A 4-year-old weighing 15 kg produces 150 mL of urine in 10 hours. What should the nurse do?

Correct Answer: C

Rationale: Rationale: The correct answer is C) Record the urine output in the chart. In pediatric nursing, monitoring urine output is crucial as it is a key indicator of renal function and hydration status in children. In this case, the 4-year-old child's urine output of 150 mL in 10 hours falls within the expected range for a child of this age and weight. It is important for the nurse to accurately document this output in the child's chart for ongoing assessment and to establish a baseline for comparison. Option A) Notify the physician; urine output is too low: This option is incorrect because the child's urine output is within the expected range for a 4-year-old. There is no indication of decreased renal function or dehydration based on the given information. Option B) Encourage increased oral intake: While hydration is important, there is no evidence in the question to suggest that the child is dehydrated or in need of increased oral intake. The current urine output is appropriate for the child's age and weight. Option D) Administer IV fluids to rehydrate: There is no indication in the question that the child is dehydrated to the point of needing IV fluids. Administering IV fluids without a proper assessment and indication can lead to fluid overload and potential complications. Educational context: Understanding normal pediatric parameters, such as urine output, is vital for pediatric nurses. By accurately documenting and interpreting urine output, nurses can detect early signs of renal dysfunction, dehydration, or other health issues in children. This question reinforces the importance of thorough assessment, documentation, and critical thinking in pediatric nursing practice.

Correct Answer: A

Rationale: The correct answer is A) electrolytes. Refeeding syndrome is a potentially life-threatening condition that can occur when nutrition is rapidly reintroduced to a malnourished individual, causing shifts in electrolytes such as phosphorus, potassium, and magnesium. These electrolyte imbalances can lead to serious complications like cardiac arrhythmias, respiratory failure, seizures, and even death. Option B) serum proteins is incorrect because while protein metabolism may be affected during refeeding, the major changes that occur typically revolve around electrolyte imbalances. Option C) hormones is incorrect because although hormonal changes can occur during refeeding, they are not the major focus in the context of refeeding syndrome. Option D) liver enzymes is incorrect because refeeding syndrome primarily affects electrolyte balance rather than liver enzymes. In an educational context, understanding refeeding syndrome is crucial for healthcare providers, especially those working with malnourished pediatric patients. It highlights the importance of slow and gradual reintroduction of nutrition to prevent serious complications. Recognizing the signs and symptoms of refeeding syndrome and monitoring electrolyte levels closely can help prevent adverse outcomes in these vulnerable patients.

Correct Answer: D

Rationale: The correct answer is D) retinoblastoma. Retinoblastoma is a rare malignant tumor that primarily affects children, typically before the age of 5. This cancer arises from the retina and is very uncommon in adults. Acute Lymphoblastic Leukemia (ALL) (option A) is a common type of leukemia that can affect both children and adults, but it is more prevalent in children. Osteosarcoma (option B) is a type of bone cancer that primarily occurs in children and young adults. Medulloblastoma (option C) is a type of brain tumor that mainly affects children, although it can rarely occur in adults. Understanding the prevalence of different types of pediatric cancers is crucial for healthcare professionals caring for pediatric patients. Recognizing the unique characteristics of various malignancies can aid in early detection, timely intervention, and improved outcomes for young patients. By knowing which tumors are more common in children, healthcare providers can tailor their screening, diagnostic, and treatment approaches accordingly.

Correct Answer: D

Rationale: In this case, the correct answer is D) stage IIB. According to the Ann Arbor Staging Classification for Hodgkin lymphoma, stage IIB indicates involvement of two or more lymph node regions on the same side of the diaphragm. In the scenario given, the patient has left cervical and supraclavicular lymph node involvement, which constitutes two different lymph node regions on the same side of the diaphragm. Option A) stage IA is incorrect because it refers to involvement of a single lymph node region. Option B) stage IB is also incorrect as it indicates involvement of a single lymph node region plus the spleen. Option C) stage IIA is not applicable here as it involves involvement of two or more lymph node regions on the same side of the diaphragm without systemic symptoms like night sweats. Understanding the Ann Arbor Staging Classification is crucial in the assessment and management of Hodgkin lymphoma patients. It helps determine the extent of the disease, plan treatment strategies, and predict prognosis. Educating healthcare providers on accurate staging criteria ensures optimal care and outcomes for pediatric patients with lymphomas.

Correct Answer: E

Rationale: In the case of a child with suspicion of Wilms tumor, a biopsy is usually not performed if there is intratumoral calcification radiologically. This is because intratumoral calcification is a characteristic feature of Wilms tumor that can be identified through imaging studies like X-rays or CT scans with a high degree of accuracy. Biopsy may not be necessary in this case as the presence of intratumoral calcification along with other clinical and radiological findings can strongly suggest the diagnosis of Wilms tumor. Option A) Age of 2-3 years is not a valid reason to exclude the need for a biopsy as Wilms tumor commonly occurs in children between 2-5 years of age. Option B) Signs of inflammation or infection are not typically associated with Wilms tumor, and the presence of these signs might actually warrant further investigation through a biopsy to rule out other conditions. Option C) Significant lymph node enlargement radiologically may also necessitate a biopsy to determine the underlying cause, as it could be indicative of metastasis or another type of tumor. Educationally, understanding the rationale behind why a biopsy may or may not be indicated in specific scenarios is crucial for healthcare providers managing pediatric oncology cases. It highlights the importance of integrating clinical presentation, imaging findings, and diagnostic procedures to make informed decisions for patient care.