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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Which of the following is the most important assessment during the acute stage of an unconscious patient like Mr. Franco?
- A. Level of awareness and response to pain
- B. Papillary reflexes and response to sensory stimuli
- C. Coherence and sense of hearing
- D. Patency of airway and adequacy of respiration
Correct Answer: D
Rationale: In the acute stage of an unconscious patient like Mr. Franco, the most critical assessment is ensuring the patency of the airway and evaluating the adequacy of respiration. Maintaining a clear airway is essential to ensure that oxygen can reach the lungs and be circulated to vital organs. Without proper airway management, a patient's condition can quickly deteriorate due to hypoxia, leading to severe complications or even death. Therefore, assessing and securing the airway is the priority in the initial management of an unconscious patient to maintain adequate oxygenation and ventilation. Monitoring the respiration rate, depth, and effort is crucial to identify any signs of respiratory distress or failure that require immediate intervention. Once the airway and breathing are addressed, further assessments related to neurological function and sensory responses can be conducted.
The first permanent tooth to erupt is
- A. central incisor at 6 yr
- B. molar at 6 yr
- C. premolar lower canine at 6-7 yr
- D. upper canine at 6-7 yr
Correct Answer: B
Rationale: The first permanent molar typically erupts around 6 years.
A 6-year-old male child presented with a cerebellar mass; after undergoing complete surgical resection of the mass, the histology of the mass reveals pilocytic astrocytoma. Of the following, the MOST appropriate next step in the management is
- A. radiotherapy
- B. chemotherapy
- C. observation
- D. concomitant chemo-radiotherapy
Correct Answer: C
Rationale: Pilocytic astrocytomas are generally low-grade tumors, and observation is often sufficient after complete resection.
Which of the ff instructions should a nurse give a client with non-Hodgkin's lymphoma who is being treated with radiation and chemotherapy?
- A. Increase fluid intake
- B. Intake low-fat meals
- C. Intake soft, bland foods
- D. Intake food rich in folic acid
Correct Answer: A
Rationale: Patients with non-Hodgkin's lymphoma who are undergoing radiation and chemotherapy need to increase their fluid intake to help flush out the toxic byproducts of the treatments from their body. Adequate hydration can also help prevent dehydration, maintain proper kidney function, and alleviate some side effects such as nausea and vomiting. It is important for the nurse to advise the client to drink plenty of water, clear fluids, and electrolyte-rich beverages to support their overall well-being during treatment.
The nurse teaches a patient how to live with a new tracheostomy. Which of the ff. instructions is appropriate?
- A. "Never suction your tracheostomy; you might damage your trachea."
- B. ""You should not feel bad about the tracheostomy – you should be feel lucky to be alive."
- C. "Be sure to protect your tracheostomy from pollutants such as powders, hair and chemicals."
- D. "Your tracheostomy will be cleaned each time you visit your doctor."
Correct Answer: C
Rationale: Option C, "Be sure to protect your tracheostomy from pollutants such as powders, hair and chemicals," is the most appropriate instruction for a patient with a new tracheostomy. It is important to keep the tracheostomy site clean and free from any potential irritants or contaminants that could cause infection or complications. Powders, hair, and chemicals can lead to irritation or clogging of the tracheostomy tube, so it is crucial for the patient to be mindful of avoiding such pollutants near the tracheostomy site.