A nurse assesses a whitish reflection instead of the expected red ...

[Diane]

A nurse assesses a whitish reflection instead of the expected red reflex when evaluating an infant's eyes. Which action should the nurse take?
 
  a. Notify the physician.
  b. Chart the finding.
  c. Check the chart to verify that the infant received eye prophylaxis at birth.
  d. Reassess for a red reflex in 1 month.

Question 2

A child with a history of fever of unknown origin, excessive bruising, lymphadenopathy, and fatigue is exhibiting symptoms most suggestive of which condition?
 
  a. Ewing's sarcoma
  b. Wilms' tumor
  c. Neuroblastoma
  d. Leukemia

[epscape]

Answer to Question 1

A
A whitish reflex in the eye, leukocoria, is a common finding of retinoblastoma. It is an overt sign of cancer and the physician needs to be notified. Checking the chart for routine eye prophylaxis at birth would be done if there was an eye infection. The finding is not normal and by charting the finding or reassessing in 1 month treatment will be delayed.

Answer to Question 2

D
Symptoms of a history of fever of unknown origin, excessive bruising, lymphadenopathy, and fatigue reflect bone marrow failure and organ infiltration, which occur in leukemia. Symptoms of Ewing's sarcoma involve pain and soft tissue swelling around the affected bone. Wilms' tumor usually manifests as an abdominal mass with abdominal pain and may include renal symptoms, such as hematuria, hypertension, and anemia. Neuroblastoma manifests primarily as an abdominal, chest, bone, or joint mass. Symptoms are dependent on the extent and involvement of the tumor.

[Diane]

Thanks for the timely response, appreciate it

[epscape]

Excellent