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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Neonates of mothers with diabetes are at risk for which complication following birth?
- A. Atelectasis
- B. Microcephaly
- C. Pneumothorax
- D. Macrosomia
Correct Answer: D
Rationale: Neonates of mothers with diabetes are at risk for macrosomia following birth. Macrosomia refers to a condition where the newborn baby is significantly larger than average, typically weighing more than 4,000 grams (8 pounds, 13 ounces) at birth. This risk is primarily due to maternal hyperglycemia, which can lead to excessive fetal growth. The elevated glucose levels in the maternal circulation can cross the placenta and stimulate fetal insulin production, resulting in increased growth and potentially leading to macrosomia. Neonates born with macrosomia are at increased risk for complications during delivery, such as shoulder dystocia, birth injuries, and the need for cesarean delivery.
A female client recovers from a serious case of insect bites. What skin related advice must the nurse give to the client and all her family members to prevent the recurrence of the ailment?
- A. Ensure minimum crowd interactions when outdoors
- B. Apply insect repellent to clothing and exposed skin
- C. Wear thick woollen clothing to cover the skin while outdoors
- D. Apply a good sunscreen lotion while going outdoors
Correct Answer: B
Rationale: The nurse should advise the client and her family members to apply insect repellent to clothing and exposed skin to prevent insect bites in the future. Insect repellents containing DEET, picaridin, or oil of lemon eucalyptus are effective in repelling mosquitoes, ticks, and other insects that may cause bites. By regularly applying insect repellent, they can reduce the risk of getting bitten and prevent a recurrence of the ailment. Other preventive measures such as wearing long sleeves and pants, avoiding heavily wooded or grassy areas, and using screens on windows and doors can also be beneficial in preventing insect bites.
A client with rheumatoid arthritis is being discharged with a prescription for aspirin (Ecotrin), 600mg PO every 6 hours. The nurse should instruct the client to notify the physician if which adverse drug reaction occurs?
- A. Dysuria
- B. Tinnitus
- C. Leg cramps
- D. Constipation
Correct Answer: B
Rationale: Tinnitus is a known adverse drug reaction to aspirin, especially at higher doses. Tinnitus is described as ringing, buzzing, or other noises in the ears. If a client experiences tinnitus while taking aspirin, it is important to notify the physician promptly as it could be a sign of aspirin toxicity. Monitoring and managing this adverse reaction are crucial to prevent further complications for the client.
When caring for the child with Kawasaki disease, the nurse should know which information?
- A. A child's fever is usually responsive to antibiotics within 48 hours.
- B. The principal area of involvement is the joints.
- C. Aspirin is contraindicated.
- D. Therapeutic management includes administration of gamma globulin and aspirin.
Correct Answer: D
Rationale: Kawasaki disease is an acute febrile illness that primarily affects children. The therapeutic management of Kawasaki disease includes the administration of gamma globulin and aspirin. Intravenous immunoglobulin (IVIG) or gamma globulin is given as a single dose to reduce the risk of coronary artery abnormalities, while aspirin is used for its anti-inflammatory effects. It is important to note that aspirin should not be given to children with viral infections due to the risk of Reye syndrome. Therefore, option D is the correct choice in this case.
Mr. and Ms. Byers' child failed to pass meconium within the first 24 hours after birth; this may indicate which of the following?
- A. Celiac disease
- B. Intussusception
- C. Hirschsprung's disease
- D. Abdominal-wall defect
Correct Answer: C
Rationale: Failure to pass meconium within the first 24 hours after birth is a characteristic sign of Hirschsprung's disease. This condition is a congenital disorder in which there is a lack of ganglion cells in certain portions of the large intestine. As a result, the affected segment of the bowel is unable to relax and pass stool, leading to the accumulation of meconium in the intestine. This condition can present with symptoms such as abdominal distension, constipation, and failure to pass stool. Early diagnosis and treatment are crucial to prevent complications such as bowel perforation.