A nurse is assessing a dark-skinned client for pallor. What action is best?

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Question 1 of 5

A nurse is assessing a dark-skinned client for pallor. What action is best?

Correct Answer: A

Rationale: The correct answer is A: Assess the conjunctiva of the eye. This is because pallor, which is paleness of the skin, can be difficult to detect on dark skin. The conjunctiva of the eye is a mucous membrane that is not pigmented and can provide a more accurate indication of pallor. Options B, C, and D are not ideal for assessing pallor in a dark-skinned client as they may not show paleness accurately. B is more related to checking for pallor in fair-skinned individuals. C and D are not reliable indicators of pallor in any skin type.

Question 2 of 5

A 4-year-old child with acute lymphoblastic leukemia is receiving high-dose methotrexate during interim maintenance. He receives ondansetron and арретitant during his stay, which control his nausea and vomiting well. These medications work by inhibiting signaling in which part of the brain?

Correct Answer: E

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.

Question 3 of 5

You receive a phone call from a community pediatrician who is caring for a 2-year-old toddler with a cancer predisposition syndrome. The pediatrician describes a child at the 95th percentile for height and weight with a history of corrective oral surgery to reduce a large tongue and a history of an omphalocele in infancy. The pediatrician is currently performing ultrasound of the abdomen and laboratory evaluation for this patient every 3 months. Which tumor is this patient most at risk of developing?

Correct Answer: D

Rationale: Step-by-step rationale for why the correct answer is D, Nephroblastoma: 1. The child has a cancer predisposition syndrome, likely Beckwith-Wiedemann syndrome (BWS). 2. BWS is associated with an increased risk of developing Wilms tumor (nephroblastoma). 3. The large tongue, omphalocele, and overgrowth placing the child at the 95th percentile for height and weight are all characteristic features of BWS. 4. Therefore, the patient is most at risk of developing nephroblastoma. Summary of why the other choices are incorrect: A: Pleuropulmonary blastoma - Not typically associated with BWS or the described clinical features. B: Hepatocellular carcinoma - Not commonly linked to BWS or the clinical presentation provided. C: Cystic nephroma - Not a typical tumor associated with BWS or the clinical findings described in the patient.

Question 4 of 5

An 18-month-old boy, whose parents are first cousins, is referred to you because of a significant episode of epistaxis. The parents report that the child had bleeding after circumcision and large hematomas with immunizations. Platelet aggregation studies show the following: This child's platelets are unable to interact with which of the following?

Correct Answer: B

Rationale: The correct answer is B: Fibrinogen. In this case, the child is likely suffering from Glanzmann thrombasthenia, a rare inherited platelet disorder where platelets lack the ability to bind to fibrinogen. This results in impaired platelet aggregation and clot formation, leading to bleeding tendencies. The other options (A, C, D) are not affected in Glanzmann thrombasthenia. Platelets interact normally with ADP (A), von Willebrand factor (C), and Platelet factor 4 (D) in this disorder.

Question 5 of 5

A 17-year-old female presents with cervical adenopathy and a history of daily fevers and drenching night sweats. A biopsy is performed and reveals classic Hodgkin lymphoma. Which of the following is least appropriate as part of the staging workup?

Correct Answer: D

Rationale: The correct answer is D: Lumbar puncture and cerebrospinal fluid (CSF) analysis. In Hodgkin lymphoma staging, CNS involvement is rare at initial presentation. Therefore, routine CSF analysis is not recommended unless there are specific neurological symptoms suggestive of CNS disease. A lumbar puncture carries risks of complications and should not be performed routinely. Choices A, B, and C are appropriate for staging in Hodgkin lymphoma to evaluate for distant metastases and characterize disease extent.

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