Nokea
Which of the following chromosomal abnormalities of childhood ALL carries the highest risk of relapse despite intensive chemotherapy?
- A. t(9;22)
- B. t(4;11)
- C. hypodiploidy
- D. t(1;19)
Correct Answer: A
Rationale: The Philadelphia chromosome (t(9;22)) is associated with a high risk of relapse in ALL.
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Which of the ff nursing interventions should a nurse perform to relieve tachycardia that may develop in a client with myocarditis from hypoxemia?
- A. Maintain the client on bed rest c.Elevate the clients head
- B. Administer a prescribed anti pyretic
- C. Administer supplemental oxygen
Correct Answer: C
Rationale: Administering supplemental oxygen is the most appropriate nursing intervention to relieve tachycardia that may develop in a client with myocarditis from hypoxemia. Myocarditis can lead to decreased oxygen delivery to the tissues, which may result in tachycardia as the body tries to compensate for the lack of oxygen. Providing supplemental oxygen will help increase oxygen levels in the blood, improving tissue perfusion and thus reducing the tachycardia. This intervention aims to address the underlying cause of the tachycardia in this situation.
Which of the following is MOST likely considered a risk factor for extraneural metastasis in primary brain tumors?
- A. age less than 10 year
- B. female gender
- C. ventriculoperitoneal (VP) shunt insertion
- D. supratentorial tumor
Correct Answer: A
Rationale: Younger age is a significant risk factor for extraneural metastasis in pediatric brain tumors.
Miss OB's malignant tumor in her left breast was discovered to be spreading all over the surrounding and adjacent tissue and not entering the blood stream, it would be:
- A. Malignant
- B. Non-malignant
- C. Benign
- D. B and C
Correct Answer: C
Rationale: A malignant tumor is characterized by its ability to spread to surrounding tissues and potentially enter the bloodstream to form secondary tumors in distant organs (metastasis). In the scenario provided, the tumor in Miss OB's left breast is described as spreading all over the surrounding and adjacent tissue but specifically noted not to be entering the bloodstream. This behavior is more indicative of a benign tumor that is growing locally but is not capable of metastasis. Therefore, the tumor is best classified as benign in this case.
The client with epilepsy is taking the prescribed dose of phenytoin (Dilantin) to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/ml. Which of the following symptoms would be expected as a result of this laboratory result?
- A. Nystagmus
- B. No symptoms, because this is normal
- C. Tachycardia therapeutic level
- D. Slurred speech
Correct Answer: A
Rationale: A phenytoin blood level of 35 mcg/ml is considered to be above the therapeutic range (usually 10-20 mcg/ml for phenytoin). At this elevated level, the client is at risk for phenytoin toxicity. Symptoms of phenytoin toxicity include nystagmus (rapid, involuntary eye movements), as well as other symptoms such as confusion, slurred speech, ataxia, and tremors. Tachycardia is not typically associated with phenytoin toxicity. Therefore, the expected symptom in this case would be nystagmus.
What is the Guthrie blood test use to diagnose in the newborn?
- A. Down syndrome
- B. Isoimmunization
- C. PKU
- D. Congenital hypothyroidism (CH)
Correct Answer: C
Rationale: The Guthrie blood test, also known as the newborn screening test, is used to diagnose phenylketonuria (PKU) in newborns. PKU is an inherited metabolic disorder in which the body cannot properly process the amino acid phenylalanine. If left untreated, PKU can lead to intellectual disabilities and other serious health problems. The Guthrie blood test is a simple and effective way to detect PKU early so that treatment can begin promptly to prevent complications.