Which is true of a Wilms tumor? (Select all that apply.)

Correct Answer: C

Rationale: In this question regarding Wilms tumor, option C is correct because Wilms tumor can occur on its own or be associated with congenital anomalies, such as WAGR syndrome. This knowledge is crucial for nurses caring for pediatric patients as it helps in early detection and appropriate management. Option A is incorrect because a Wilms tumor is not referred to as neuroblastoma; neuroblastoma is a separate type of cancer that affects nerve tissue. Option B is incorrect as Wilms tumor is most commonly seen in children under the age of 5, with peak incidence around 3 years old. Option D is incorrect because Wilms tumor is actually a fast-growing tumor originating from the kidneys, not a slow-growing one. Understanding the characteristics of Wilms tumor is important for nurses working in pediatric oncology to provide optimal care, educate families about the condition, and recognize associated anomalies that may impact treatment decisions. Nurses need to be knowledgeable about pediatric cancers to effectively support patients and families through diagnosis, treatment, and survivorship.

Correct Answer: A

Rationale: The primary critical observation for Apgar scoring is the heart rate. This is because the heart rate is vital for life and immediate assessment of the infant's heart rate provides crucial information about the baby's overall well-being and response to the birthing process. The Apgar score assesses five components: heart rate, respiratory effort, muscle tone, reflex irritability, and skin color. Among these components, the heart rate is considered the most critical because it directly reflects the infant's cardiovascular status and their ability to maintain adequate perfusion of vital organs. Therefore, for quick assessment and immediate intervention, the heart rate is prioritized as the primary observation in Apgar scoring.

Correct Answer: D

Rationale: The priority of care when a baby born to an insulin-dependent diabetic mother is brought to the nursery is to check the baby's serum glucose level and administer glucose if it is less than 40 mg/dL. Babies born to diabetic mothers, especially those with poorly controlled blood sugar levels, are at risk for hypoglycemia (low blood sugar) due to the sudden drop in glucose supply after delivery. Hypoglycemia can be dangerous for newborns and can lead to serious complications if left untreated. Therefore, monitoring the baby's serum glucose levels and providing appropriate intervention, such as administering glucose if necessary, is critical to ensure the baby's well-being.

Correct Answer: D

Rationale: In a child with Wilms' tumor, the nurse would expect to detect an abdominal mass upon assessment. Wilms' tumor, also known as nephroblastoma, is a type of kidney cancer that commonly presents as a firm, non-tender abdominal mass. This mass may be felt upon palpation of the abdomen. Gross hematuria (A) is not a typical finding associated with Wilms' tumor. Dysuria (B) is the term used to describe painful or difficult urination and is not a characteristic symptom of Wilms' tumor. Nausea and vomiting (C) are also not commonly associated with Wilms' tumor, unless the tumor is causing obstruction or compression of nearby structures in the abdomen.

Correct Answer: A

Rationale: Drinking acidic juices, such as cranberry juice, can help make the urine more acidic, which can potentially prevent bacteria from sticking to the urinary tract walls and reduce the risk of urinary tract infections. It is important to note that while acidic juices can be beneficial in some cases, they should not be relied upon as the sole preventive measure for UTIs. Other important preventive measures include staying hydrated, practicing good hygiene, and urinating before and after intercourse.