Nokea
You are evaluating a 6-year-old child with ALL on interim maintenance phase who has frequent mucositis and myelosuppression that needs frequent discontinuation of his treatment. Of the following, the MOST valuable test for this child is
- A. complete blood count
- B. pharmacogenetic testing of the thiopurine S-methyltransferase (TPMT) gene
- C. renal function test
- D. bone marrow study
Correct Answer: B
Rationale: TPMT gene testing helps determine the child's ability to metabolize thiopurine drugs, which may explain the adverse effects.
You may also like to solve these questions
A 9mo-old infant develops a left adrenal mass; histological examination with genetic characteristics confirms neuroblastoma. Which of the following carries a better outcome?
- A. amplification of the MYCN (N-myc) proto-oncogene
- B. hyperdiploidy
- C. loss of heterozygosity of 17q chromosome
- D. loss of 1p chromosome
Correct Answer: B
Rationale: Hyperdiploidy is associated with a better prognosis in neuroblastoma.
Maintaining the infusion rate of hyperalimentation solutions is a nursing responsibility. What side effects would you anticipate from too rapid infusion rate?
- A. Cellular dehydration and potassium
- B. Hypoglycemia and hypovolemia
- C. Potassium excess and CHF
- D. Circulatory overload and hypoglycemia SITUATION: In the recall of the fluids and electrolytes, the nurse should be able to understand the calculations and other conditions related to loss or retention.
Correct Answer: D
Rationale: Too rapid infusion of hyperalimentation solutions can lead to circulatory overload due to the rapid volume expansion, which can strain the heart and lead to fluid overload. This can manifest as symptoms such as shortness of breath, crackles in the lungs, and edema. Additionally, a rapid infusion rate can cause a sudden surge in glucose levels, potentially leading to hypoglycemia due to increased insulin release in response to the elevated glucose levels. It is important for the nurse to maintain a careful and appropriate infusion rate to prevent these complications and ensure patient safety.
A 3-day-old neonate has a large, soft, painless mass involving the head and neck region that mostly transilluminate; CT scan reveals a cystic mass involving the neck and intrathoracic mediastinum. The BEST modality for treatment of this neonate is
- A. surgical resection
- B. injection sclerosing agent
- C. laser therapy
- D. systemic interferon therapy
Correct Answer: A
Rationale: Surgical resection is the definitive treatment for cystic hygroma.
The nurse is assessing a 2-week-old for signs of DDH. The nurse should expect the infant to have which of the following?
- A. Excessive hip abduction.
- B. Femoral lengthening of an affected leg.
- C. Asymmetry of gluteal and thigh folds.
- D. Pain when lying prone.
Correct Answer: C
Rationale: Developmental dysplasia of the hip (DDH) is a condition where the hip joint does not develop normally. In infants, one of the signs of DDH is the presence of asymmetry of gluteal (buttock) and thigh folds. This is due to the dislocated or subluxed hip being positioned differently than the healthy hip. The nurse should look for this sign during the assessment of a 2-week-old infant to help identify potential hip joint problems early on. Excessive hip abduction, femoral lengthening of an affected leg, and pain when lying prone are not typical signs of DDH in a 2-week-old infant.
A child 2 years 6 months of age has arranged a play date with a neighbor's child aged 2 years 9 months. During the play date, which behavior is most typical for children of this age?
- A. Share and trade toys while playing.
- B. Play with one another with little or no conflict.
- C. Engage in parallel play (playing alongside but not directly with one another).
- D. Play with only one or two items, ignoring most of the other toys.
Correct Answer: C
Rationale: Toddlers typically engage in parallel play rather than cooperative play.