Page 936 - Saunders Comprehensive Review For NCLEX-RN

Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Complex Care: Emergency Situations/Management
Health Problem: Pediatric-Specific: Cancers
Priority Concepts: Clinical Judgment; Intracranial Regulation
Reference: Hockenberry, Wilson, Rodgers (2017), p. 834.

314. Answer: 1

Rationale: Wilms’ tumor is the most common intra-abdominal and kidney tumor
of childhood. If Wilms’ tumor is suspected, the tumor mass should not be palpated
by the nurse. Excessive manipulation can cause seeding of the tumor and spread of
the cancerous cells. Hematuria, fever, and hypertension are clinical manifestations
associated with Wilms’ tumor.
Test-Taking Strategy: Focus on the subject, the action to avoid. Knowledge that
this tumor is an intra-abdominal and kidney tumor will assist in eliminating options
2 and 4 because of the relationship of these options to renal function. Next, thinking
about the effect of palpating the tumor will direct you to the correct answer from the
remaining options.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Implementation
Content Area: Pediatrics: Oncological
Health Problem: Pediatric-Specific: Cancers
Priority Concepts: Cellular Regulation; Safety
Reference: McKinney et al. (2018), p. 1165.

315. Answer: 2

Rationale: Osteosarcoma is the most common bone cancer in children. Cancer
usually is found in the metaphysis of long bones, especially in the lower extremities,
with most tumors occurring in the femur. Osteosarcoma is manifested clinically by
progressive, insidious, and intermittent pain at the tumor site. By the time these
children receive medical attention, they may be in considerable pain from the tumor.
Options 1, 3, and 4 are accurate regarding osteosarcoma.
Test-Taking Strategy: Note the strategic words, need for information. These words
indicate a negative event query and ask you to select an option that is an incorrect
statement. Knowledge that osteosarcoma is a malignant tumor of the bone will direct
you to the correct option.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pediatrics: Oncological
Health Problem: Pediatric-Specific: Cancers
Priority Concepts: Cellular Regulation; Clinical Judgment
Reference: McKinney et al. (2018), pp. 1162-1163.

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