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A nurse assesses a male patient who has developed gynecomastia while receiving treatment for peptic ulcers. Which medication from the patient’s history should the nurse recognize as a contributing factor?
- A. Amoxicillin (Amoxil)
- B. Cimetidine (Tagamet)
- C. Metronidazole (Flagyl)
- D. Omeprazole (Prilosec)
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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You are evaluating a 6-year-old child with ALL on interim maintenance phase who has frequent mucositis and myelosuppression that needs frequent discontinuation of his treatment. Of the following, the MOST valuable test for this child is
- A. complete blood count
- B. pharmacogenetic testing of the thiopurine S-methyltransferase (TPMT) gene
- C. renal function test
- D. bone marrow study
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Parents are speaking with the urologist about their son's undescended testicle. Which statement by the child's father causes the nurse to determine he understands the information presented?
- A. An undescended testicle can reduce fertility.
- B. The testicle usually descends spontaneously during the first month of life.
- C. Surgical correction reduces the risk for testicular tumors.
- D. The optimal time to surgically correct the condition is at diagnosis.
Correct Answer: A
Rationale: The correct answer is A because an undescended testicle can reduce fertility. Even after surgical correction (orchiopexy), fertility rates may be reduced, especially when one testis remains undescended. The statement in choice B is incorrect as the testicle should have descended into the scrotum by the time the infant is 4-6 months old. While choice C is true that surgical correction can reduce the risk of testicular tumors, the question focuses on the father's understanding of the information presented, which is better reflected in choice A. Choice D is incorrect because the optimal time for surgical correction of an undescended testicle is typically around 6-18 months of age, not necessarily at the time of diagnosis.
Which clinical manifestations should the nurse anticipate when assessing a child admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?
- A. Massive proteinuria, hypoalbuminemia, and edema
- B. Hematuria, bacteriuria, and weight gain
- C. Decreased urine specific gravity and increased urinary output
- D. Gross hematuria, albuminuria, and fever
Correct Answer: A
Rationale: Minimal change nephrotic syndrome (MCNS) is characterized by massive proteinuria, hypoalbuminemia, and edema. Proteinuria results from the loss of proteins, particularly albumin, in the urine, leading to hypoalbuminemia. The low oncotic pressure due to hypoalbuminemia causes fluid to shift into the interstitial spaces, resulting in edema. These clinical manifestations are classic signs of MCNS and help differentiate it from other renal conditions.
A school-age child is 2 hours postoperative following a tonsillectomy. Which of the following actions should the nurse include in the plan of care?
- A. Place a heating pad at the surgical site.
- B. Encourage the child to cough every 2 hours.
- C. Administer analgesics to the child on a regular schedule.
- D. Apply an ice collar to the child's neck.
Correct Answer: D
Rationale: After a tonsillectomy, applying an ice collar to the child's neck helps decrease pain and swelling. Heat should be avoided as it can increase bleeding. Encouraging coughing may increase the risk of bleeding. Administering analgesics on a regular schedule is essential for pain management, but the immediate postoperative period may require additional interventions like ice collar application.
Epstein-Barr virus (EBV) infection is more likely to be associated with all the following malignancies EXCEPT
- A. Burkitt lymphoma
- B. nasopharyngeal T-cell lymphoma
- C. carcinoma
- D. Hodgkin lymphoma
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.