Nokea
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.
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Which manifestation is more specific to occur in anaplastic large cell lymphoma (ALCL) than other types of non-Hodgkin lymphoma?
- A. primary bone marrow involvement
- B. intestinal involvement
- C. CNS involvement
- D. primary mediastinal involvement
Correct Answer: D
Rationale: Primary mediastinal involvement is a hallmark feature of ALCL.
Mr. and Mrs. Robertson's son was diagnosed with idiopathic thrombocytopenic purpura. They should be aware that the drug to be avoided is:
- A. Acetaminophen
- B. Aspirin
- C. Codeine
- D. Morphine
Correct Answer: B
Rationale: Idiopathic thrombocytopenic purpura is a condition characterized by a low platelet count. Aspirin is a known blood thinner and can further decrease platelet function, potentially worsening thrombocytopenia. Therefore, Mr. and Mrs. Robertson's son should avoid taking aspirin to prevent any exacerbation of his condition.
Which of the following outcomes would indicate successful treatment of diabetes insipidus?
- A. Fluid intake of less than 2,500mL
- B. Blood pressure of 90/50mmHg
- C. Pulse rate of 126 beats/min
- D. Urine output of more than 200mL/hour
Correct Answer: A
Rationale: Successful treatment of diabetes insipidus is indicated when the patient's excessive urination (polyuria) and thirst (polydipsia) are controlled. One of the primary goals of treatment is to achieve fluid balance by reducing urine output and, consequently, decreasing the excessive thirst. When the fluid intake is less than 2,500mL, it suggests that the patient's excessive thirst has decreased, indicating successful management of the condition. Monitoring and managing fluid intake are crucial in the treatment of diabetes insipidus to prevent dehydration and electrolyte imbalances. A lower fluid intake is a positive indicator that the treatment is effectively addressing the increased urine output characteristic of diabetes insipidus.
A client with severe head trauma sustained in a car accident is admitted to the intensive care unit. Thirty six-hours later, the client's urine output suddenly rises above 200mL/hour, leading the nurse to suspect diabetes insipidus. Which laboratory findings support the nurse's suspicion of diabetes insipidus?
- A. Above-normal urine and serum osmolality levels
- B. Below-normal urine and serum osmolality levels
- C. Above-normal urine osmolality level, below-normal serum osmolality level
- D. Below- normal urine osmolality level, above-normal serum osmolality level
Correct Answer: B
Rationale: Diabetes insipidus is a condition characterized by the inability of the kidneys to adequately concentrate urine, leading to excessive dilute urine production. In diabetes insipidus, both urine and serum osmolality levels are typically below normal due to the dilution of urine. When urine output suddenly rises above 200mL/hour in a client with severe head trauma, it may indicate diabetes insipidus, especially if the urine and serum osmolality levels are below normal. This abnormality in osmolality levels is due to the impaired ability of the kidneys to concentrate urine, resulting in decreased urine osmolality and subsequent dilution of the serum osmolality.
You are meeting with parents of a 12-year-old girl who recently diagnosed with papillary thyroid carcinoma (PTC). The statement that should be included in your discussion is
- A. PTC has a grim overall prognosis
- B. FTC do not require radioactive iodine therapy
- C. supraphysiologic levothyroxine therapy is required during long-term follow-up
- D. calcitonin/carcinogenic antigen monitoring is required during the course of treatment
Correct Answer: C
Rationale: Levothyroxine suppression therapy is standard in differentiated thyroid cancer.