Nokea
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.
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The first permanent tooth to erupt is
- A. central incisor at 6 years
- B. molar at 6 years
- C. premolar lower canine at 6-7 years
- D. upper canine at 6-7 years
Correct Answer: B
Rationale: The first molar typically erupts at 6 years.
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.
In neuroblastoma, metastatic spread can occur via local invasion or distant hematogenous/lymphatic routes. The LEAST common site of metastases in neuroblastoma is
- A. long bone
- B. bone marrow
- C. lung
- D. skin
Correct Answer: D
Rationale: Skin metastases are rare in neuroblastoma compared to bone, bone marrow, and lung involvement.
In the operating room, personnel should be responsible for ensuring cleanliness, proper temperature, humidity, and lighting. Who carries those responsibilities?
- A. circulating nurse
- B. scrub nurse
- C. surgeon
- D. anesthesiologist
Correct Answer: A
Rationale: The circulating nurse is responsible for ensuring the cleanliness, proper temperature, humidity, and lighting in the operating room. The circulating nurse plays a crucial role in maintaining the overall environment and ensuring that it meets the necessary standards for the safety and well-being of the patient and the surgical team. They are in charge of coordinating and overseeing all aspects of the operating room environment, including maintaining a sterile field, assisting with instrument setup, and ensuring that all equipment is functioning properly. Additionally, the circulating nurse manages communication within the operating room and ensures that all necessary supplies are available during the surgical procedure. It is within the circulating nurse's scope of practice to take charge of these responsibilities to create an optimal operating room environment.
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.