Which type of leukemia has been MOST likely developed in a 2-year-old child with Down syndrome in the neonatal period?
- A. ALL
- B. CML
- C. AML M1
- D. AML M6
Correct Answer: D
Rationale: Transient myeloproliferative disorder in neonates with Down syndrome can evolve into AML M6.
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Which is most important to document about immunizations in the child's health history?
- A. Dosage of immunizations received
- B. Occurrence of any reaction after an immunization
- C. The exact date the immunizations were received
- D. Practitioner who administered the immunizations
Correct Answer: C
Rationale: The most important information to document about immunizations in a child's health history is the exact date the immunizations were received. This information is crucial for tracking when the child is due for their next immunizations and to ensure they are following the recommended vaccination schedule. The dosage of immunizations received, occurrence of any reaction after an immunization, and the practitioner who administered the immunizations are also important details to document but the most critical one is the date to accurately maintain the vaccination records and plan future immunization appointments.
Which finding would you expect in a 4-week-old with biliary atresia?
- A. Abdominal distention, enlarged liver and spleen, clay-colored stools, and tea-colored urine.
- B. Abdominal distention with bruises and hematuria.
- C. Yellow sclera/skin, oily skin, and prolonged bleeding times.
- D. No manifestations until advanced disease.
Correct Answer: A
Rationale: Biliary atresia typically presents with hepatosplenomegaly, pale stools, and dark urine due to impaired bile excretion.
A client with suspected lymphoma is scheduled for lymphangiography. The nurse should inform the client that this procedure may cause which harmless, temporary change?
- A. Purplish stools
- B. Redness of the upper part of the feet
- C. Bluish urine
- D. Coldness of the soles
Correct Answer: C
Rationale: Lymphangiography is a procedure in which a contrast dye is injected into the lymphatic vessels to help identify abnormalities. One harmless, temporary change that a client may experience after lymphangiography is the passing of bluish urine. This happens as a result of the contrast dye being excreted in the urine, causing it to temporarily change color. It is important for the nurse to inform the client about this possibility to prevent unnecessary worry or concern after the procedure. No concerns are associated with purplish stools, redness of the upper part of the feet, or coldness of the soles after a lymphangiography.
Which of the following signs indicates to the nurse that digoxin (Lanoxin) has been effective for a patient?
- A. Urine output decreases
- B. Heart rate higher than 95
- C. Urine output increases
- D. Heart rate lower than 50
Correct Answer: C
Rationale: Digoxin is a medication commonly used to treat heart failure and certain types of irregular heart rhythms. One of the therapeutic effects of digoxin is an improvement in cardiac output, leading to better tissue perfusion. As the heart's pumping ability improves, blood flow to the kidneys also increases, resulting in an increase in urine output. Therefore, an increase in urine output is a positive indication that digoxin is effective for the patient. Monitoring urine output can be a valuable way for nurses to assess the response to digoxin therapy and the overall cardiac function of the patient.
A nurse is preparing an IM injection of prednisolone acetate, 30 mg. It is supplied as 50 mg/mL. How many mL should the nurse prepare?
- A. 0.5 mL
- B. 0.7 mL
- C. 0.6 mL
- D. 0.8 mL
Correct Answer: A
Rationale: To calculate the volume of medication needed, we can use the formula: Volume (mL) = Dose (mg) / Concentration (mg/mL). In this case, the nurse needs to prepare 30 mg of prednisolone acetate, which is supplied in a concentration of 50 mg/mL.