Nokea
Osteosarcoma is the most common primary malignant bone tumor in children and adolescents; it has multiple subtypes and requires different modalities of treatment including surgery and chemotherapy. Of the following, the subtype of osteosarcoma which is treated by surgery alone is
- A. fibroblastic
- B. chondroblastic
- C. parosteal
- D. periosteal
Correct Answer: D
Rationale: Periosteal osteosarcoma is often treated with surgery alone if margins are clear.
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What should be the initial bolus of crystalloid fluid replacement for a pediatric patient in shock?
- A. 20 ml/kg
- B. 10 ml/kg
- C. 30 ml/kg
- D. 15 ml/kg
Correct Answer: A
Rationale: The initial bolus of crystalloid fluid replacement for a pediatric patient in shock is generally recommended to be 20 ml/kg. This is based on the principles of fluid resuscitation in pediatric patients to restore perfusion and improve hemodynamic stability. Administering the appropriate initial fluid bolus is crucial in treating pediatric patients in shock to avoid complications like cardiovascular collapse and multi-organ dysfunction. It is important to adjust the volume and rate of fluid administration based on the individual patient's response and ongoing assessment to prevent fluid overload.
What type of breath sound is normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium?
- A. Vesicular
- B. Bronchial
- C. Adventitious
- D. Bronchovesicular
Correct Answer: A
Rationale: Vesicular breath sounds are normal, low-pitched sounds heard over the majority of the lung surface. They are usually soft and rustling with a longer inspiratory phase than expiratory phase. Vesicular breath sounds are produced by air moving through smaller bronchioles and alveoli. These sounds can be heard over the entire lung surface except for the upper intrascapular area and the area beneath the manubrium, where bronchovesicular breath sounds are typically heard.
After the introduction of the Back to Sleep campaign in 1992, an increased incidence has been noted of which of the following pediatric disorders? (Select all that apply.)
- A. SIDS
- B. Torticollis
- C. Failure to thrive
- D. Apnea of infancy
Correct Answer: B
Rationale: After the introduction of the Back to Sleep campaign in 1992, which encouraged placing infants on their backs to sleep to reduce the risk of Sudden Infant Death Syndrome (SIDS), an increased incidence has been noted of Torticollis (B) and Plagiocephaly (E).
Why does emotional counselling or helping the client perform common daily activities become important nursing care interventions in clients with Parkinson's or Huntington's diseases, or even epilepsy?
- A. Because clients suffer from depression, anxiety, and inability to perform basic self care
- B. Because clients become paralytic throughout the body
- C. Because the clients bone become weak, brittle, and painful to even move
- D. Because clients generally become very aggressive and violent with other people CARING FOR CLIENTS WITH NEUROLOGIC DEFICITS
Correct Answer: A
Rationale: Emotional counseling and helping with common daily activities are important nursing care interventions for clients with neurologic diseases such as Parkinson's, Huntington's, and epilepsy because these clients often experience depression, anxiety, and difficulty performing basic self-care tasks. These diseases can have a significant impact on the client's mental health, leading to feelings of helplessness and loss of independence. Providing emotional support and assistance with daily activities can help improve the client's overall well-being and quality of life. Additionally, these interventions can also help prevent complications such as complications such as pressure sores, infections, and malnutrition that may arise from the inability to perform self-care tasks independently.
A patient admitted with gastrointestinal tract bleeding has a hemoglobin level of 6 g/dL. She asks the nurse why she feels SOB. Which response is best?
- A. "Anemia prevents your lungs from absorbing oxygen effectively."
- B. "You do not have enough hemoglobin to carry oxygen to your tissues."
- C. ""You don't have enough blood to feed your cells."
- D. "You have lost a lot of blood, and that has damaged your lungs."
Correct Answer: B
Rationale: The best response is option B, "You do not have enough hemoglobin to carry oxygen to your tissues." Hemoglobin is the protein in red blood cells that carries oxygen from the lungs to the tissues throughout the body. With a low hemoglobin level of 6 g/dL due to gastrointestinal tract bleeding, there is a reduced capacity to carry oxygen to the body's tissues. This decreased oxygen-carrying capacity leads to symptoms of shortness of breath (SOB) because the body's cells are not receiving an adequate supply of oxygen. It is important to provide a clear and accurate explanation to the patient about the relationship between hemoglobin, oxygen transport, and symptoms of anemia like shortness of breath.