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What is a priority intervention for an infant with a temporary colostomy for Hirschsprung disease?
- A. Teaching how to irrigate the colostomy
- B. Protecting the skin around the colostomy
- C. Discussing the implications of a colostomy during puberty
- D. Using simple, straightforward language to prepare the child
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A four-year-old boy is admitted to the hospital with leg pain and fever. He is pale-looking and has bruises over various areas of his body. The physician suspects acute lymphoblastic leukemia (ALL). Which test would be used to confirm the diagnosis?
- A. Bone marrow aspirate
- B. Red blood cell count
- C. Lumbar puncture
- D. Bone scan
Correct Answer: A
Rationale: A bone marrow aspirate is the definitive test to confirm acute lymphoblastic leukemia (ALL) in this case. It allows for the examination of leukemic cells in the bone marrow, providing a direct assessment of the disease. Red blood cell count (Choice B) is not specific for diagnosing leukemia but may show anemia commonly seen in leukemia patients. Lumbar puncture (Choice C) is used to assess central nervous system involvement, not primarily for confirming ALL. Bone scan (Choice D) is not a standard diagnostic test for ALL and is mainly used for evaluating bone metastases in other conditions.
Which information about hemophilia will the nurse include in the teaching plan for the parents of a child diagnosed with hemophilia?
- A. Autosomal dominant disorder in which the blood clotting factors are deficient.
- B. X-linked recessive inherited disorder in which blood clotting factors are deficient.
- C. X-linked recessive inherited disorder involving decreased platelets causing prolonged bleeding.
- D. Autosomal recessive disorder in which the blood clotting factors are deficient.
Correct Answer: B
Rationale: The correct answer is B: Hemophilia is an X-linked recessive disorder, primarily affecting males and passed from mothers to sons. It involves a deficiency in clotting factors, leading to prolonged bleeding. Choice A is incorrect as hemophilia is not autosomal dominant. Choice C is incorrect as hemophilia does not involve platelets. Choice D is incorrect as hemophilia is not autosomal recessive.
In which type of cancer are the urinary excretion of the breakdown products of catecholamines, especially vanillylmandelic acid (VMA) and homovanillic acid (HVA), detected?
- A. Neuroblastoma
- B. Nephroblastoma
- C. Leukemia
- D. Osteosarcoma
Correct Answer: A
Rationale: The correct answer is A: Neuroblastoma. Neuroblastoma, a cancer that arises from nerve tissue, is associated with increased levels of catecholamine metabolites, including VMA and HVA, in the urine. Nephroblastoma (Wilms tumor) is a type of kidney cancer and is not typically associated with elevated levels of catecholamine breakdown products. Leukemia is a cancer of the blood and bone marrow and does not lead to increased VMA and HVA excretion in urine. Osteosarcoma is a bone cancer and is not linked to elevated levels of catecholamine metabolites in the urine.
What are classified as hydrocarbon poisons?
- A. All below
- B. Gasoline
- C. Turpentine
- D. Lighter fluid
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Using knowledge of child development, what approach is best when preparing a toddler for a procedure?
- A. Avoid asking the child to make choices.
- B. Plan for a teaching session to last about 20 minutes.
- C. Demonstrate on a doll how the procedure will be done.
- D. Show the necessary equipment without allowing child to handle it.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.