Nokea
A 2-year-old child is being evaluated for a right flank mass; radiological appearance is consistent with rupture of Wilms tumor. The BEST therapeutic approach for this child is
- A. radiotherapy
- B. concomitant chemotherapy-radiotherapy
- C. another surgery
- D. observation
Correct Answer: B
Rationale: Concomitant chemotherapy and radiotherapy are essential to manage ruptured Wilms tumor and reduce the risk of dissemination.
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A 58-year-old man is diagnosed with cancer of the larynx. Which of the ff. are early symptoms of this cancer?
- A. Anemia and fatigue
- B. A noticeable lump in the neck
- C. Crackles and stridor
- D. Dysphagia or hoarseness
Correct Answer: D
Rationale: Early symptoms of cancer of the larynx typically include persistent hoarseness or a change in the voice quality. This may be due to the tumor affecting the vocal cords. Dysphagia, or difficulty swallowing, can also be an early sign. As the tumor grows, it may cause obstruction or compression in the throat, leading to difficulties in swallowing. These symptoms should prompt further evaluation by a healthcare provider for proper diagnosis and treatment planning. Anemia and fatigue (Choice A) are more general symptoms that can occur in cancer patients but are not typically specific to laryngeal cancer. The presence of a noticeable lump in the neck (Choice B) may indicate swelling of lymph nodes due to cancer spread but is not an early symptom commonly associated with laryngeal cancer. Crackles and stridor (Choice C) are respiratory sounds associated with conditions affecting the airways and are less likely to be early symptoms
A 1-year-old child develops right eye ptosis, miosis, and loss of sweating; you suspect neuroblastoma. The MOST valuable investigation to confirm the diagnosis is
- A. CT scan of the neck and chest
- B. CT scan of the abdomen
- C. CT scan of the brain
- D. magnetic resonance imaging (MRI) of the brain
Correct Answer: A
Rationale: CT scan of the neck and chest can help identify a primary neuroblastoma mass in the adrenal gland or sympathetic chain.
The nurse knows which of the following statements about TPN and peripheral parenteral nutrition is true?
- A. TPN is usually indicated for clients needing short term (less than 3 weeks) nutritional support, whereas PPN is for long term maintenance
- B. A client needing more than 3000 calories would receive PPN, whereas TPN is given to those requiring less than 3000 calories
- C. TPN is often given to those with fluid restrictions, whereas PPN is used for those without constraints on their fluid intake
- D. TPN is given to those who need to augment oral feeding, whereas PPN is used for those who are nothing by mouth
Correct Answer: C
Rationale: The statement that is true about TPN and peripheral parenteral nutrition (PPN) is that TPN is often given to those with fluid restrictions, whereas PPN is used for those without constraints on their fluid intake. This is because TPN is a hypertonic solution that can cause fluid overload if given in large volumes, so it's typically reserved for patients who have fluid restrictions. On the other hand, PPN is a less concentrated solution that can be safely administered to patients without fluid restrictions.
Which of the following symptoms is a classic sign of systemic lupus erythematosus (SLE)?
- A. Superficial lesions over the cheek and
- B. Weight loss nose
- C. Difficulty urinating
Correct Answer: A
Rationale: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various organs in the body. One of the classic signs of SLE is the presence of a facial rash in the shape of a butterfly over the cheeks and bridge of the nose. This rash is known as a malar rash and is often one of the first visible symptoms of the disease. Weight loss and difficulty urinating are not typical signs of SLE.
Regarding physical growth of middle childhood (6-11 years), all are true EXCEPT
- A. 3-3.5 kg weight increment/yr
- B. 6-7 cm height increment/yr
- C. brain stops myelinization by 8 years
- D. risk for future obesity falls by 6 years
Correct Answer: D
Rationale: Risk for obesity does not necessarily fall by 6 years.