A 9-year-old boy develops acute myelogenous leukemia (AML) one year after completion of therapy for soft tissue sarcoma at his right thigh. Which of the following chemotherapeutic agents is MOST likely the cause of secondary acute myelogenous leukemia AML in this boy?

Correct Answer: C

Rationale: Etoposide is known to be associated with secondary AML due to its potential to induce chromosomal abnormalities.

Correct Answer: C

Rationale: Compartment syndrome is a serious condition that can occur when increased pressure within a muscle compartment impairs blood supply, leading to tissue ischemia and potential necrosis. Symptoms of compartment syndrome include severe, unrelieved pain that is disproportionate to the injury, as well as pain with passive stretch of the affected muscles. This pain is often described as deep, constant, and out of proportion to physical findings. Other signs that may indicate compartment syndrome include pallor, pulselessness, paresthesia, and paralysis, but the most specific and early sign is severe, unrelieved pain. While weak movement of the patient's toes and decreased pedal pulses can also be seen in compartment syndrome, they are not as specific or early indicators as severe, unrelieved pain.

Correct Answer: D

Rationale: The thymus gland plays a crucial role in the immune system as it is primarily responsible for the maturation and differentiation of T lymphocytes (T cells). T cells are essential for cell-mediated immunity and play a key role in recognizing and attacking pathogens such as bacteria, viruses, and cancer cells. The thymus is where immature T cells mature and undergo education to ensure they can distinguish between self and non-self antigens effectively. This process is crucial for the proper functioning of the immune system to protect the body from infections and diseases.

Correct Answer: C

Rationale: The major manifestation of nephrotic syndrome is edema. Nephrotic syndrome is a kidney disorder characterized by increased permeability of the glomerular filtration barrier, leading to excessive protein loss in the urine. This results in low levels of protein in the blood, particularly albumin, leading to a decrease in oncotic pressure. The decreased oncotic pressure causes fluid to accumulate in the interstitial spaces, leading to edema formation. Patients with nephrotic syndrome typically present with periorbital edema, pedal edema, and ascites due to the fluid redistribution in the body. Hematuria, hyperalbuminemia, and anemia are not typically the primary manifestations of nephrotic syndrome.

Correct Answer: C

Rationale: Etoposide is known to be associated with secondary AML due to its potential to induce chromosomal abnormalities.

Correct Answer: D

Rationale: Periosteal osteosarcoma is often treated with surgery alone if margins are clear.

Correct Answer: B

Rationale: An adolescent girl with severe weight loss and disrupted metabolism associated with anorexia nervosa is likely to exhibit tachycardia (rapid heart rate) and tachypnea (rapid breathing). These symptoms are common manifestations of the body's response to malnutrition and starvation. Tachycardia occurs as a compensatory mechanism to maintain an adequate supply of oxygen to vital organs, while tachypnea helps to eliminate excess carbon dioxide due to metabolic imbalances. It is essential for the nurse to recognize these signs during the physical assessment as they indicate the severity of the condition and the need for immediate intervention to prevent further complications. Dysmenorrhea and oliguria, heat intolerance and increased blood pressure, and lowered body temperature and brittle nails are not typically associated with the physical manifestations of anorexia nervosa.

Correct Answer: C

Rationale: The correct statement indicating understanding of the instructions for use of a home apnea monitor is "We will check the monitor several times a day to be sure the alarm is working." This is important because regular monitoring of the device's functioning ensures that it is able to detect any potential apnea episodes or abnormalities in the infant's breathing patterns. Checking the monitor several times a day helps in maintaining the safety and effectiveness of the monitor in alerting the parents to any potential issues with the infant's breathing. The other options are incorrect: A is incorrect because adjusting the monitor to eliminate false alarms can compromise its accuracy, B is incorrect as the infant should sleep in a separate safe sleep environment to reduce the risk of SIDS, and D is incorrect as the monitor should be placed near the infant's crib but not directly in it for safety reasons.

Correct Answer: C

Rationale: Pernicious anemia is primarily caused by the body's inability to absorb vitamin B12 due to a lack of intrinsic factor produced by the stomach. However, chronic blood loss can also lead to anemia by depleting the body's iron stores necessary for the production of healthy red blood cells. Acute blood loss can quickly lower the hemoglobin levels in the blood, while chronic blood loss can lead to iron-deficiency anemia over time. Therefore, in assessing clients for pernicious anemia, the nurse should be alert for the risk factor of acute or chronic blood loss as a potential cause of anemia.