A 13-year-old is worried because his breasts are growing and are tender. What should the nurse tell him?

Correct Answer: C

Rationale: In this scenario, the correct answer is C) It is a normal condition of puberty (gynecomastia) that usually resolves within a year or two. The educational rationale behind this answer lies in understanding the physiological changes that occur during puberty. Gynecomastia, the development of breast tissue in males, is a common occurrence during adolescence due to hormonal changes. By reassuring the 13-year-old that this is a normal part of puberty and will likely resolve on its own within a year or two, the nurse can provide comfort and alleviate concerns. Option A is incorrect because drawing blood is not necessary in this situation where gynecomastia is a common and benign condition during puberty. Option B is incorrect because medication is not typically required to correct gynecomastia as it tends to resolve on its own. Option D is incorrect as gynecomastia is not a rare finding in boys during puberty. Educationally, it is important for healthcare providers working with adolescents to have a solid understanding of the physical and emotional changes that occur during puberty. By providing accurate information and reassurance, nurses can support adolescents through this phase of development. Additionally, addressing concerns related to body image and puberty can help promote positive self-esteem and mental well-being in teenagers.

Correct Answer: A

Rationale: In this scenario, the best position for an 8-year-old who has returned after an appendectomy for a ruptured appendix is the right side-lying position (Option A). This position helps prevent pressure on the surgical site, reducing the risk of complications like wound dehiscence and promoting optimal healing. Placing the child on the right side also helps minimize the risk of accidental pressure or trauma to the surgical area. The semi-Fowler position (Option B) is not the most appropriate in this case as it does not provide the same level of protection and support to the surgical site as the right side-lying position does. Placing the child prone (Option C) or left side-lying (Option D) can exert pressure on the surgical area, increasing the risk of complications and discomfort for the child. Educationally, understanding the rationale behind positioning post-appendectomy is crucial for pediatric nurses and healthcare providers caring for these patients. Proper positioning plays a significant role in promoting healing, preventing complications, and ensuring the overall well-being of the child post-surgery. By selecting the correct position, healthcare professionals can contribute to the child's recovery and comfort, ultimately improving patient outcomes.

Correct Answer: D

Rationale: In the context of pediatric burns and child abuse, the correct answer is D) scalding injuries because they are the most commonly inflicted burn in cases of child abuse. Scald burns result from contact with hot liquids or steam, and they can be deliberately inflicted by an abuser. Children are especially vulnerable to scald burns due to their sensitive skin and inability to move away from the source of injury quickly. Option A) contact with a hot iron is less common in cases of child abuse as it requires direct contact with a hot object, which may leave distinct patterns of injury different from typical abuse-related burns. Option B) contact with radiators is also less common in child abuse cases and may result in different patterns of burns compared to scald injuries typically seen in abuse cases. Option C) cigarette application can cause burns, but it is less commonly associated with child abuse compared to scalding injuries. In cases of child abuse, inflicted burns are more likely to be severe and widespread, often involving patterns suggestive of intentional harm. Educationally, understanding the patterns and common mechanisms of different types of burns in pediatric patients is crucial for healthcare providers, especially those working in pediatric emergency or critical care settings. Recognizing the signs of abuse-related burns and knowing the appropriate interventions and reporting protocols are vital to safeguarding the well-being of vulnerable children.

Correct Answer: C

Rationale: The correct answer is C) Wilms tumor. Aniridia (absence of the iris) and hemihypertrophy (asymmetrical overgrowth of one side of the body) are features of WAGR syndrome, which includes Wilms tumor as a significant risk. Wilms tumor is a type of kidney cancer that primarily affects children. Understanding this association is crucial for pediatric critical care nurses as early detection and intervention are vital for improving outcomes in children with Wilms tumor. Option A) rhabdomyosarcoma is a soft tissue tumor that is not typically associated with aniridia and hemihypertrophy. Option B) hepatoblastoma is a liver cancer that is not linked to the specific features seen in WAGR syndrome. Option D) medulloblastoma is a type of brain tumor and is not commonly associated with aniridia and hemihypertrophy. Educationally, knowing these associations helps nurses in identifying potential risks in pediatric patients presenting with these physical characteristics. It underscores the importance of a comprehensive assessment in pediatric patients to ensure timely diagnosis and appropriate management of any associated conditions.

Correct Answer: B

Rationale: In pediatric oncology, tumor lysis syndrome (TLS) is a potentially life-threatening complication that can occur after initiating chemotherapy. Metabolic derangements in TLS result from the rapid release of intracellular contents into the bloodstream. The correct answer, B) hypernatremia, is not typically associated with TLS in children. A) Hyperuricemia is a common finding in TLS due to the release of uric acid from lysed cells. C) Hyperkalemia occurs as potassium is released from damaged cells, leading to potential cardiac arrhythmias. D) Hyperphosphatemia is also a hallmark of TLS, as phosphorus is released from lysed cells, potentially causing renal damage. Educationally, understanding the metabolic effects of TLS is crucial for nurses caring for pediatric oncology patients. Recognizing these electrolyte imbalances promptly can guide appropriate interventions to prevent complications such as renal failure or cardiac arrhythmias. Nurses play a vital role in monitoring, assessing, and managing TLS in collaboration with the healthcare team to ensure the best outcomes for pediatric patients undergoing cancer treatment.