A healthy 20-day-old male examination reveals a palpable liver margin below the right costal margin; lab findings: white blood count, 18700/mm3; hemoglobin, 8.8 g/dl; blast cells, 10%; the BEST approach for the management is consistent with acute myeloproliferative disorder

Correct Answer: A

Rationale: The correct answer is A) intensive chemotherapy. In this scenario, the presence of blast cells in the peripheral blood of a 20-day-old infant with hepatomegaly and abnormal blood counts suggests a high likelihood of acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL), both of which require intensive chemotherapy for treatment. Option B) low dose chemotherapy pulses would not be the best approach as aggressive treatment is usually required for acute myeloproliferative disorders to achieve remission and prevent disease progression. Option C) bone marrow transplantation is typically reserved for cases of refractory or relapsed disease, not as initial management. Option D) close follow-up alone is insufficient as immediate treatment is necessary in the presence of blast cells and abnormal blood counts in a pediatric patient. From an educational standpoint, it is crucial for healthcare providers to recognize the urgency of appropriate management in pediatric patients presenting with concerning findings like blast cells in the blood. Understanding the treatment approaches for pediatric leukemias is essential for providing timely and effective care to these vulnerable patients.

Correct Answer: B

Rationale: The correct answer is B) type of pure epithelial histology because hepatoblastomas with pure epithelial histology have been associated with the most favorable outcomes compared to other histological types. Pure epithelial hepatoblastomas typically respond better to treatment and have a higher survival rate. Option A) mixed type of pure epithelial and mesenchymal elements is incorrect because the presence of mesenchymal elements can indicate a more aggressive tumor behavior. Option C) type of mixed fetal and embryonal histology and Option D) type of undifferentiated histology are also incorrect as they are associated with poorer prognoses and more aggressive disease progression. In an educational context, understanding the histological classification of hepatoblastoma is crucial for pediatric oncology practitioners to make informed treatment decisions and predict patient outcomes. This question highlights the importance of recognizing the different histological types and their implications for patient management and prognosis in pediatric oncology.

Correct Answer: B

Rationale: The correct answer is B) There is an increased risk for ectopic pregnancy or infertility. Pediatric nurses play a crucial role in educating patients about the potential consequences of pelvic inflammatory disease (PID) on their reproductive health. PID can lead to scarring and damage to the fallopian tubes, increasing the risk of ectopic pregnancy (a serious condition where the fertilized egg implants outside the uterus) or infertility (difficulty conceiving). By choosing this option, the nurse addresses the patient's concerns accurately and provides important information for their future reproductive health decisions. Option A is incorrect because while PID can lead to complications during pregnancy, such as preterm birth, it does not specifically increase the occurrence of spontaneous abortion. Option C is incorrect as placenta previa is not directly associated with PID. Option D is incorrect as PID can indeed impact fertility and increase the risk of complications like ectopic pregnancy, making it an oversimplified and inaccurate response to the patient's inquiry. Educationally, this question highlights the importance of pediatric nurses being knowledgeable about the long-term effects of PID on adolescent patients' reproductive health. It emphasizes the need for clear and accurate communication with patients to empower them to make informed decisions about their healthcare and future fertility.

Correct Answer: D

Rationale: In this question focusing on infant developmental milestones, the correct answer is option D) cruises. Cruising typically occurs around 9-12 months of age, not at 7 months. At 7 months, infants are usually mastering skills such as transferring objects from hand to hand, using a radial palm grasp, and actively bouncing. Option A) transferring objects from hand to hand is a fine motor skill that infants develop around 6-7 months of age. This skill showcases their growing dexterity and hand-eye coordination. Option B) actively bouncing refers to the ability of infants to bounce while being held or when supported in a standing position. This skill is usually seen around 6-9 months and demonstrates their increasing strength and coordination. Option C) using a radial palm grasp is a grasping skill where the infant picks up objects using their whole hand and fingers. This grasp typically emerges around 6-7 months and is an important precursor to more refined pincer grasp. In an educational context, understanding typical developmental milestones in infants is crucial for educators, caregivers, and healthcare professionals. It helps in monitoring a child's progress, identifying any potential delays early on, and providing appropriate interventions or support when needed. By knowing what to expect at different ages, professionals can create enriching environments that support optimal development and learning for infants.

Correct Answer: B

Rationale: The correct answer is B) colic. Colic is the most common cause of sleeping difficulty in infants during the first 2 months of life. Colic presents with excessive crying, fussiness, and difficulty in consoling the baby, leading to disrupted sleep patterns. This condition typically peaks around 6 weeks of age and gradually improves by 3-4 months. Option A) gastro-esophageal reflux can cause discomfort in infants, but it typically manifests as more of a feeding issue rather than a primary cause of sleeping difficulty in the first 2 months. Option C) formula intolerance can also lead to fussiness and discomfort in infants, but it is less common than colic as a cause of sleeping difficulties in the early months of life. Option D) developmentally self-resolving sleeping behavior refers to normal changes in an infant's sleep patterns as they grow and develop. While this can impact sleep, it is not the most common cause of sleeping difficulty in the first 2 months. Educationally, understanding the common causes of sleeping difficulty in infants is crucial for healthcare providers, caregivers, and educators working with young children. Recognizing colic as a primary culprit in disrupted sleep can guide interventions and support strategies for both the infant and their caregivers, promoting better sleep hygiene and overall well-being in the early months of life.