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
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.
Nursing Test Bank
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Related Questions
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
Correct Answer is B
Explanation
A. Test the stool for occult blood: Testing for occult blood in the stool is not relevant for diagnosing pinworms.
B. Perform a tape test: The tape test involves applying transparent tape to the perianal area to collect pinworm eggs, which is the appropriate diagnostic method for Enterobius vermicularis.
C. Initiate IV fluids: IV fluids are not indicated for the diagnosis or treatment of pinworms unless the child is severely dehydrated, which isn't suggested by the scenario.
D. Collect stool specimens for culture: Stool culture is not used to diagnose pinworms; the tape test is more appropriate.
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