Wilm's tumor is condition affecting?

Appeared in: HPSSSB Staff Nurse - 2016

Explanation

Wilms' tumor, also known as nephroblastoma, is the most common primary malignant renal (kidney) tumor of childhood.
The name 'nephroblastoma' itself indicates its origin, with 'nephro-' referring to the kidney and '-blastoma' referring to a tumor of embryonic cells.
It typically presents as an abdominal mass in children under 5 years old, with a peak incidence between ages 2 and 3.
The tumor arises from incompletely differentiated renal mesenchyme, which are primitive kidney cells.

Option B: Wilms' tumor does not originate in the bone. The most common primary malignant bone tumors in children are osteosarcoma and Ewing sarcoma.
Option C: The liver is not the site of origin for Wilms' tumor. The most common malignant liver tumor in early childhood is hepatoblastoma.
Option D: Wilms' tumor does not affect the brain. Common pediatric brain tumors include medulloblastoma, astrocytoma, and ependymoma.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology and organ of origin for Wilms' tumor (nephroblastoma) as background academic context rather than a clinical decision trigger.
The single most critical nursing intervention is to avoid palpating the abdomen once a Wilms' tumor is suspected. Palpation can rupture the tumor's thin capsule, spreading cancer cells into the abdominal cavity and worsening the prognosis.
Nurses must place a clear sign on the child's bed stating "DO NOT PALPATE ABDOMEN" to alert all healthcare team members.
Monitoring for hypertension is crucial, as the tumor can secrete excess renin, leading to high blood pressure that requires management.

How to Approach the Question

First, identify the key term in the question: "Wilms' tumor".
This is a factual recall question that tests your knowledge of pediatric oncology.
Recall the alternative name for Wilms' tumor, which is "nephroblastoma".
Break down the term 'nephroblastoma': the prefix "nephro-" refers to the kidney (nephrons), and "-blastoma" indicates a tumor of embryonic cells.
This direct linguistic clue points to the kidney as the affected organ.
Mentally eliminate the other options by recalling the names of common pediatric cancers associated with those organs (e.g., osteosarcoma for bone, hepatoblastoma for liver).

Concept Tested & Keywords

Concept Tested: Pathophysiology and organ of origin for Wilms' tumor (nephroblastoma).
Stem keywords: Wilm's tumor, condition affecting
Lead-in keywords: BEST, MOST RELEVANT CLUE
Negative lead-in flag: false

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 933-935

E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 2 (pp 239-476 of 713) p. 192-194

Practise the full HPSSSB Staff Nurse - 2016

Attempt every question from this paper in a timed mock, then review the full solution for each one.