Nokea
In pediatric rhabdomyosarcoma, stages are dependent on primary site whether favorable or unfavorable. Which of the following sites of involvement is considered unfavorable?
- A. vagina
- B. uterus
- C. testis
- D. paranasal sinuses
Correct Answer: D
Rationale: Paranasal sinuses are considered unfavorable sites in rhabdomyosarcoma staging.
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The least common late neurologic sequelae that may be encountered post craniospinal irradiation in a 9-year-old child with medulloblastoma is
- A. microcephaly
- B. learning disabilities
- C. cognitive impairment
- D. second malignancy
Correct Answer: D
Rationale: Second malignancy is a rare late effect compared to cognitive and learning impairments.
A mother requests that her child receive the varicella vaccine at the 9-month checkup. The nurse's best response is:
- A. Vaccinated children will likely develop a mild case of chickenpox.
- B. The varicella vaccine is not usually administered before 1 year of age.
- C. The vaccine will be given after the doctor examines your child.
- D. A booster will be needed at 18 months.
Correct Answer: B
Rationale: The varicella vaccine is typically not given until the child is 12 months or older.
Which occurs in septic shock?
- A. Hypothermia
- B. Increased cardiac output
- C. Vasoconstriction
- D. Angioneurotic edema
Correct Answer: C
Rationale: In septic shock, vasoconstriction is a common phenomenon. This occurs as part of the body's response to the infection, where blood vessels constrict in an attempt to maintain blood pressure and perfusion to vital organs. The vasoconstriction leads to increased systemic vascular resistance and contributes to the hypotension seen in septic shock. The body's natural response to infection also involves a release of inflammatory mediators, which can cause vasodilation in some areas while concurrent vasoconstriction occurs in others, resulting in uneven blood flow distribution and contributing to organ dysfunction. Therefore, vasoconstriction is a key factor in the pathophysiology of septic shock.
Which is descriptive of attention deficit hyperactivity disorder (ADHD)?
- A. Manifestations exhibited are so bizarre that the diagnosis is fairly easy.
- B. Manifestations affect every aspect of the child's life but are most obvious in the classroom.
- C. Learning disabilities associated with ADHD eventually disappear when adulthood is reached.
- D. Diagnosis of ADHD requires that all manifestations of the disorder be present.
Correct Answer: B
Rationale: Option B is descriptive of attention deficit hyperactivity disorder (ADHD). Manifestations of ADHD can significantly impact the child's life, but are most noticeable in the classroom setting. Children with ADHD may struggle with paying attention, staying organized, controlling impulsive behavior, and following instructions in the school environment. While symptoms can also affect other areas of life, such as social interactions and familial relationships, they are typically most prominently displayed in the structured school setting, making it easier to recognize and diagnose the disorder.
You are discussing with medical students the role of chemotherapy in malignant germ cell tumors (GCTs); you state that GCTs are sensitive to some types of chemotherapy. Of the following, the MOST effective chemotherapeutic agent in GCTs is
- A. vincristine
- B. cyclophosphamide
- C. cisplatin
- D. methotrexate
Correct Answer: C
Rationale: Cisplatin is a cornerstone in the treatment of germ cell tumors.