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Although most relapses in children with Wilms tumor occur early (within 2 yr of diagnosis) and have a favorable outcome, about 15% suffer relapse. Relapse includes all the following EXCEPT
- A. low stage (I/II) at diagnosis
- B. no prior radiotherapy
- C. anaplastic histology
- D. more than 12 mo from nephrectomy
Correct Answer: C
Rationale: Anaplastic histology is associated with a poorer prognosis and is not typically associated with favorable relapse outcomes.
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Although the etiology of hepatoblastoma is unknown, there are many associated risk factors for development of hepatoblastoma EXCEPT
- A. Beckwith-Wiedemann syndrome
- B. familial adenomatous polyposis syndrome
- C. prematurity
- D. Hepatitis C
Correct Answer: D
Rationale: Hepatitis C infection is not a recognized risk factor for hepatoblastoma.
The nurse understands that a patient with status asthmaticus will likely initially evidence symptoms of:
- A. metabolic acidosis.
- B. metabolic alkalosis.
- C. respiratory acidosis.
- D. respiratory alkalosis.
Correct Answer: C
Rationale: In status asthmaticus, a severe and prolonged asthma attack can lead to inadequate ventilation due to airway obstruction. This results in retention of carbon dioxide (CO2) in the blood, leading to respiratory acidosis. As the CO2 levels rise, it combines with water in the blood to form carbonic acid, lowering the blood pH levels. Symptoms of respiratory acidosis can include shortness of breath, confusion, lethargy, and potentially life-threatening complications. Treatment for status asthmaticus aims to improve ventilation and restore normal blood gas levels to alleviate respiratory acidosis.
The age at which the infant can see an object, grasp it, and bring it to the mouth is
- A. 4 months
- B. 5 months
- C. 6 months
- D. 7 months
Correct Answer: A
Rationale: This milestone is typically achieved around 4 months.
You are explaining the risk of leukemia in children with Down syndrome to medical students; your discussion will include all the following statements EXCEPT
- A. acute leukemia occurs more frequently in children with Down syndrome than in the general population
- B. AML is more common in children with Down syndrome as compared to ALL
- C. children with Down syndrome have a slightly inferior outcome ratio of ALL/AML in general
- D. children with Down syndrome who develop AML demonstrate remarkable sensitivity to antimetabolites
Correct Answer: C
Rationale: Children with Down syndrome often have better outcomes when treated with specific regimens, contrary to this option.
A preschool child is being admitted to the hospital with dehydration and a urinary tract infection (UTI). Which urinalysis result should the nurse expect with these conditions?
- A. WBC <1; specific gravity 1.008
- B. WBC <2; specific gravity 1.025
- C. WBC >2; specific gravity 1.016
- D. WBC >2; specific gravity 1.030
Correct Answer: C
Rationale: When a child is admitted to the hospital with dehydration and a urinary tract infection (UTI), the urinalysis result that the nurse should expect is an increased white blood cell (WBC) count, indicated by WBC >2, along with a slightly elevated specific gravity, typically around 1.016. A specific gravity of 1.016 suggests some concentration of urine due to dehydration, while an increased WBC count indicates the presence of infection in the urinary tract. These findings are consistent with dehydration and UTI in a preschool child. Options A, B, and D do not fully align with the expected urinalysis results in this clinical scenario.