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A 9-year-old boy develops acute myelogenous leukemia (AML) one year after completion of therapy for soft tissue sarcoma at his right thigh. Which of the following chemotherapeutic agents is MOST likely the cause of secondary acute myelogenous leukemia AML in this boy?
- A. cyclophosphamide
- B. vincristine
- C. etoposide
- D. doxorubicin
Correct Answer: C
Rationale: Etoposide is known to be associated with secondary AML due to its potential to induce chromosomal abnormalities.
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What is an advantage of peritoneal dialysis?
- A. Treatments are done in hospitals.
- B. Protein loss is less extensive.
- C. Dietary limitations are not necessary.
- D. Parents and older children can perform treatments.
Correct Answer: B
Rationale: An advantage of peritoneal dialysis is that protein loss is less extensive compared to hemodialysis. Peritoneal dialysis operates by using the peritoneal membrane in the abdomen to act as a natural filter, helping to remove waste products and excess fluids from the body. The process of peritoneal dialysis allows for a slower, more continuous removal of waste substances, which results in reduced protein loss as compared to hemodialysis. This can be beneficial for maintaining overall nutritional status and preventing complications related to protein deficiencies in patients undergoing dialysis treatment.
A female client with lymphedema expresses her anxiety about the abnormal enlargement of an arm. Which of the ff suggestions should a nurse give to support the clients self image?
- A. Place the arm in the sling
- B. Apply cold soaks to the affected arm
- C. Introduce variations in styles of clothing
- D. Tie a tight bandage to the arm
Correct Answer: C
Rationale: Introducing variations in styles of clothing can help the client feel more comfortable and confident despite the abnormal enlargement of her arm due to lymphedema. By wearing different styles of clothing that accommodate the affected arm, the client can still express her personal style and feel good about her appearance. This approach can help improve the client's self-image and self-esteem, supporting her emotionally as she copes with the condition. Placing the arm in a sling, applying cold soaks, or tying a tight bandage are not appropriate suggestions for addressing the client's anxiety and self-image concerns in this situation.
A parent of an infant with colic tells the nurse, "All this baby does is scream at me; it is a constant worry." What is the nurse's best action?
- A. Encourage parent to verbalize feelings.
- B. Encourage parent not to worry so much.
- C. Assess parent for other signs of inadequate parenting.
- D. Reassure parent that colic rarely lasts past age 9 months.
Correct Answer: A
Rationale: The nurse's best action is to encourage the parent to verbalize their feelings. This allows the parent to express their emotions and concerns, which can be therapeutic and provide an opportunity for support and understanding. By acknowledging the parent's feelings and providing a listening ear, the nurse can help validate the parent's experiences and build a trusting relationship. Additionally, encouraging the parent to express their emotions can help them cope with the challenges of caring for a colicky infant and seek appropriate resources for support. It is important for the nurse to be empathetic and supportive towards the parent's feelings during this difficult time.
A child with a Wilms tumor is scheduled for surgery. Which best describes the procedure?
- A. Only the affected kidney will be removed.
- B. Both kidneys will be removed.
- C. Only the tumor mass will be excised.
- D. The tumor is removed, and a biopsy of the unaffected kidney is done.
Correct Answer: A
Rationale: The standard treatment for Wilms tumor is a nephrectomy of the affected kidney while preserving the other kidney.
The mother of a child with a congenital cardiac defect asks the nurse why her child squats after exertion. The nurse should reply that this position:
- A. Reduces muscle aches
- B. Increases cardiac efficiency
- C. Enhances the pull of gravity
- D. Decreases blood volume in the extremities
Correct Answer: B
Rationale: The position of squatting after exertion increases cardiac efficiency in children with congenital cardiac defects, specifically those with Tetralogy of Fallot. By squatting, the child decreases systemic vascular resistance and increases systemic venous return, which helps to enhance cardiac output by improving blood flow to the lungs. This position allows for better oxygenation of the blood and helps alleviate cyanosis in children with Tetralogy of Fallot.