdomen seems to be swollen. During further assessment, the mother tells the nurse that their child is eating well and that their activity level is unchanged. The nurse, suspecting the possibility of Wilms tumor, should avoid which action during the physical assessment?
Monitoring the temperature for the presence of fever
Monitoring the blood pressure for the presence of hypertension
Assessing the urine for the presence of hematuria
Palpating the abdomen for a mass
The Correct Answer is D
A. Monitoring the temperature for fever is appropriate as part of a general assessment and could help identify signs of infection.
B. Monitoring blood pressure is important because hypertension can be associated with Wilms tumor.
C. Assessing the urine for hematuria is appropriate, as hematuria can be a symptom of Wilms tumor.
D. Palpating the abdomen is contraindicated in suspected Wilms tumor cases because it could cause the tumor to rupture, potentially spreading cancerous cells. Therefore, palpating the abdomen should be avoided until further diagnostic procedures are performed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. An upper gastrointestinal series is commonly used to diagnose gastroesophageal reflux (GER), which can cause symptoms like spitting up and crying after feedings, leading to failure to thrive. This test helps visualize the esophagus, stomach, and duodenum for abnormalities.
B. A biopsy of the small intestine is typically done to diagnose celiac disease, which is less likely in this clinical scenario.
C. An ultrasound is used to diagnose pyloric stenosis, which presents with projectile vomiting and is less consistent with the described symptoms.
D. A lower gastrointestinal series is used to detect intestinal blockages, which are not suggested by the symptoms of spitting up and crying immediately after feeding.
Correct Answer is C
Explanation
A. Reduced intellectual processing is not typically associated with hyperthyroidism; it is more commonly associated with hypothyroidism.
B. Slow, lethargic movements are more indicative of hypothyroidism rather than hyperthyroidism.
C. Recent weight loss is a common symptom of hyperthyroidism due to increased metabolic rate and appetite changes.
D. A swollen, protuberant abdomen is not a typical symptom of hyperthyroidism. It is more associated with other conditions such as hypothyroidism or gastrointestinal issues.
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