Which physical assessment technique will the nurse omit when caring for a 2-year-old child diagnosed with Wilms' tumor?

Percussing ankle and knee reflexes

Assessing for bowel sounds

Performing range-of-motion exercises on low extremities

Palpating the abdomen

Answer and Explanation

The Correct Answer is D

A. Percussing ankle and knee reflexes. Safe and non-invasive, and does not risk disturbing the tumor.
B. Assessing for bowel sounds. Routine part of assessment and does not involve manipulating the tumor.
C. Performing range-of-motion exercises on lower extremities. Safe and non-invasive, unrelated to the abdominal tumor.
D. Palpating the abdomen. Palpating the abdomen in a child with Wilms' tumor is avoided to prevent the risk of tumor rupture and subsequent metastasis.

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Correct Answer is ["C","D","E"]

Explanation

A. Excessive hair growth: Hair loss, not excessive hair growth, is a common side effect of chemotherapy.
B. Increased appetite. Chemotherapy often causes nausea, vomiting, and reduced appetite, not an increase in appetite.
C. Fatigue. Fatigue is a common side effect of chemotherapy due to its impact on the body, including reduced blood counts and overall systemic stress.
D. Possible infections: Chemotherapy weakens the immune system, increasing the risk of infections. The nurse will monitor the child for signs of infection and implement measures to prevent them, like proper hand hygiene and maintaining a clean environment.
E. Easy bruising: Chemotherapy can affect blood clotting, making the child more susceptible to bruising. The nurse will educate the parents and child about precautions to minimize bruising risks

A. Have the child sit with her head tilted forward and hold pressure on her nose for 10 min. B. Place the child in a sitting position and tilt her head back. C. Apply ice at the opening of the nares for 5 min and then re-check for bleeding. D. Place the child in a supine position with a pillow under her head.

Correct Answer is A

Explanation

A. Have the child sit with her head tilted forward and hold pressure on her nose for 10 min. Tilting the head forward helps prevent blood from flowing down the throat and causing nausea or choking. Applying pressure to the nose for 10 minutes helps to stop the bleeding.
B. Place the child in a sitting position and tilt her head back. Tilted head back can cause blood to flow down the throat and potentially cause aspiration or choking. It's not recommended in managing nosebleeds.
C. Apply ice at the opening of the nares for 5 min and then re-check for bleeding. While cold compresses can help constrict blood vessels, direct pressure and maintaining a forward head position are more effective for stopping nosebleeds.
D. Place the child in a supine position with a pillow under her head. Supine position can cause blood to flow down the throat and is not recommended in managing nosebleeds due to the risk of aspiration.

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Which physical assessment technique will the nurse omit when caring for a 2-year-old child diagnosed with Wilms' tumor?

Nursing Test Bank

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