A nurse is collecting data from a 1-year-old child who has Wilms’ tumor. Which of the following findings should the nurse expect?

Choice A reason: Wilms’ tumor, a pediatric kidney malignancy, presents as a painless abdominal mass, often palpable in the flank, due to tumor growth in the renal parenchyma. This disrupts normal kidney structure, causing a firm, non-tender mass. It’s the most common finding, reflecting the tumor’s physical presence in the abdomen. Choice B reason: Diarrhea is not associated with Wilms’ tumor, which primarily affects the kidney, causing mass effect or hematuria. Gastrointestinal symptoms may occur in other conditions like neuroblastoma, but Wilms’ tumor typically presents with an abdominal mass, making diarrhea an incorrect expected finding in this malignancy. Choice C reason: Jaundice results from liver dysfunction or biliary obstruction, not Wilms’ tumor, which affects the kidney. While metastasis to the liver is possible, it’s rare and not a primary feature. An abdominal mass is the hallmark sign, making jaundice an incorrect expected manifestation in a 1-year-old. Choice D reason: Swollen joints suggest rheumatologic or metastatic bone disease, not Wilms’ tumor, which primarily causes a renal mass. Joint involvement is uncommon, as Wilms’ tumor affects the kidney, leading to an abdominal mass. This makes swollen joints an incorrect expected finding in this pediatric malignancy.