Nokea
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.
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Nurse Katriz is planning a client education program for sickle cell disease (SCD); what topics should be included in the plan of care?
- A. Aerobic exercise to improve oxygenation
- B. Fluid restraint to 1 qt (1 L)/day
- C. A high-iron, high-protein diet
- D. Proper hand washing and infectionavoidance
Correct Answer: D
Rationale: People with sickle cell disease (SCD) are at a higher risk of infections due to their impaired immune system. Infections can trigger a sickle cell crisis, which can be life-threatening. Therefore, proper hand washing and infection avoidance are crucial components of the care plan for clients with SCD. This topic should be included in Nurse Katriz's client education program to help reduce the risk of infections and promote better health outcomes for individuals with SCD.
Which finding requires immediate attention in a child with glomerulonephritis?
- A. Sleeping most of the day with BP 170/90.
- B. Urine output of 190 mL in 8 hours with Coca-Cola-colored urine.
- C. Severe headache and photophobia.
- D. Refusal to eat with poor appetite.
Correct Answer: C
Rationale: A severe headache with photophobia may indicate hypertensive encephalopathy; this requires prompt evaluation.
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.
A patient is being taught the action of digoxin, which is an inotropic agent. The nurse defines an inotropic agent as a medication that has which of the following actions?
- A. Decreases heart rate
- B. Increases conduction time
- C. Increases heart rate
- D. Strengthens heart contraction
Correct Answer: D
Rationale: An inotropic agent, such as digoxin, is a medication that strengthens the contraction of the heart muscle. It works by increasing the force of each heartbeat, helping the heart pump more efficiently. This can be beneficial in conditions such as heart failure or certain types of arrhythmias where the heart's pumping ability is compromised. Inotropic agents do not decrease heart rate, increase conduction time, or increase heart rate; their primary action is to enhance the heart's contractility.
The nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan?
- A. Exposure to sunlight will help control skin rashes.
- B. There are no activity limitations between flare-ups.
- C. Monitor body temperature
- D. Corticosteroids may be stopped when symptoms are relieved.
Correct Answer: C
Rationale: Monitoring body temperature is important in clients with systemic lupus erythematosus (SLE) because fever can indicate an infection or a disease flare-up. Clients with SLE are at higher risk of infections due to their compromised immune system, and fever can be a sign of an underlying issue that needs prompt attention. It is essential for the nurse to educate the client about monitoring body temperature regularly and seeking medical advice if there is a sudden increase in temperature.