You are the nurse assigned to work with a child on the pediatric unit who has a diagnosis of Wilm's tumor. You will need to advise personnel of which of the following things?
The child's fluid and salt intake will be restricted until after surgery
The child's abdomen is not to be palpated, and handling must be gentle
Touching or holding the child requires the person to don a gown and mask
Blood pressure readings are not to be taken on the left arm
The Correct Answer is B
Rationale:
A. The child's fluid and salt intake will be restricted until after surgery: Fluid and salt restrictions are not standard for Wilm’s tumor unless the child has concurrent kidney failure or hypertension. Most children maintain normal fluid and electrolyte management.
B. The child's abdomen is not to be palpated, and handling must be gentle: Wilm’s tumor is a kidney tumor that is often encapsulated. Palpation of the abdomen can risk rupturing the tumor capsule, which could lead to tumor seeding in the abdominal cavity and worsening prognosis.
C. Touching or holding the child requires the person to don a gown and mask: Gowns and masks are used for infection control in cases of contagious illness or in immunocompromised patients, not for the presence of a tumor.
D. Blood pressure readings are not to be taken on the left arm: Blood pressure restrictions on a specific arm are usually related to vascular access devices (like PICC lines) or conditions involving circulation in that arm. Wilm’s tumor does not require avoidance of BP measurements on a particular arm unless there is a separate vascular concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. The child's fluid and salt intake will be restricted until after surgery: Fluid and salt restrictions are not standard for Wilm’s tumor unless the child has concurrent kidney failure or hypertension. Most children maintain normal fluid and electrolyte management.
B. The child's abdomen is not to be palpated, and handling must be gentle: Wilm’s tumor is a kidney tumor that is often encapsulated. Palpation of the abdomen can risk rupturing the tumor capsule, which could lead to tumor seeding in the abdominal cavity and worsening prognosis.
C. Touching or holding the child requires the person to don a gown and mask: Gowns and masks are used for infection control in cases of contagious illness or in immunocompromised patients, not for the presence of a tumor.
D. Blood pressure readings are not to be taken on the left arm: Blood pressure restrictions on a specific arm are usually related to vascular access devices (like PICC lines) or conditions involving circulation in that arm. Wilm’s tumor does not require avoidance of BP measurements on a particular arm unless there is a separate vascular concern.
Correct Answer is C
Explanation
Rationale:
A. Growth of pubic hair: Pubic hair growth, or pubarche, typically occurs after the initial signs of puberty and is a secondary sexual characteristic, not the first sign.
B. Growth spurt: The rapid increase in height follows the onset of puberty but usually comes after breast development has started.
C. Breast bud development: Thelarche, or breast bud development, is the earliest visible sign of puberty in girls, marking the start of hormonal changes and sexual maturation.
D. Menarche: Menarche, the onset of menstruation, occurs later in puberty after several other physical changes, including breast development and growth spurt.
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