a child has been diagnosed with a wilms tumor what should preoperative nursing care include
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Nursing Elites

ATI RN

ATI Nursing Care of Children 2019 B

1. A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include?

Correct answer: A

Rationale: The correct answer is A: Careful bathing and handling. Preoperative care for a child with a Wilms tumor should focus on preventing any trauma to the abdomen, which could lead to tumor rupture. Monitoring behavioral status and maintaining strict isolation are not as critical in this situation. Behavioral status is important but not a priority in preoperative care for a Wilms tumor. Strict isolation is not necessary unless there are specific infectious concerns, which is not typically the case for a Wilms tumor. Administration of packed red blood cells is not a standard preoperative intervention for Wilms tumor.

2. Which pediatric condition is characterized by a "string sign" on an upper GI series?

Correct answer: B

Rationale: The correct answer is B: Hypertrophic pyloric stenosis. The "string sign" is associated with hypertrophic pyloric stenosis, a condition where the pyloric canal is narrowed, leading to gastric outlet obstruction. Intussusception (choice A) typically presents with colicky abdominal pain and currant jelly stools. Hirschsprung disease (choice C) is characterized by the absence of ganglion cells in the distal colon. Meckel diverticulum (choice D) is a congenital outpouching of the small intestine that can present with painless rectal bleeding.

3. When transitioning from intravenous to oral morphine, what would the nurse anticipate regarding the oral dose in comparison to the intravenous dose to achieve equianalgesia?

Correct answer: B

Rationale: When switching from intravenous to oral morphine, a higher oral dose is required to achieve equianalgesia due to significant metabolism from the first-pass effect. Choosing the same oral dose as the intravenous dose would provide less pain relief. Opting for a dose greater than the intravenous dose is necessary to achieve the same analgesic effect. Therefore, options A, C, and D are incorrect.

4. The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?

Correct answer: D

Rationale: A child with a BMI greater than the 95th percentile is classified as obese, according to standard growth charts used in pediatric practice.

5. What diet is most appropriate for the child with chronic renal failure (CRF)?

Correct answer: C

Rationale: A low-phosphorus diet is important in managing chronic renal failure to prevent hyperphosphatemia and its associated complications, such as bone disease. Protein intake should be controlled but not necessarily low, and vitamin D supplementation is often required, not reduced.

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