Nokea
You are explaining the risk of leukemia in children with Down syndrome to medical students; your discussion will include all the following statements EXCEPT
- A. acute leukemia occurs more frequently in children with Down syndrome than in the general population
- B. AML is more common in children with Down syndrome as compared to ALL
- C. children with Down syndrome have a slightly inferior outcome ratio of ALL/AML in general
- D. children with Down syndrome who develop AML demonstrate remarkable sensitivity to antimetabolites
Correct Answer: C
Rationale: Children with Down syndrome often have better outcomes when treated with specific regimens, contrary to this option.
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During the initial assessment, he is placed in a modified Trendelenburg position. What desired effect should the position have on the client?
- A. An increase in the client's blood pressure
- B. An increase in the client's respiratory rate f. An increase in the client's heart rate h. A decrease in blood loss
- C. An increase in the client's respiratory rate
- D. An increase in the client's heart rate h. A decrease in blood loss
Correct Answer: A
Rationale: Placing a client in a modified Trendelenburg position involves having the client lie flat on the back with the legs elevated above the level of the heart. The main purpose of this position is to help increase blood pressure in cases of hypotension or shock. By raising the legs above the heart level, gravity helps to facilitate the return of venous blood to the heart, which can increase cardiac output and, consequently, blood pressure. This position is commonly used in clinical settings to help improve perfusion to vital organs and assist in stabilizing a client's blood pressure.
Which of the following disorders leads to cyanosis from deoxygenated blood entering the systemic arterial circulation?
- A. Aortic stenosis (AS)
- B. Coarctation of aorta
- C. Patent ductus arteriosus (PDA)
- D. Tetralogy of Fallot
Correct Answer: D
Rationale: Tetralogy of Fallot is a congenital heart defect characterized by four primary abnormalities: pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. Due to the pulmonary stenosis, less blood reaches the lungs to be oxygenated, resulting in deoxygenated blood entering the systemic arterial circulation. This leads to cyanosis, which is often referred to as "Tet spells" in these patients. Cyanosis is the bluish discoloration of the skin and mucous membranes caused by the presence of deoxygenated hemoglobin. The other conditions listed do not typically result in deoxygenated blood entering the systemic arterial circulation and causing cyanosis.
a child has surgery for pyloric stenosis, you offer him his first feeding post operatively, following this it would be best to position him:
- A. supine, to prevent sudden infant death syndrome
- B. Trendelenburg, to prevent pressure on the suture line
- C. on his right side to encourage flow through the pylorus
- D. prone, to encourage maximum digestion of milk curds
Correct Answer: C
Rationale: Positioning the child on his right side after surgery for pyloric stenosis helps to promote the flow of formula through the pylorus and into the intestines. Placing the child in this position can aid in preventing any potential complications from the surgery and promote proper digestion. The right side position assists in the drainage of the stomach contents, thereby reducing the risk of complications related to the surgery and promoting the healing process. It is essential to follow this positioning recommendation as part of the post-operative care for a child who has undergone surgery for pyloric stenosis.
A baby is born temporarily immune to the diseases to which the mother is immune. The nurse understands that this is an example of which of the following types of immunity?
- A. Naturally acquired passive immunity
- B. Naturally acquired active immunity
- C. Artificially acquired passive immunity
- D. Artificially acquired active immunity
Correct Answer: A
Rationale: In the scenario described, the baby is born with temporary immunity to diseases that the mother is immune to. This is an example of naturally acquired passive immunity, where the baby receives preformed antibodies from the mother, providing immediate protection against certain diseases. This type of immunity is passive because the baby did not produce the antibodies themselves, and it is naturally acquired as it occurs through the transfer of antibodies from the mother to the baby during pregnancy.
Which finding is an early indicator of bladder cancer?
- A. Painless hematuria
- B. Nocturia
- C. Occasional polyuria
- D. Dysuria
Correct Answer: A
Rationale: Painless hematuria, which is the presence of blood in the urine without any associated pain, is an early indicator of bladder cancer. This symptom is often one of the first signs of this type of cancer and should be promptly evaluated by a healthcare provider. It is crucial not to ignore the presence of blood in the urine, as it can indicate various underlying conditions, including bladder cancer. While other symptoms like Nocturia (waking up at night to urinate), Occasional polyuria (increased urination), and Dysuria (painful urination) can also occur with bladder cancer, painless hematuria is a significant red flag for the disease.