Nokea
You are evaluating a 2-year-old boy with multiple bruises. Physical examination is unremarkable apart from multiple bruising areas. Lab investigations including coagulation profile are normal. Of the following, bruises that are LEAST likely suggestive of physical abuse is
- A. bruises over the neck
- B. looped extension cord marks on the body
- C. bruises over bony prominences
- D. bruising of the torso
Correct Answer: C
Rationale: Bruises over bony prominences are common in toddlers due to falls and rough play, whereas bruises in unusual locations like the neck or torso are more suspicious for abuse.
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A 13-year-old boy is hospitalized for a femur fracture after being hit by a car while racing bikes. The parents are concerned about his judgment. The nurse should tell the parents that this behavior is:
- A. Typical of young teens.
- B. Related to hormonal surges during adolescence.
- C. An isolated incident that will not likely happen again.
- D. Related to underdeveloped judgment and impulse control in adolescence.
Correct Answer: D
Rationale: The adolescent brain is still developing, which can lead to poor judgment and impulsive behavior.
The MOST common type of cerebral palsy is
- A. ataxic cerebral palsy
- B. spastic cerebral palsy
- C. dystonic cerebral palsy
- D. dyskinetic cerebral palsy
Correct Answer: B
Rationale: Spastic cerebral palsy is the most common type.
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.
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.
Nurse Dorothy is caring for a child with Cushing's syndrome; which of the following should she include in the plan of care?
- A. Increase fluids to prevent dehydration
- B. Encourage a diet high in carbohydrates
- C. Monitor weight each day and report for weight loss
- D. Encourage a diet high in potassium
Correct Answer: C
Rationale: When caring for a child with Cushing's syndrome, it is important to monitor weight each day and report any weight loss. Cushing's syndrome is characterized by a metabolic disorder that can lead to weight gain, particularly in the abdominal area. However, sudden weight loss in a child with Cushing's syndrome can be a sign of worsening condition or inadequate treatment. Therefore, monitoring weight regularly is crucial in managing the child's condition and adjusting the treatment plan accordingly.