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Radiotherapy is an effective modality of treatment in variable pediatric solid tumors. Of the following, the LEAST responsive tumor to radiotherapy is
- A. rhabdomyosarcoma
- B. neuroblastoma
- C. nephroblastoma
- D. osteosarcoma
Correct Answer: D
Rationale: Osteosarcoma is relatively radioresistant compared to other listed tumors.
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Which of the following is an intraoperative outcome for a patient undergoing an inguinal hernia repair?
- A. Verbalizes fears
- B. Demonstrates leg exercises
- C. Maintains skin integrity
- D. Explains deep breathing exercises
Correct Answer: C
Rationale: Intraoperative outcomes refer to the immediate goals and conditions that are assessed during a surgical procedure. Maintaining skin integrity is a crucial intraoperative outcome for a patient undergoing an inguinal hernia repair surgery. This outcome focuses on ensuring that the patient's skin remains intact, without any damage or breakdown during the surgical procedure. It involves proper positioning of the patient, adequate support to vulnerable areas, and meticulous monitoring of the skin throughout the surgery to prevent any pressure injuries or skin trauma. Other outcomes listed, such as verbalizing fears, demonstrating leg exercises, and explaining breathing exercises, are more pertinent to preoperative or postoperative care rather than intraoperative outcomes.
The nurse is assessing a 3-day-old, breastfed newborn who weighed 7 pounds, 8 ounces at birth. The newborn's mother is now concerned that the newborn weighs 6 pounds, 15 ounces. Which is the most appropriate nursing intervention?
- A. Recommend supplemental feedings of formula.
- B. Explain that this weight loss is within normal limits.
- C. Assess child further to determine cause of excessive weight loss.
- D. Encourage mother to express breast milk for bottle feeding the newborn.
Correct Answer: B
Rationale: It is normal for newborns to lose weight in the first few days of life, typically up to 10% of their birth weight. In this case, the newborn's weight loss from 7 pounds, 8 ounces to 6 pounds, 15 ounces is within the expected range. It is important for the nurse to reassure the mother that this weight loss is normal and to encourage continued breastfeeding on demand to support newborn hydration and nutrition. There is no need for supplemental feedings at this point unless there are other signs of feeding issues or concerns.
The nurse is caring for a 3-week-old preterm newborn born at 29 weeks of gestation. While taking vital signs and changing the newborn's diaper, the nurse observes the newborn's color is pink but slightly mottled, arms and legs are limp and extended, hiccups are present, and heart rate is regular and rapid. The nurse should recognize these behaviors as manifestations of:
- A. stress.
- B. subtle seizures.
- C. preterm behavior.
- D. onset of respiratory distress.
Correct Answer: C
Rationale: The behaviors described, such as slightly mottled skin, limp and extended extremities, hiccups, and a rapid but regular heart rate, are typical of preterm newborn behavior. Preterm infants often exhibit these characteristics due to their immature neurological and physiological systems. The mottled skin may be due to the immature vascular system, while the limp and extended extremities are common in preterm newborns as they have less muscle tone compared to full-term infants. Hiccups are also common in newborns, including preterm infants, and are generally not a cause for concern. The rapid heart rate is typical in newborns, particularly in the immediate postnatal period. Therefore, in this scenario, these behaviors are most likely related to the preterm status of the newborn rather than indicating stress, seizures, or respiratory distress.
A patient has hand-foot syndrome related to his sickle cell anemia. What findings does the nurse expect to see as the patient is assessed?
- A. Unequal growth of fingers and toes.
- B. Purplish discoloration of hands and feet.
- C. Webbing between fingers and toes.
- D. Deformities of the wrists and ankles.
Correct Answer: B
Rationale: Hand-foot syndrome, also known as dactylitis, is a common manifestation of sickle cell anemia. It is characterized by painful swelling and inflammation of the hands and feet, often resulting in a purplish discoloration due to decreased blood flow and oxygen delivery to the affected areas. This condition typically affects the soft tissues and joints of the hands and feet, leading to pain, swelling, and limited mobility. Unequal growth of fingers and toes, webbing between fingers and toes, and deformities of the wrists and ankles are not typically associated with hand-foot syndrome in sickle cell anemia.
The primary critical observation for Apgar scoring is the:
- A. Heart rate
- B. Respiratory rate
- C. Presence of meconium
- D. Evaluation of the Moro reflex
Correct Answer: A
Rationale: The primary critical observation for Apgar scoring is the heart rate. This is because the heart rate is vital for life and immediate assessment of the infant's heart rate provides crucial information about the baby's overall well-being and response to the birthing process. The Apgar score assesses five components: heart rate, respiratory effort, muscle tone, reflex irritability, and skin color. Among these components, the heart rate is considered the most critical because it directly reflects the infant's cardiovascular status and their ability to maintain adequate perfusion of vital organs. Therefore, for quick assessment and immediate intervention, the heart rate is prioritized as the primary observation in Apgar scoring.