Nokea
all the following are major signs of DM except :
- A. polydipsia
- B. hypernatremia
- C. polyphagia
- D. hyporeflexia and bradycardia
Correct Answer: D
Rationale: Hyporeflexia (reduced deep tendon reflexes) and bradycardia (slow heart rate) are not typical signs of diabetes mellitus (DM). The major signs of DM are the classic "3 Ps": polydipsia (excessive thirst), polyuria (excessive urination), and polyphagia (excessive hunger). These symptoms are usually due to elevated blood glucose levels leading to increased thirst, frequent urination, and hunger. Additionally, unexplained weight loss can also be a common symptom of DM. Other complications related to DM, such as neuropathy, can lead to issues like hyporeflexia, but they are not considered major signs of DM itself.
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You are meeting with parents of a 10-year-old child who recently develops acute lymphoblastic leukemia (ALL). Which of the following is LEAST likely to increase the risk of CNS relapse in children with ALL?
- A. first traumatic lumbar puncture (LP)
- B. T-cell leukemia
- C. cranial nerve involvement at the time of diagnosis
- D. presence of lymphoblast in the CSF at any time during treatment
Correct Answer: A
Rationale: A first traumatic lumbar puncture is less likely to increase the risk of CNS relapse compared to other factors like T-cell leukemia or cranial nerve involvement.
Of the following, the WORST prognostic factor in pediatric osteosarcoma is
- A. primary pelvic bone tumor
- B. poor histologic response to treatment
- C. bony metastases at the time of diagnosis
- D. lung metastases at the time of diagnosis
Correct Answer: B
Rationale: Poor histologic response to neoadjuvant chemotherapy is a strong predictor of poor prognosis.
Katie is admitted to the intensive care unit of Nurseslabs Medical Center for diabetic ketoacidosis; which of the following is of primary importance when caring for the child?
- A. Giving I.V. NPH insulin in high doses
- B. Evaluating the child for cardiac abnormalities
- C. Limiting fluids to prevent aggravating cerebral edema
- D. Monitoring and recording the child's vital signs for hypertension
Correct Answer: B
Rationale: When caring for a child with diabetic ketoacidosis in the intensive care unit, evaluating the child for cardiac abnormalities is of primary importance. Diabetic ketoacidosis can lead to electrolyte imbalances, such as hypokalemia, which can result in cardiac complications, such as arrhythmias and cardiac arrest. Monitoring the child's cardiac function, including obtaining an electrocardiogram (EKG) and assessing for signs of heart failure, is essential in managing and preventing potential cardiac complications in this critical condition. While the other options are important considerations in the care of a child with diabetic ketoacidosis, evaluating the child for cardiac abnormalities takes precedence due to the life-threatening implications of cardiac complications in this setting.
What is the best initial action for the nurse to take?
- A. Try to have the client breathe slower or
- B. Give O2 via nasal cannula into the paper bag
- C. Administer sodium bicarbonate
- D. Monitor the client's fluid balance
Correct Answer: A
Rationale: The best initial action for the nurse to take when a client is experiencing hyperventilation is to try to have the client breathe slower. This is because hyperventilation is often caused by rapid, shallow breathing and slowing down the breathing pattern can help restore normal gas exchange and alleviate symptoms. Providing oxygen via a nasal cannula or administering sodium bicarbonate would not directly address the underlying issue of hyperventilation. Monitoring fluid balance is important for overall assessment but not the priority when dealing with acute respiratory distress due to hyperventilation.
Hepatoblastoma is a neoplasm of undifferentiated precursors of hepatocytes. It is of different histological classification; which type predict the MOST favorable outcome?
- A. mixed type of pure epithelial and mesenchymal elements
- B. type of pure epithelial histology
- C. type of mixed fetal and embryonal histology
- D. type of undifferentiated histology
Correct Answer: B
Rationale: Pure epithelial histology, particularly fetal type, is associated with the best prognosis.