Nokea
You are evaluating a 6-mo-old girl with a firm right suprarenal mass. Histologically, there is no bony involvement, 10% bone marrow involvement, subcutaneous nodules involvement, and massive abdominal mass. The N-myc oncogene is not amplified. According to the international neuroblastoma staging system, the infant is stratified as
- A. stage I
- B. stage II A
- C. stage III
- D. stage IV S
Correct Answer: D
Rationale: Stage IV S refers to infants <1 year with localized primary tumor, distant metastases limited to liver, skin, or bone marrow (with <10% involvement), and no amplification of N-myc.
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Which should the nurse anticipate in the newborn whose mother used cocaine during pregnancy?
- A. Seizures
- B. Hyperglycemia
- C. Cardiac and respiratory problems
- D. Neurobehavioral depression or excitability
Correct Answer: C
Rationale: When a newborn's mother uses cocaine during pregnancy, the baby may experience cardiac and respiratory problems. Cocaine can negatively impact the development of the baby's cardiovascular system, potentially leading to issues such as abnormal heart rhythms, increased blood pressure, and even heart attacks in severe cases. Additionally, cocaine can also affect the respiratory system, putting the newborn at risk of breathing difficulties or even respiratory distress. Therefore, it is crucial for the nurse to anticipate these potential complications and provide appropriate monitoring and care to address any cardiac and respiratory issues that may arise in a newborn exposed to cocaine in utero.
Which virus causes genital warts?
- A. Cytomegalovirus
- B. Human papillomavirus
- C. Herpes simplex virus type II
- D. Human immunodeficiency virus
Correct Answer: B
Rationale: Genital warts are caused by the human papillomavirus (HPV). HPV is a common sexually transmitted infection (STI) that can infect the genital areas of both men and women. There are many different strains of HPV, some of which can cause genital warts. These warts may appear as small bumps or clusters in the genital or anal area. It's important to note that not all HPV strains cause genital warts, and some can lead to more serious conditions such as cervical cancer. Getting vaccinated against HPV and practicing safe sex can help reduce the risk of HPV infection and its associated complications.
Which explanation regarding cardiac catheterization is appropriate for a preschool child?
- A. Postural drainage will be performed every 4 to 6 hours after the test.
- B. It is necessary to be completely "asleep" during the test.
- C. The test is short, usually taking less than 1 hour.
- D. When the procedure is done, you will have to keep your leg straight for at least 4 hours.
Correct Answer: C
Rationale: For a preschool child, the appropriate explanation about cardiac catheterization would be that the test is short, usually taking less than 1 hour. This explanation is suitable for a preschool child because it provides a simple and clear understanding of what to expect during the procedure. Preschool-aged children have limited attention spans and may become anxious about medical procedures, so providing a concise and reassuring explanation can help alleviate their fears. Additionally, knowing that the test will not take a long time can help the child feel more at ease about the procedure.
In JRA, the autoimmune reaction primarily occurs in the:
- A. joint tendons.
- B. cartilage.
- C. synovial tissue.
- D. interstitial space.
Correct Answer: C
Rationale: In Juvenile Rheumatoid Arthritis (JRA), which is now referred to as Juvenile Idiopathic Arthritis (JIA), the autoimmune reaction primarily occurs in the synovial tissue of the joints. The synovial tissue lines the inside of the joint capsule and produces synovial fluid, which helps to lubricate and nourish the joint. In JIA, the immune system mistakenly targets the synovial tissue, leading to inflammation, pain, and damage to the joints. This inflammatory process can result in swelling, warmth, stiffness, and eventual joint destruction if left untreated. Therefore, the synovial tissue is the primary site of the autoimmune reaction in JRA/JIA.
Which patient should be monitored most closely for dehydration?
- A. The 50-year-old with an ileostomy
- B. The 72-year-old with diabetes mellitus
- C. The 19-year-old with chronic asthma
- D. The 28-year-old with a broken femur
Correct Answer: A
Rationale: A patient with an ileostomy has an increased risk of dehydration because the ileostomy bypasses a significant portion of the small intestine where most of the water absorption occurs. As a result, the patient is more likely to experience fluid and electrolyte imbalances, leading to dehydration. It is important to monitor this patient closely for signs and symptoms of dehydration, such as decreased urine output, dry mouth, dark-colored urine, weakness, dizziness, and confusion, and take appropriate measures to ensure adequate hydration.