Nokea
Niklaus was born with hypospadias; which of the following should be avoided when a child has such condition?
- A. Surgery
- B. Circumcision
- C. Intravenous pyelography (IVP)
- D. Catheterization
Correct Answer: B
Rationale: Hypospadias is a congenital condition where the opening of the urethra is located on the underside of the penis instead of the tip. If a child is born with hypospadias, circumcision should be avoided. Circumcision involves removing part of the foreskin, which can cause complications for children with hypospadias, such as affecting future surgical repair procedures or worsening the hypospadias itself. Therefore, it is recommended to avoid circumcision in children with hypospadias.
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Which of the following settings is most therapeutic for an agitated head-injured patient?
- A. A day room with family visitors and variety of caregivers
- B. A semiprivate room with one or two consistent caregivers
- C. A ward with other head-injured patients and volunteers to assist with needs
- D. A hallway near the nurse's station with adequate sensory stimulation
Correct Answer: B
Rationale: For an agitated head-injured patient, the most therapeutic setting would be a semiprivate room with one or two consistent caregivers. Consistency and familiarity can help reduce agitation and promote a sense of security for the patient. A quieter environment with fewer stimuli can also help in managing agitation and promoting a sense of calmness. By having consistent caregivers, the patient can build trust and feel more comfortable, which can contribute to their overall well-being and recovery. It is essential to minimize external factors that could contribute to further agitation, making a semiprivate room with consistent caregivers the most optimal setting for an agitated head-injured patient.
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.
Which of the following types of translocation of childhood AML that typically associated with granulocytic sarcoma mass?
- A. inv(16)
- B. t(8;21)
- C. t(6;9)
- D. inv(3)
Correct Answer: A
Rationale: The inv(16) translocation is strongly associated with granulocytic sarcoma in AML.
A mother of a term neonate asks what the thick, white, cheesy coating is on his skin. Which correctly describes this finding?
- A. Lanugo
- B. Milia
- C. Nevus flammeus
- D. Vernix 6
Correct Answer: D
Rationale: The thick, white, cheesy coating on the skin of a newborn baby is called vernix caseosa. It is a substance produced by the fetal sebaceous glands and is meant to protect the baby's skin while in the amniotic fluid. Vernix helps to maintain the skin's hydration, provides a barrier against infection, and aids in the transition from the wet intrauterine environment to the dry extrauterine world. It is usually found on the skin of term newborns but can be present in preterm babies as well. As the baby is exposed to air and dries off, the vernix will naturally diminish.
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.