Appropriate nursing interventions for J.E. would be

Correct Answer: A

Rationale: For J.E., who suffered head injuries in a motor vehicle accident, appropriate nursing interventions should focus on holistic care to prevent complications and promote recovery. Option A includes skin care and position changes every 2 hours (q2h) and as needed, which is crucial for preventing pressure injuries in the immobile patient. Maintaining alignment of extremities helps prevent muscle contractures. Respiratory exercises are essential for preventing atelectasis and improving lung function in patients at risk for pneumonia due to decreased mobility. These interventions address the immediate needs of the patient and aim to prevent further complications related to immobility and head injury. Options B, C, and D lack the comprehensive approach to care provided in option A, making it the most appropriate choice for J.E.

Correct Answer: A

Rationale: An important consideration regarding TPN administration is ensuring the intravenous (IV) site is kept aseptic while infusing the solution. This is crucial to prevent the risk of infection, as TPN solutions are highly concentrated and can provide an ideal environment for the growth of microorganisms. Strict aseptic technique must be maintained during the entire process of TPN administration, from preparation to infusion, to minimize the risk of introducing pathogens into the patient's system. Failure to maintain aseptic technique can lead to serious complications such as bloodstream infections, which can be life-threatening for the patient.

Correct Answer: B

Rationale: The first action the nurse should take upon the arrival of the adult who suffered a diving accident and is intubated and on a backboard with a cervical collar is to insert a large bore IV line. This is a priority because the person may require urgent fluid resuscitation or medication administration, and having IV access is crucial for immediate intervention in trauma cases. After establishing IV access, other assessments such as vital signs, lung sounds, and neurological checks can follow.

Correct Answer: B

Rationale: The correct answer is B) neurofibromatosis. Neurofibromatosis is a genetic disorder that can increase the risk of developing optic gliomas, which are tumors that form along the optic nerve. This association is well-documented in medical literature, making it the most likely genetic syndrome in the given options to be associated with optic glioma. Option A) Down syndrome is a chromosomal disorder caused by an extra copy of chromosome 21 and is not typically associated with an increased risk of optic glioma. Option C) Monosomy refers to a chromosomal abnormality where a cell is missing one chromosome, which is not known to be associated with an increased risk of optic glioma. Option D) Bloom's syndrome is a rare genetic disorder characterized by short stature and an increased risk of cancer, but it is not typically associated with optic glioma. In an educational context, understanding the association between genetic syndromes and specific health risks, such as optic glioma in the case of neurofibromatosis, is crucial for healthcare professionals, especially those working with pediatric patients. This knowledge can aid in early detection, management, and providing appropriate support to patients and their families affected by these conditions.

Correct Answer: D

Rationale: In pediatric oncology, tumor lysis syndrome (TLS) is a serious complication that can occur during the treatment of malignancies due to the rapid breakdown of cancer cells. Burkitt lymphoma, which is a fast-growing type of non-Hodgkin lymphoma, is more likely to manifest TLS because of its high proliferation rate and sensitivity to chemotherapy. The rapid destruction of Burkitt lymphoma cells can lead to the release of large amounts of intracellular contents, such as potassium, phosphate, and uric acid, overwhelming the body's ability to eliminate them. In contrast, the other malignancies listed in the options are less likely to result in TLS. Acute myelogenous leukemia (AML) is more associated with bone marrow involvement and may not lead to the same extent of tumor lysis as Burkitt lymphoma. Nephroblastoma (Wilms tumor) and neuroblastoma are solid tumors that are less prone to rapid cell turnover compared to hematologic malignancies like Burkitt lymphoma, making TLS less common in these cases. From an educational perspective, understanding the risk factors for TLS in different pediatric malignancies is crucial for nurses and healthcare providers caring for pediatric oncology patients. Recognizing the malignancies that are more likely to manifest TLS can guide clinical management decisions, such as implementing preventive measures and close monitoring to prevent potential complications associated with TLS, such as renal failure, cardiac arrhythmias, and metabolic disturbances.