You are meeting with parents of a 10-year-old child who recently develops acute lymphoblastic leukemia (ALL). Which of the following is LEAST likely to increase the risk of CNS relapse in children with ALL?
- A. first traumatic lumbar puncture (LP)
- B. T-cell leukemia
- C. cranial nerve involvement at the time of diagnosis
- D. presence of lymphoblast in the CSF at any time during treatment
Correct Answer: A
Rationale: A first traumatic lumbar puncture is less likely to increase the risk of CNS relapse compared to other factors like T-cell leukemia or cranial nerve involvement.
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What might you conclude if you notice a wide perineum and unequal gluteal and thigh folds when assessing a newborn?
- A. Osteogenesis imperfecta
- B. Torticollis
- C. Scoliosis
- D. Hip dysplasia
Correct Answer: D
Rationale: When assessing a newborn and noticing a wide perineum and unequal gluteal and thigh folds, it may signal the possibility of developmental dysplasia of the hip (DDH), also known as hip dysplasia. DDH is a condition where the hip joint does not properly form in newborns, leading to instability and potential dislocation. The wide perineum and unequal gluteal and thigh folds are physical signs that can be indicative of hip dysplasia. It is essential to diagnose and treat hip dysplasia early to prevent long-term complications like difficulty walking and osteoarthritis. Regular screening of newborns for hip dysplasia risk factors and physical exam findings is crucial for early detection and intervention.
Which of the ff actions should the nurse perform to monitor for electrolyte imbalances and dehydration in a client with a neurologic deficit?
- A. Measure intake and output
- B. Perform the mini-mental status
- C. Use the Glasgow Coma scale examination
- D. Assess vital signs
Correct Answer: A
Rationale: Monitoring intake and output is essential in assessing for electrolyte imbalances and dehydration in a client with a neurologic deficit. Unlike options B, C, and D, measuring intake and output provides direct information on the client's fluid balance and kidney function. Electrolyte imbalances can lead to neurological complications and alterations in mental status, making it crucial to keep track of the amounts of fluids ingested and excreted by the client. Additionally, dehydration can exacerbate neurological deficits, so monitoring intake and output can help prevent this complication.
Antibodies are made of which of the following types of substances?
- A. Fat
- B. Protein
- C. Sugar
- D. Carbohydrates CARE OF PATIENTS WITH IMMUNE DISORDERS
Correct Answer: B
Rationale: Antibodies, also known as immunoglobulins, are proteins produced by the immune system in response to the presence of pathogens like bacteria, viruses, and other foreign substances. These proteins are specifically designed to recognize and bind to antigens, which are molecules that the immune system identifies as foreign or harmful. Antibodies play a crucial role in the immune response by marking pathogens for destruction by other immune cells and signaling the immune system to attack the invaders. Therefore, antibodies are primarily made up of proteins.
The nurse should include which of the following in preprocedure teaching for a patient scheduled for carotid angiography?
- A. "You will be put to sleep before the needle Is inserted."
- B. "The test will take several hours."
- C. "You may fee! a burning sensation when the dye is injected."
- D. "There will be no complications."
Correct Answer: C
Rationale: It is important for the nurse to include in preprocedure teaching for a patient scheduled for carotid angiography the information that the patient may feel a burning sensation when the dye is injected. This information helps prepare the patient for a common sensation during the procedure, reducing anxiety and promoting patient understanding and cooperation. Providing this education enhances the patient's overall experience and enables them to better cope with the procedure. The other options are not accurate or complete in providing necessary preprocedure information for the patient.
The nurse assesses the motor functions during a neurologic examination of a client. Which of the ff steps will help the nurse perform the examination effectively? Choose all that apply
- A. Allow the client to grasp the nurses hand firmly
- B. Check the patient's sensitivity to heat, cold, touch, and pain.
- C. Ask the client to pick up small and large objects between the thumb and forefinger
- D. Ask questions that require cognition and logic
Correct Answer: A
Rationale: A. Allowing the client to grasp the nurse's hand firmly is essential to assess grip strength, coordination, and muscle tone, which are important aspects of motor function evaluation during a neurologic examination.