Nokea
A 10-mo-old boy has a left suprarenal mass. Surgery is accomplished with complete removal of the mass as well as the non-adherent lymph nodes; surgical biopsies are taken during surgery. The histology reveals poorly differentiated neuroblastoma with microscopic ipsilateral lymph nodes involvement. The contralateral lymph nodes are negative. Of the following, the BEST therapeutic approach for this infant is
- A. chemotherapy
- B. radiotherapy
- C. concomitant chemo-radiotherapy
- D. chemotherapy followed by radiotherapy
Correct Answer: A
Rationale: Complete resection with microscopic residual disease typically warrants adjuvant chemotherapy.
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A 46 y.o. woman is admitted to the rehabilitation unit with left-sided hemiparesis resulting from a subarachnoid hemorrhage. She is not oriented to her surroundings or situation, but she does recognize her family. On admission, she tells her nurse that she can walk to the bathroom without assistance. Which of the ff. responses by the nurse is best?
- A. Allow her to ambulate unassisted, to encourage positive self-esteem.
- B. Ask her to demonstrate her ability to ambulate.
- C. Explain that someone will assist her as long as she is in the rehabilitation facility.
- D. Ask another staff member to help ambulate the patient the first time.
Correct Answer: C
Rationale: The best response by the nurse is to explain that someone will assist the patient as long as she is in the rehabilitation facility. This is important for ensuring the safety of the patient, especially considering her condition with left-sided hemiparesis resulting from a subarachnoid hemorrhage. While encouraging independence is important in rehabilitation, it should not compromise the patient's safety. The nurse should prioritize the patient's well-being and provide necessary assistance to prevent any potential falls or injuries during ambulation.aising the risk of falling or getting injured.
Which is true of a Wilms tumor? (Select all that apply.)
- A. It is also referred to as neuroblastoma.
- B. It is most commonly seen between the ages of 2 and 5 years.
- C. It can occur on its own or be associated with congenital anomalies.
- D. It is a slow-growing tumor.
Correct Answer: C
Rationale: Wilms tumor typically occurs in children aged 2-5 years and may be associated with congenital anomalies. It is not the same as neuroblastoma, and its prognosis is generally good with treatment.
Which blood gas analyses are most indicative of respiratory acidosis?
- A. pH = 7.22, PCO2 = 55 mmHg, HCO3 = 30 mEq/L.
- B. pH = 7.28, PCO2 = 45 mmHg, HCO3 = 15 mEq/L.
- C. pH = 7.34, PCO2 = 35 mmHg, HCO3 = 25 mEq/L.
- D. pH = 7.40, PCO2 = 25 mmHg, HCO3 = 30 mEq/L.
Correct Answer: A
Rationale: Respiratory acidosis is indicated by a low pH and elevated PCO2, as seen in option A.
Why must clients who will undergo diagnostic skin test avoid taking antihistamine or cold preparations for at least 48-72 hrs before testing?
- A. Antihistamines may increase the potential for excessive bleeding
- B. Antihistamines may aggravate the allergic reaction
- C. Antihistamines may increase the potential for false negative results
- D. Antihistamines may cause wheezing
Correct Answer: C
Rationale: Antihistamines are medications commonly used to relieve symptoms of allergies, including itching, sneezing, and hives. When a client undergoing a diagnostic skin test for allergies takes antihistamines, it can suppress the body's allergic response, leading to false negative results. This means that the test may not accurately identify all the substances to which the client is allergic, potentially leading to a misdiagnosis. To ensure the accuracy of the skin test, clients are advised to avoid taking antihistamines or cold preparations for at least 48-72 hours before the testing to allow their body to exhibit the appropriate allergic response.
The clue to need a help for a child who does not respond correctly to 'Give me' or 'Sit down' or 'Come here' when spoken without gestural cues is by age of
- A. 15 months
- B. 18 months
- C. 21 months
- D. 24 months
Correct Answer: D
Rationale: By 24 months, a child should be able to follow simple commands without gestures.