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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At health fair, an oncology nurse answers questions about risk factors for various types of cancer. One person with a family history of colon cancer asks the nurse to identify risk factors for this type of cancer. The nurse should identify:
- A. Smoking
- B. Obesity
- C. Heavy alcohol consumption
- D. Saccharin consumption
Correct Answer: B
Rationale: Obesity is a known risk factor for colon cancer. Studies have shown that individuals who are obese have an increased risk of developing colon cancer compared to those who are of normal weight. The excess fat tissue, particularly around the abdomen, can lead to chronic inflammation and hormonal changes in the body, which can contribute to the development of cancer cells. It is essential for individuals with a family history of colon cancer to be mindful of maintaining a healthy weight as part of their overall cancer prevention strategies. Smoking, heavy alcohol consumption, and saccharin consumption are not identified as primary risk factors for colon cancer.
A client metastatic ovarian cancer is prescribed cisplatin (Platinol). Before administering the first dose, the nurse reviews the client's medication history for drugs that may interact with cisplatin. Which drug may cause significant interactions when given concomitantly with cisplatin?
- A. Erythromycin
- B. A cephalosporin
- C. A tetracycline
- D. An amino glycoside Situation: A client with ovarian cancer is prescribed hydroxyurea (Hydrea), an antimetabolite drug.
Correct Answer: D
Rationale: Amino glycosides, such as gentamicin or amikacin, can interact significantly with cisplatin, leading to increased risk of kidney damage or hearing loss. Both amino glycosides and cisplatin are known to have nephrotoxic and ototoxic effects independently. When combined, the risk of these side effects is potentiated, making it important to monitor renal function and hearing closely when these drugs are co-administered. Therefore, it is crucial to avoid the concomitant use of amino glycosides with cisplatin in order to prevent harmful drug interactions and reduce the risk of adverse effects in the client with metastatic ovarian cancer.
Persons with up to 70% prevalence of peculiar facial anatomy are considered risk factors for obstructive sleep apnea EXCEPT
- A. hypotonia
- B. developmental delay
- C. central adiposity
- D. hypothyroidism
Correct Answer: D
Rationale: Hypothyroidism is not a typical risk factor for obstructive sleep apnea.
Children with severe traumatic brain injury (TBI) may experience autonomic dysfunction characterized by all the following EXCEPT
- A. elevated temperature
- B. elevated heart rate
- C. elevated respiratory rate
- D. lowered blood pressure
Correct Answer: D
Rationale: Autonomic dysfunction in TBI typically involves elevated temperature, heart rate, and respiratory rate due to dysregulation of the autonomic nervous system. Lowered blood pressure is less common and may indicate hypovolemia or other conditions rather than autonomic dysfunction.
The majority of lumbar disc herniations occur at the level of:
- A. L1 - L2
- B. L4-L5
- C. L3-L4
- D. S1-S2
Correct Answer: B
Rationale: The majority of lumbar disc herniations occur at the level of L4-L5. This is because the L4-L5 disc segment bears the highest amount of stress and load in the lumbar spine due to its location and mechanics. The intervertebral disc between the fourth (L4) and fifth (L5) lumbar vertebrae is subject to repetitive movements and mechanical stress, making it more susceptible to herniation compared to other levels in the lumbar spine. Additionally, the anatomy of the L4-L5 disc makes it more prone to degeneration and herniation, leading to a higher prevalence of herniated discs at this level.