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Which statement is descriptive of renal transplantation in children?
- A. It is an acceptable means of treatment after age 10 years.
- B. It is the preferred means of renal replacement therapy in children.
- C. Children can receive kidneys only from other children.
- D. The decision for transplantation is difficult because a relatively normal lifestyle is not possible.
Correct Answer: B
Rationale: Renal transplantation is considered the preferred means of renal replacement therapy in children with end-stage renal disease. This is because transplantation offers the best long-term outcomes and quality of life for children compared to other forms of renal replacement therapy such as dialysis. Children who undergo successful renal transplantation tend to have improved growth, development, and overall health compared to those who remain on dialysis. Transplantation can provide children with the opportunity to live a relatively normal and healthy life, making it the preferred treatment option in pediatric patients with end-stage renal disease.
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A 1-year old boy presents with high grade fever and conjunctivitis for 4 days followed by generalized maculopapular rash. One of his elder siblings had similar complaints 10 days back. The most likely diagnosis is?
- A. Rubella
- B. Kawasaki disease
- C. Scarlet fever
- D. Measles
Correct Answer: D
Rationale: Measles presents with high-grade fever, conjunctivitis, and a maculopapular rash appearing after a few days of illness, often following a similar illness in a sibling.
In a newborn's eyes, strabismus is a normal finding because of:
- A. congenital cataracts.
- B. lack of binocularity.
- C. absence of red reflex.
- D. inability of pupil to react to light.
Correct Answer: B
Rationale: Strabismus, or misalignment of the eyes, is a common condition in newborns due to the lack of binocularity. Binocularity refers to the ability of both eyes to focus simultaneously on a single point, which is not fully developed in newborns. As a result, it is normal for a newborn's eyes to appear misaligned at times. This lack of coordination between the eyes typically resolves as the infant's visual system matures and they develop the ability to focus both eyes together. Therefore, the presence of strabismus in a newborn is usually considered a normal finding related to the immature visual development rather than a sign of pathology such as congenital cataracts, absence of red reflex, or pupil reactivity issues.
The nurse caring for a 14-year-old girl with DI understands which of the following about this disorder?
- A. DI is treated on a short-term basis with hormone replacement therapy.
- B. DI may cause anorexia if proper meal planning is not addressed.
- C. DI is treated with vasopressin on a lifelong basis.
- D. DI requires strict fluid limitation until it resolves.
Correct Answer: C
Rationale: Diabetes Insipidus (DI) is a condition characterized by the inability of the kidneys to conserve water, leading to excessive thirst and excretion of large volumes of dilute urine. Central DI, the most common form in children, is treated with a synthetic form of the hormone vasopressin, also known as desmopressin. Vasopressin helps the kidneys to retain water, thereby reducing urine output and preventing excessive dehydration. Since DI is a chronic condition, treatment with vasopressin is typically required on a lifelong basis to manage symptoms and prevent complications. It is important for healthcare providers to understand the long-term nature of DI treatment in order to provide appropriate care and support to patients with this condition.
Which of the following blood study results would the nurse expect as most likely when caring for the child with iron deficiency anemia?
- A. Increased hemoglobin
- B. Normal hematocrit
- C. Decreased mean corpuscular volume (MCV)
- D. Normal total iron-binding capacity (TIBC)
Correct Answer: C
Rationale: Iron deficiency anemia is characterized by a decreased mean corpuscular volume (MCV) due to the microcytic red blood cells that result from inadequate iron availability for hemoglobin synthesis. This leads to smaller red blood cells, which are reflected in a decreased MCV. Iron deficiency anemia would not typically result in an increased hemoglobin or normal hematocrit since the lack of iron impairs the production of red blood cells. Additionally, the total iron-binding capacity (TIBC) would usually be increased in iron deficiency anemia as the body attempts to compensate for the decreased iron levels by increasing its ability to bind and transport iron. Therefore, the nurse would expect a decreased mean corpuscular volume (MCV) in a child with iron deficiency anemia.
You are discussing with medical students the role of chemotherapy in malignant germ cell tumors (GCTs); you state that GCTs are sensitive to some types of chemotherapy. Of the following, the MOST effective chemotherapeutic agent in GCTs is
- A. vincristine
- B. cyclophosphamide
- C. cisplatin
- D. methotrexate
Correct Answer: C
Rationale: Cisplatin is a cornerstone in the treatment of germ cell tumors.