A client on hemodialysis is complaining of muscle weakness and numbness in his legs. His lab results are: Na 136 mEq/L, K 5.9 mEq/L, Cl 100 mEq/L, ca 8.5 mg/dl. Which electrolyte imbalance is the client suffering from?

Correct Answer: A

Rationale: The client is experiencing muscle weakness and numbness in his legs, which are symptoms commonly associated with hyperkalemia (high potassium levels). The potassium level of 5.9 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia. Hyperkalemia can lead to muscle weakness, numbness, and potentially more severe complications like cardiac arrhythmias.

Correct Answer: A

Rationale: In the context of pediatric nursing, understanding the common side effects of stimulant medications is crucial for providing safe and effective care to children with conditions like ADHD. The correct answer, appetite suppression (option A), is a well-documented side effect of stimulant medications like methylphenidate and amphetamines. These medications work by increasing dopamine and norepinephrine levels in the brain, leading to decreased appetite as a side effect. Option B, gastrointestinal tract symptoms, while possible with some medications, is not a common side effect of stimulant medications and is more commonly associated with other types of drugs. Sedation (option C) is also not a typical side effect of stimulant medications, as they tend to have a stimulating effect on the central nervous system. Option D, hepatitis, is not a known side effect of stimulant medications and would be more indicative of a serious adverse reaction or unrelated condition. Educationally, understanding the side effects of medications used in pediatric populations is essential for safe medication administration and patient monitoring. Nurses need to be able to recognize common side effects, like appetite suppression with stimulant medications, to educate patients and families, monitor for adverse reactions, and collaborate with healthcare providers to adjust treatment plans as needed.

Correct Answer: A

Rationale: In childhood Acute Myeloid Leukemia (AML), the translocation inv(16) is typically associated with a granulocytic sarcoma mass. This type of translocation involves the inversion of chromosome 16, leading to the fusion of the CBFB and MYH11 genes. This fusion gene is a characteristic feature of AML with eosinophilia, also known as AML-M4eo. Option A (inv(16)) is the correct answer because it specifically mentions the translocation associated with granulocytic sarcoma mass in childhood AML. Option B (t(8;21)) is not the correct answer for this question. This translocation involves the fusion of the RUNX1 (AML1) gene on chromosome 21 with the ETO (MTG8) gene on chromosome 8, and it is associated with AML subtype M2. Option C (t(6;9)) is also incorrect. This translocation results in the fusion of the DEK gene on chromosome 6 with the NUP214 gene on chromosome 9 and is commonly found in AML subtype M2. Option D (inv(3)) is not the correct answer either. This inversion involves chromosome 3 and is associated with a subtype of myelodysplastic syndrome (MDS) rather than childhood AML. Educational Context: Understanding the specific genetic abnormalities associated with different subtypes of AML is crucial in the diagnosis and management of pediatric patients with leukemia. Knowledge of these chromosomal translocations helps healthcare providers make informed decisions regarding treatment options and prognosis for children with AML. This question highlights the importance of recognizing the genetic basis of AML subtypes and their clinical implications.

Correct Answer: D

Rationale: In neuroblastoma, the least common site of metastasis is the skin (Option D). This is because neuroblastoma tends to metastasize to organs and tissues such as the long bones (Option A), bone marrow (Option B), and lungs (Option C) before involving the skin. Metastasis to the long bones and bone marrow is common in neuroblastoma due to their rich blood supply and hematopoietic function, which make them favorable sites for cancer spread. Additionally, neuroblastoma commonly metastasizes to the lungs due to their direct connection to the primary tumor site in the abdomen or chest. Understanding the pattern of metastasis in neuroblastoma is crucial for healthcare providers caring for pediatric patients. It helps in early detection of metastases, appropriate staging of the disease, and planning effective treatment strategies. Educators teaching pediatric oncology should emphasize the common sites of metastasis in neuroblastoma to ensure students have a comprehensive understanding of the disease process and its implications for patient care.

Correct Answer: C

Rationale: In the context of treating malignant germ cell tumors (GCTs), cisplatin is the most effective chemotherapeutic agent among the options provided. Cisplatin is a platinum-based agent that has shown significant efficacy in the treatment of GCTs due to its ability to target rapidly dividing cancer cells. It is commonly used in combination with other chemotherapy drugs to achieve optimal outcomes in GCT patients. Vincristine (Option A) is not typically used in the treatment of GCTs and is more commonly utilized in hematologic malignancies. Cyclophosphamide (Option B) and methotrexate (Option D) are also not considered first-line agents for GCT treatment. Cyclophosphamide is more commonly used in lymphomas and solid tumors, while methotrexate is often used in leukemias and certain types of lymphomas. Educationally, understanding the appropriate chemotherapeutic agents for specific types of cancers is crucial for healthcare providers, especially in the field of oncology. Knowing the most effective treatments can significantly impact patient outcomes and quality of life. It is important to educate medical students on the rationale behind selecting specific chemotherapy agents based on the type of cancer being treated to ensure the best possible care for patients with GCTs.