A healthy 4-year-old child has a left flank mass. Computerized tomography (CT) scan of the abdomen shows a localized renal mass. Radical nephrectomy is performed; the histology shows clear cell sarcoma of the kidney. The MOST appropriate next step in the management is

Correct Answer: C

Rationale: The correct answer is C) bone scan. Clear cell sarcoma of the kidney is a rare malignant tumor that commonly metastasizes to the bones, lungs, and brain. Performing a bone scan is crucial to assess for any potential metastasis to the bones, which can guide further treatment and prognosis. Option A) CT scan of the chest is less appropriate as clear cell sarcoma of the kidney is known to metastasize to the bones rather than the chest. Option B) CT scan of the brain is less relevant initially as bone metastasis is more common than brain metastasis in clear cell sarcoma of the kidney. Option D) MRI of the brain is also less relevant at this stage compared to evaluating for bone metastasis. In an educational context, understanding the typical metastatic patterns of different cancers is crucial in determining the appropriate diagnostic and management steps. This case highlights the importance of considering potential metastatic sites based on the primary tumor type, guiding clinical decision-making and improving patient outcomes.

Correct Answer: C

Rationale: The correct answer to the question is option C) A platelet count of 18 x 10^3/µL, which requires the nurse's intervention. In the context of a patient who received chemotherapy 10 days ago, a critically low platelet count indicates a risk of bleeding, which is a common side effect of chemotherapy. Thrombocytopenia, or low platelet count, can lead to serious complications like hemorrhage, especially in pediatric patients who may not be able to communicate symptoms effectively. Option A) A blood urea nitrogen level of 10 mg/dL is within the normal range and does not require immediate intervention in this scenario. Option B) A hemoglobin of 8.6 g/dL may be low but is not as urgently concerning as a critically low platelet count. Option D) A serum glucose of 110 mg/dL is also within normal limits and does not warrant immediate intervention related to the chemotherapy received. In an educational context, understanding the significance of laboratory values in pediatric patients post-chemotherapy is crucial for providing safe and effective care. Nurses need to prioritize assessments and interventions based on the potential risks associated with specific lab values to prevent complications and ensure positive patient outcomes.

Correct Answer: E

Rationale: In this question from the ATI Pediatric Proctored Exam, the correct answer is E) musturbation. This is the correct answer because "musturbation" is not a developmental stage or milestone in preschool children. It is likely a distractor meant to confuse test-takers. Option A) handedness is achieved by 3 years of age is correct because preschool-aged children typically establish a dominant hand by around 3 years old. Option B) boys are usually later than girls in achieving bladder control is correct as well. Girls typically achieve bladder control earlier than boys during the preschool years. Option C) knowing gender by 4 years is also true. By around 4 years old, children typically have a good understanding of their own gender and can correctly identify the gender of others. Educationally, understanding the typical developmental milestones of preschool children is crucial for healthcare providers working with this age group. By knowing what is expected at each stage of development, healthcare providers can identify any potential delays or issues early on and provide appropriate interventions. This knowledge also helps in educating parents and caregivers about what to expect and how to support their child's development.

Correct Answer: C

Rationale: The correct answer to the question "The average length of an infant at 1 year of age is" is option C) 30 inches. This is the correct answer because by the age of 1 year, infants typically experience a significant amount of growth from birth. On average, a one-year-old infant would have reached a length of around 30 inches as part of their normal growth and development. Option A) 10 inches is too small for the average length of a one-year-old infant. Infants grow rapidly in their first year, and by the age of 1, they would have far surpassed 10 inches in length. Option B) 20 inches is also too short for the average length of a one-year-old. By the age of 1, infants have typically doubled their birth length, making 20 inches below the average length for this age group. Option D) 40 inches is too long for the average length of a one-year-old infant. While infants do experience significant growth in their first year, reaching 40 inches by the age of 1 would be well above the average length for this age group. Educationally, understanding typical growth and development milestones in infants is crucial for healthcare professionals working with pediatric populations. Knowing the average length of a one-year-old infant helps in monitoring their growth, development, and overall health. It also aids in identifying any potential issues or delays in growth that may require further assessment and intervention.

Correct Answer: C

Rationale: In the context of car safety for a 3-year-old child, the BEST option is a forward-facing car seat (Option C). This is because a forward-facing car seat is specifically designed to provide the necessary support and protection for a child of this age and size. The harness system in a forward-facing car seat secures the child in a way that minimizes the risk of injury in the event of a sudden stop or collision. Option A, vehicle seat belt, is not suitable for a 3-year-old child as seat belts are designed for adults and may not properly fit or protect a child of this age. Option B, rear-facing safety seat, is more appropriate for infants and younger toddlers as it offers better support for their developing neck and spine. Option D, lap and shoulder seat belts, may not provide the proper restraint and protection needed for a child of this age, as it lacks the specialized design and support of a car seat. Educationally, it is important to understand the developmental and physical differences between children of various ages when it comes to car safety. Properly securing a child in an age-appropriate car seat is crucial for their safety in the event of a car accident. As educators, we must emphasize the importance of using the correct car seat for a child's age, weight, and height to ensure their well-being while traveling in a vehicle.