An adult suffered 2nd and third degree burns over 20% of hid body 2 days ago. What is the best way to assess the client's fluid balance?

Correct Answer: A

Rationale: Maintaining strict records of intake and output is the best way to assess the client's fluid balance in this situation. Severe burns can lead to fluid loss, which can result in dehydration and other complications. By carefully monitoring the amount of fluid the client is taking in (intake) and the amount of fluid being eliminated from the body (output), healthcare providers can assess the client's fluid balance and make necessary adjustments to prevent dehydration or fluid overload. This approach provides accurate and specific information to guide fluid management and ensure optimal recovery for the client with burns. Monitoring skin turgor, daily weight, and checking for edema are also important measures, but maintaining strict records of intake and output is the most direct and effective method for assessing fluid balance in a client with burns.

Correct Answer: A

Rationale: The correct answer is A) type 6. Human papillomavirus (HPV) infection is a well-known risk factor for cervical carcinoma. However, not all types of HPV are associated with malignancy. Type 6 is considered low-risk and is typically linked to benign genital warts rather than cervical cancer. Option B) type 16 and Option C) type 18 are high-risk HPV types commonly found in cervical carcinomas. These types are known to have oncogenic potential and are strongly associated with the development of cervical cancer. Option D) type 31 is also a high-risk HPV type that can lead to the development of cervical cancer. Although it is not specifically mentioned in the question stem, it is important to note that multiple high-risk HPV types are implicated in cervical malignancies. In the context of pediatric nursing, understanding the association between HPV types and cervical carcinoma is crucial for providing effective care and education to patients and their families. By recognizing the specific types of HPV that pose the greatest risk for developing cancer, healthcare providers can emphasize the importance of preventive measures such as vaccination and regular screenings to reduce the incidence of cervical malignancies in the future.

Correct Answer: A

Rationale: The correct answer is A) pilocytic astrocytoma. Chemotherapy is not effective in treating pilocytic astrocytoma because this type of tumor is typically slow-growing and well-differentiated. Surgical resection is usually the primary treatment for pilocytic astrocytoma, and it is often curative on its own due to the tumor's characteristics. Craniopharyngioma, pineoblastoma, and supratentorial primitive neuroectodermal tumors (SPNETs) are all types of childhood CNS tumors that can be responsive to chemotherapy. These tumors are more aggressive and may require a multimodal approach to treatment, which can include chemotherapy in addition to surgery and/or radiation therapy. In an educational context, understanding which childhood CNS tumors are responsive to chemotherapy is crucial for pediatric critical care nurses, as they play a key role in the care of these patients. Knowing the most effective treatment modalities for different tumor types helps nurses advocate for the best care for their patients and ensures better outcomes.

Correct Answer: D

Rationale: In this question, the correct answer is D) periosteal. Periosteal osteosarcoma is a subtype that is typically treated by surgery alone without the need for chemotherapy. This is because periosteal osteosarcoma tends to be a low-grade tumor that is more localized and less aggressive compared to other subtypes. Option A) fibroblastic and Option B) chondroblastic are subtypes that usually require a combination of surgery and chemotherapy for treatment due to their higher aggressiveness and tendency to spread. Option C) parosteal, while a subtype of osteosarcoma, may also require a combination of treatments depending on the extent of the tumor and its characteristics. Educationally, understanding the different subtypes of osteosarcoma and their respective treatment modalities is crucial for healthcare providers working with pediatric oncology patients. It helps in determining the most appropriate and effective treatment plan for each patient based on the specific characteristics of their tumor, ultimately leading to better outcomes and quality of care.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) etoposide as the most likely cause of secondary acute myelogenous leukemia (AML) in the 9-year-old boy. Etoposide is a topoisomerase II inhibitor commonly associated with the development of secondary AML as a result of its genotoxic effects on hematopoietic stem cells. Cyclophosphamide (option A) is an alkylating agent known for causing bladder toxicity and secondary malignancies, but it is not the primary culprit in this case. Vincristine (option B) is a vinca alkaloid that mainly causes peripheral neuropathy and does not typically lead to secondary AML. Doxorubicin (option D) is an anthracycline known for cardiotoxicity, but it is not strongly associated with AML development. Educationally, understanding the potential long-term complications of chemotherapy agents is crucial for healthcare providers caring for pediatric oncology patients. This case underscores the importance of monitoring patients for secondary malignancies post-chemotherapy and the need for vigilant surveillance for adverse effects of specific chemotherapeutic agents.