All the following are features of rapid eye movement (REM) EXCEPT

Correct Answer: D

Rationale: In pediatric emergency nursing, understanding the features of rapid eye movement (REM) is crucial for assessing a child's neurological status. The correct answer, option D - CT scan of head and neck, is not typically associated with assessing REM. A) Polysomnography is a test used to monitor and record various physiological activities during sleep, including REM. It is a key tool in diagnosing sleep disorders but is not specific to REM alone. B) EEG (electroencephalogram) is a valuable tool for assessing brain activity, including during sleep stages like REM. EEG can detect abnormal brain waves associated with certain conditions, but it is not exclusive to REM. C) Fiberoptic nasopharyngeal examination may be used to assess airway patency and structures in emergency situations but is not directly related to monitoring REM. Educationally, understanding the features and monitoring techniques for REM in pediatric patients is essential for providing comprehensive care. By knowing the appropriate diagnostic tools and assessments for different aspects of neurological function, nurses can effectively evaluate and manage pediatric emergencies.

Correct Answer: D

Rationale: In the case of a 2-year-old with an asymptomatic right flank mass suspected to be a Wilms tumor, the least likely investigation to be performed is a biopsy of the mass (Option D). This is because in pediatric oncology, especially when dealing with suspected Wilms tumor, biopsies are generally avoided due to the risk of tumor spillage and seeding. A plain abdominal radiography (Option A) is less likely to provide detailed information compared to a CT scan of the abdomen (Option B) which is preferred for evaluating the extent of the tumor. A CT scan of the chest (Option C) is important to assess for metastasis, a common occurrence in Wilms tumor. Educationally, understanding the appropriate diagnostic approach in pediatric oncology is crucial for nurses caring for children with suspected malignancies. It is essential to grasp the rationale behind choosing specific investigations to ensure accurate diagnosis and appropriate management without compromising the child's well-being.

Correct Answer: D

Rationale: In the context of pediatric emergency nursing, understanding Kasabach-Merritt syndrome is crucial for providing effective care to pediatric patients. Kasabach-Merritt syndrome is a rare condition characterized by profound thrombocytopenia, microangiopathic hemolytic anemia, and coagulopathy. The correct answer, D) association with infantile hemangiomas, is the exception because Kasabach-Merritt syndrome is actually associated with kaposiform hemangioendotheliomas, not infantile hemangiomas. Thrombocytopenia in Kasabach-Merritt syndrome results from platelet consumption within the vascular tumor, leading to bleeding tendencies. Microangiopathic hemolytic anemia occurs due to red blood cell damage as they pass through the abnormal vasculature. Coagulopathy is also a common feature, manifesting as prolonged clotting times and increased risk of bleeding. Educationally, recognizing the distinguishing features of Kasabach-Merritt syndrome is essential for timely diagnosis and management in pediatric emergency settings. By understanding the correct association and the pathophysiology of this syndrome, nurses can intervene promptly to prevent life-threatening complications such as severe bleeding or disseminated intravascular coagulation. This knowledge empowers pediatric nurses to advocate for appropriate treatment strategies and collaborate effectively with the interprofessional team to optimize patient outcomes.

Correct Answer: D

Rationale: The correct answer is D) the majority of affected boys can be successfully retreated, and the survival rate is good. This statement is crucial to mention to the parents because it provides them with hope and reassurance during a challenging time. It emphasizes that relapse is not uncommon in ALL but that there are effective treatment options available, and the prognosis is positive. Option A is incorrect because while testicular relapse can occur in boys with ALL, it does not happen in the majority of cases. Option B is incorrect as it describes a specific symptom of testicular relapse rather than providing overall information on prognosis. Option C is incorrect because while ultrasonography may be used in the diagnosis, it is not the only method, and the statement does not address the treatment or survival rate, which is important for parents to know. From an educational perspective, providing accurate and reassuring information to parents of pediatric patients is essential in helping them understand the situation, make informed decisions, and cope effectively with the challenges ahead. It is crucial to balance honesty about the condition with hope and optimism about the available treatments and outcomes.

Correct Answer: B

Rationale: In pediatric emergency nursing, understanding small round blue cell tumors is crucial for differential diagnosis and prompt treatment. In this scenario, the correct answer is B) osteosarcoma. Osteosarcoma is not classified as a small round blue cell tumor; it is a primary bone tumor arising from osteoid tissue. Non-Hodgkin lymphoma (Option A), Ewing sarcoma (Option C), and rhabdomyosarcoma (Option D) are examples of small round blue cell tumors commonly seen in pediatric oncology. Non-Hodgkin lymphoma is a hematologic malignancy, while Ewing sarcoma and rhabdomyosarcoma are solid tumors that predominantly affect bones and soft tissues. Educationally, differentiating between these tumor types is essential for accurate diagnosis and treatment planning in pediatric oncology. Understanding the distinct histological features and clinical presentations of each tumor type helps healthcare providers provide optimal care and improve patient outcomes.