A 3-day-old neonate has a large, soft, painless mass involving the head and neck region that mostly transilluminate; CT scan reveals a cystic mass involving the neck and intrathoracic mediastinum. The BEST modality for treatment of this neonate is
- A. surgical resection
- B. injection sclerosing agent
- C. laser therapy
- D. systemic interferon therapy
Correct Answer: A
Rationale: Surgical resection is the definitive treatment for cystic hygroma.
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or a client with newly diagnosed cancer, the nurse formulates a nursing diagnosis of Anxiety related to the threat of death secondary to cancer diagnosis. Which expected outcome would be appropriate for this client?
- A. "Client verbalizes feelings of anxiety."
- B. "Client doesn't guess at prognosis."
- C. "Client uses any effective method to reduce tension."
- D. "Client stops seeking information."
Correct Answer: C
Rationale: The most appropriate expected outcome for a client experiencing anxiety related to a cancer diagnosis would be "Client uses any effective method to reduce tension." This outcome focuses on the client actively managing their anxiety by utilizing various strategies to decrease tension and promote feelings of calmness. It empowers the client to take control of their anxiety and seeks to foster a sense of well-being during a difficult time. The other options do not directly address the active management of anxiety as effectively as option C.
Biopsy is not usually performed for a child with suspicion of Wilms tumor EXCEPT
- A. age of 2-3 year
- B. signs of inflammation or infection
- C. significant lymph node enlargement radiologically
- D. intratumoral calcification radiologically
Correct Answer: E
Rationale: Presence of intratumoral calcifications may warrant biopsy to rule out other diagnoses.
Which is an important nursing consideration in the care of the newborn with PKU?
- A. Suggest ways to make formula more palatable.
- B. Teach proper administration of phenylalanine hydroxylase.
- C. Encourage the breastfeeding mother to adhere to a low-phenylalanine diet.
- D. Give reassurance that dietary restrictions are a temporary inconvenience.
Correct Answer: C
Rationale: Encouraging the breastfeeding mother to adhere to a low-phenylalanine diet is an important nursing consideration in the care of the newborn with PKU. Phenylketonuria (PKU) is an inborn error of metabolism in which the body cannot metabolize phenylalanine properly. If a newborn with PKU consumes formula or breast milk that contains high levels of phenylalanine, it can lead to severe intellectual disability and other health complications. By encouraging the breastfeeding mother to follow a low-phenylalanine diet, the newborn's exposure to phenylalanine can be minimized, helping to prevent the negative effects of PKU.
Mr. Mendres asks Nurse Rose what causes peptic ulcer to develop. Nurse Rose responds that recent research indicates that peptic ulcers are the result of which of the following?
- A. genetic defect in the gastric mucosa
- B. helicobacter pylori infection
- C. high fat diet
- D. work related stress
Correct Answer: B
Rationale: Recent research suggests that the majority of peptic ulcers are caused by an infection with Helicobacter pylori bacteria. This bacterium weakens the protective mucous coating of the stomach and duodenum, leading to damage from stomach acid. Genetic defects in the gastric mucosa, high fat diet, and work-related stress may exacerbate the condition but are not the primary cause of peptic ulcers. Therefore, the most likely cause based on current understanding is H. pylori infection.
A one-month-old patient, who has developmental dysplasia of the hip, is placed in a hip spica cast. The patient's mother expresses the desire to continue breastfeeding. What is the pediatric nurse's best response?
- A. After breastfeeding, hold your baby upright for 45 minutes.
- B. Due to the weight of the cast, breastfeeding is not encouraged. I recommend that you bottle-feed.
- C. Breastfeeding can continue without significant changes; ensure proper positioning to accommodate the cast.
- D. none of the above.
Correct Answer: C
Rationale: Breastfeeding can continue even with a hip spica cast, but proper positioning is essential to ensure comfort for both the infant and the mother.