A 12-year-old male adolescent, recently diagnosed with Hodgkin lymphoma, shows left cervical and supraclavicular lymph node involvement and drenching night sweats. Based on Ann Arbor Classification, the patient is classified as

Correct Answer: D

Rationale: In this case, the correct answer is D) stage IIB. According to the Ann Arbor Classification system for staging Hodgkin lymphoma, stage IIB indicates involvement of two or more lymph node regions on the same side of the diaphragm. Option A) stage IA is incorrect because it represents involvement of a single lymph node region. Option B) stage IB is also incorrect as it denotes involvement of a single lymph node region and the adjacent or nearby tissue. Option C) stage IIA is not applicable in this scenario as it signifies involvement of two or more lymph node regions on the same side of the diaphragm without systemic symptoms. Educationally, understanding the staging of Hodgkin lymphoma is crucial for healthcare providers, especially for nurse practitioners working in pediatric oncology. It guides treatment decisions, prognosis, and follow-up care. This question reinforces the importance of knowing the Ann Arbor Classification system and applying it to determine the extent of disease in pediatric patients with Hodgkin lymphoma.

Correct Answer: A

Rationale: The correct answer is A) surgical resection for the large, soft, painless mass involving the head and neck region in the 3-day-old neonate. This presentation is consistent with a congenital cystic hygroma, a benign lymphatic malformation that often involves the neck and mediastinum. Surgical resection is the best modality for definitive treatment as it allows for complete removal of the cystic mass and prevents potential complications such as infection, hemorrhage, and airway compromise. Option B) injection sclerosing agent is not the best choice in this case as the cystic hygroma is large and involves critical anatomical structures in the head and neck region. Sclerosing agents may not be effective in completely resolving such a mass. Option C) laser therapy is not appropriate for treating a large cystic hygroma involving both the neck and mediastinum. Laser therapy is more commonly used for superficial lesions and may not adequately address the extent of the lesion in this case. Option D) systemic interferon therapy is not typically used as a first-line treatment for congenital cystic hygromas. Surgical resection is preferred over systemic therapies for definitive management of such lesions. In an educational context, understanding the appropriate treatment modalities for different pediatric conditions is crucial for nurse practitioners working in pediatric settings. Recognizing the characteristics of congenital cystic hygromas and knowing the optimal management approach helps ensure timely and effective care for pediatric patients.

Correct Answer: D

Rationale: Albuterol sulfate (Proventil HFA) is a bronchodilator primarily used to treat bronchospasm in conditions like asthma and chronic obstructive pulmonary disease (COPD). The major pharmacologic action of albuterol sulfate is option D, relaxing constricted bronchial smooth muscle. This medication acts on beta-2 adrenergic receptors in the lungs, leading to the relaxation of bronchial smooth muscle, which in turn dilates the airways, making it easier for the individual to breathe. Option A is incorrect because albuterol does not directly decrease airway reactivity; instead, it relaxes the smooth muscles in the airways. Option B is incorrect because albuterol does not primarily decrease inflammation, which is more characteristic of corticosteroids. Option C is incorrect as albuterol does not directly affect the action of cilia but rather acts on bronchial smooth muscle. In an educational context, understanding the pharmacologic actions of common medications like albuterol sulfate is crucial for healthcare providers, especially those working with pediatric patients who may present with respiratory conditions. Knowing how albuterol works helps in appropriate prescribing, patient education on medication use, and monitoring for therapeutic effects and potential side effects.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) responds to his/her name. At 15 months old, a child should typically be able to respond to their name being called. This is a crucial developmental milestone that indicates their awareness and ability to interact socially. Option A) walks alone is a normal developmental milestone for a 15-month-old, as most children are able to walk independently around this age. Option B) makes tower of 3 cubes is also a typical milestone as it demonstrates fine motor skills and hand-eye coordination development. Option C) inserts raisin in a bottle is another age-appropriate task that assesses fine motor skills and coordination. Understanding these milestones is essential for healthcare providers, especially in pediatric care. By recognizing what is developmentally appropriate for a child's age, healthcare providers can identify potential delays or issues early on and provide appropriate interventions or referrals. This knowledge also helps in building rapport with parents by providing them with accurate information about their child's development and addressing any concerns they may have.

Correct Answer: C

Rationale: In pediatric practice, understanding the common causes of obstructive sleep apnea is crucial for nurse practitioners. The MOST common cause in children is adenotonsillar hypertrophy (Option C). This occurs when the tonsils and adenoids are enlarged, obstructing the airway during sleep. Option A, obesity, can contribute to sleep apnea but is not the most common cause in children. Option B, allergies, may cause nasal congestion but is not typically the primary cause of obstructive sleep apnea in children. Option D, pharyngeal reactive edema due to gastroesophageal reflux, can lead to airway inflammation but is less common than adenotonsillar hypertrophy in causing obstructive sleep apnea in children. Educationally, this question highlights the importance of recognizing adenotonsillar hypertrophy as a primary cause of obstructive sleep apnea in children. Nurse practitioners need to be able to differentiate between various causes to provide appropriate care and referrals for pediatric patients with sleep-disordered breathing. Understanding the prevalence and significance of adenotonsillar hypertrophy in pediatric sleep apnea is essential for effective management and improving outcomes in this patient population.