Correct Answer: C

Rationale: Gross hematuria: Gross hematuria refers to visible blood in the urine, which can present as pink, red, or cola-colored urine. While hematuria can be associated with various kidney conditions, including Wilms' tumor, it is not a consistent or defining symptom of this specific tumor. Additionally, because the tumor is typically confined within the kidney and does not usually invade the urinary tract, gross hematuria might not always be present. Dysuria: Dysuria is the medical term for painful or difficult urination. It is not a typical symptom of Wilms' tumor, as this tumor primarily affects the kidney and may not directly affect the urinary tract in a way that causes painful urination. An abdominal mass: This is the correct answer. Wilms' tumor often presents as a palpable abdominal mass, which may be felt during physical examination. The mass is usually firm, non-tender, and confined to one side of the abdomen. Detection of an abdominal mass should prompt further diagnostic evaluation to confirm the diagnosis and plan appropriate treatment. Nausea and vomiting: While some children with Wilms' tumor may experience nausea and vomiting, these symptoms are nonspecific and can be caused by various conditions. They are not considered characteristic or defining features of Wilms' tumor. The presence of nausea and vomiting would prompt further assessment to determine the underlying cause.

Correct Answer: D

Rationale: I will have to feed my baby formula, rather than breast milk.' - This statement indicates a misunderstanding. Breast milk is generally preferred for infants with gastroesophageal reflux (GER) because it is more easily digested and less likely to exacerbate reflux symptoms compared to formula. Breastfeeding mothers may be encouraged to continue breastfeeding, and formula-fed infants may benefit from specialized formulas designed to reduce reflux symptoms. 'I should move my baby into a side-lying position during sleep.' - This statement indicates a misunderstanding. Placing an infant in a side-lying position during sleep is not recommended due to the risk of sudden infant death syndrome (SIDS). Instead, infants with GER should be placed on their back to sleep, as recommended by safe sleep guidelines. Elevating the head of the crib or bassinet slightly may also help reduce reflux symptoms during sleep. 'My baby's formula can be thickened with oatmeal.' - This statement indicates an understanding of the teaching. Thickening formula with oatmeal or rice cereal can help reduce gastroesophageal reflux (GER) symptoms in infants by making the formula heavier and less likely to reflux back into the esophagus. However, this should only be done under the guidance of a healthcare provider to ensure proper preparation and feeding technique. 'I will keep my baby in an upright position after feedings.' - This statement indicates an understanding of the teaching. Keeping the baby in an upright position after feedings can help reduce reflux symptoms by allowing gravity to keep the stomach contents down. Parents can hold the baby upright on their shoulder or in an infant seat for a period of time after feeding to minimize reflux episodes.

Correct Answer: B

Rationale: I know this can be embarrassing. I have kids myself so I understand, and it doesn't bother me.' This response acknowledges the child's feelings and reassures the parents that bedwetting is a common occurrence, especially during hospitalization. It also demonstrates empathy by sharing a personal experience. However, it may not address the parents' concerns about their child's bedwetting or provide information on how to manage it. 'Children who are hospitalized often regress. The toileting skills will return when your child is feeling better.' This response provides an explanation for the bedwetting incident, reassuring the parents that it is a common response to hospitalization and will likely resolve once the child feels better. It offers support and normalization of the behavior, which can help alleviate the parents' concerns. 'I will discuss your child's loss of bladder control with the provider.' This response indicates that the nurse will address the issue with the healthcare provider, which is appropriate if further evaluation or intervention is needed. However, it may not directly address the parents' concerns or provide immediate reassurance. 'Why is she wetting the bed in the hospital? She must wet the bed at home.' This response may come across as accusatory or judgmental, which can increase parental anxiety or guilt. It does not provide reassurance or support to the parents and does not address the child's immediate needs.

Correct Answer: C

Rationale: There are a few causes of this condition and they tell me my child has crossed eyes because of a muscle imbalance.': This statement demonstrates the mother's comprehension of the cause of strabismus, which can indeed result from a muscle imbalance affecting the alignment of the eyes. Understanding the cause is essential for the mother to grasp the rationale behind treatment interventions. 'I will have my child wear an eye patch over the good eye to help strengthen the weak eye.': Patching the stronger eye is a common treatment approach for strabismus to encourage the weaker eye to become stronger and improve alignment. The mother's statement indicates her awareness of this treatment modality. 'My child will outgrow this by the time he is 2 years old and be able to see just fine.': While some cases of strabismus may improve as a child grows, not all cases resolve spontaneously. This statement suggests the mother's belief in the possibility of spontaneous resolution, which may be accurate in some instances but not guaranteed for all cases of strabismus. 'If this eye patch does not work I know we will have to do surgery to correct my child's crossed eyes.': Surgery is indeed an option for correcting strabismus, especially if conservative measures like patching do not yield satisfactory results. The mother's understanding of this potential treatment escalation reflects her grasp of the condition's management plan.

Correct Answer: B

Rationale: Left side: Placing the infant on the left side after feeding is not typically recommended for managing gastroesophageal reflux. This position may not provide optimal support for digestion and may not effectively reduce reflux symptoms. Upright: This is the correct answer. Placing the infant in an upright position after feeding can help reduce gastroesophageal reflux. Gravity helps keep stomach contents down, preventing them from flowing back up into the esophagus. Holding the infant upright on the caregiver's shoulder or in a baby carrier can be effective in minimizing reflux symptoms. Right side: Placing the infant on the right side after feeding is not typically recommended for managing gastroesophageal reflux. Similar to the left side, this position may not provide optimal support for digestion and may not effectively reduce reflux symptoms. Prone: Placing the infant in a prone (face-down) position after feeding is not recommended due to the risk of sudden infant death syndrome (SIDS). Prone positioning is associated with an increased risk of SIDS, and current guidelines advise against placing infants to sleep or rest on their stomachs. Additionally, a prone position may not effectively reduce gastroesophageal reflux and may pose other risks to the infant's health and safety.