Nokea
During the physical assessment, the nurse recalls that the areas most frequently affected by multiple sclerosis are the:
- A. Lateral, 3rd and 4th ventricles
- B. Pons medulla and cerebral peduncles
- C. Optic nerve and chiasm
- D. Above areas
Correct Answer: C
Rationale: Multiple sclerosis (MS) is a disease that primarily affects the central nervous system (CNS) by causing inflammation, damage, and scarring in the myelin sheath that covers nerve fibers. The optic nerve and chiasm are common areas affected by MS, leading to symptoms such as blurred or double vision, loss of color vision, and pain with eye movement. This involvement is known as optic neuritis, a common early symptom of MS. While MS can affect various parts of the CNS, the optic nerve and chiasm are among the most frequently involved areas, making choice C the correct answer in this case.
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A 5 years old boy presents with joint swelling after minor trauma, mother gives history of prolonged bleeding from circumcision site. His platelets count is 170000, PT is 10 seconds and APTT is 60 seconds. What is most likely the diagnosis?
- A. Idiopathic thrombocytopenic purpura
- B. Platelets function defect
- C. Von Willebrand disease
- D. Hemophilia
Correct Answer: D
Rationale: Hemophilia is characterized by prolonged APTT with normal platelet count and PT, indicating a coagulation factor deficiency.
Acyclovir (Zovirax) is given to children with chickenpox to:
- A. minimize scarring.
- B. decrease the number of lesions.
- C. prevent aplastic anemia.
- D. prevent spread of the disease.
Correct Answer: B
Rationale: Acyclovir (Zovirax) is an antiviral medication commonly used to treat infections caused by the herpes virus, including chickenpox. When given to children with chickenpox, acyclovir helps decrease the number of lesions present on the skin by slowing down the replication of the virus. This not only helps alleviate the discomfort associated with the rash but also reduces the risk of potential complications and accelerates the healing process. While acyclovir does not completely eliminate the virus from the body, it can help control the symptoms and prevent severe manifestations.
Which should the nurse anticipate in the newborn whose mother used cocaine during pregnancy?
- A. Seizures
- B. Hyperglycemia
- C. Cardiac and respiratory problems
- D. Neurobehavioral depression or excitability
Correct Answer: C
Rationale: When a newborn's mother uses cocaine during pregnancy, the baby may experience cardiac and respiratory problems. Cocaine can negatively impact the development of the baby's cardiovascular system, potentially leading to issues such as abnormal heart rhythms, increased blood pressure, and even heart attacks in severe cases. Additionally, cocaine can also affect the respiratory system, putting the newborn at risk of breathing difficulties or even respiratory distress. Therefore, it is crucial for the nurse to anticipate these potential complications and provide appropriate monitoring and care to address any cardiac and respiratory issues that may arise in a newborn exposed to cocaine in utero.
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.
You are evaluating a 6-mo-old girl with a firm right suprarenal mass. Histologically, there is no bony involvement, 10% bone marrow involvement, subcutaneous nodules involvement, and massive abdominal mass. The N-myc oncogene is not amplified. According to the international neuroblastoma staging system, the infant is stratified as
- A. stage I
- B. stage II A
- C. stage III
- D. stage IV S
Correct Answer: D
Rationale: Stage IV S refers to infants <1 year with localized primary tumor, distant metastases limited to liver, skin, or bone marrow (with <10% involvement), and no amplification of N-myc.