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In neuroblastoma, metastatic spread can occur via local invasion or distant hematogenous/lymphatic routes. The LEAST common site of metastases in neuroblastoma is
- A. long bone
- B. bone marrow
- C. lung
- D. skin
Correct Answer: D
Rationale: Skin metastases are rare in neuroblastoma compared to bone, bone marrow, and lung involvement.
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Severe and extensive hemolysis causes which of the ff?
- A. Leg ulcers
- B. Shock
- C. Priapism
- D. Compromised growth
Correct Answer: B
Rationale: Severe and extensive hemolysis can lead to the destruction of a large number of red blood cells, causing a significant release of hemoglobin into the bloodstream. This excessive release of hemoglobin can overwhelm the body's ability to clear it, leading to the accumulation of toxic byproducts such as free hemoglobin and heme. These byproducts can lead to various complications, one of which is the potential for causing shock. Shock is a life-threatening condition characterized by inadequate tissue perfusion and oxygen delivery to vital organs due to a systemic vascular response to the circulating toxins and byproducts of hemolysis. It is a severe consequence of extensive hemolysis and requires immediate medical intervention to stabilize the patient.
When caring for a patient with AIDS, which of the following nursing actions would be the most appropriate for infection control?
- A. Wear gloves at all times
- B. Wear gown and mask at all times
- C. Wear gloves for blood/body fluid contact
- D. Wear a mask during patient contact times
Correct Answer: C
Rationale: The most appropriate nursing action for infection control when caring for a patient with AIDS is to wear gloves for blood/body fluid contact. HIV, the virus that causes AIDS, is primarily spread through exposure to infected blood or body fluids. Therefore, wearing gloves when there is a potential for blood or body fluid contact is crucial in preventing the transmission of the virus. Wearing gloves at all times may not be necessary if there is no direct contact with blood or body fluids, and wearing a gown and mask at all times may not be indicated unless there is a specific need based on the situation. Wearing a mask during patient contact times may also not be necessary unless there is a risk of exposure to respiratory secretions.
Common side effects of stimulant medications include
- A. appetite suppression
- B. gastrointestinal tract symptoms
- C. sedation
- D. hepatitis
Correct Answer: A
Rationale: Appetite suppression is a common side effect of stimulant medications used to treat ADHD.
which of the following must be present in order for an infant with complete transposition of the great vessels to survive at birth?
- A. coarctation of aorta
- B. pulmonary stenosis
- C. patent ductus arteriosus
- D. mitral stenosis
Correct Answer: C
Rationale: In an infant with complete transposition of the great vessels, the survival at birth depends on the presence of a patent ductus arteriosus (PDA) to allow mixing of oxygenated and deoxygenated blood. In this condition, the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle, leading to separate circulatory pathways for oxygenated and deoxygenated blood. The survival of the infant is dependent on the remaining fetal shunts, such as a PDA, to maintain an adequate mixing of blood until corrective surgery can be performed. Therefore, the presence of a PDA is essential for the survival of an infant with complete transposition of the great vessels at birth.
Prenatal screening is recommended for all pregnant women to detect neural tube defect. If a neural tube defect is present, one of the following is often elevated
- A. human chorionic gonadotropin
- B. a-fetoprotein
- C. estriol
- D. inhibin
Correct Answer: B
Rationale: Alpha-fetoprotein (AFP) levels are elevated in maternal serum when a neural tube defect is present due to fetal leakage of AFP into the amniotic fluid and maternal circulation.