Children with high-risk neuroblastoma have poor survival. Current treatment consists of all the following EXCEPT

Correct Answer: D

Rationale: In the treatment of high-risk neuroblastoma in children, the current standard of care includes surgery, intensive chemotherapy, and radiation therapy. Allogenic bone marrow transplantation is not a typical part of first-line treatment for neuroblastoma. The correct answer, D, is right because while bone marrow transplantation can be used in certain scenarios, it is not a routine part of initial treatment for high-risk neuroblastoma. Intensive chemotherapy is crucial in targeting rapidly dividing cancer cells, surgery aims to remove the primary tumor, and radiation therapy helps to kill any remaining cancer cells. Option A, surgery, is a necessary component to remove the primary tumor and reduce the tumor burden. Option B, intensive chemotherapy, is essential to target cancer cells throughout the body. Option C, radiation, is used to kill cancer cells and reduce the risk of recurrence. In an educational context, understanding the components of treatment for high-risk neuroblastoma is vital for pediatric nurses to provide comprehensive care to these patients. Knowing the rationale behind each treatment modality helps nurses advocate for their patients and understand the goals of therapy. This knowledge also enables them to identify potential complications and side effects associated with each treatment option.

Correct Answer: D

Rationale: In pediatric nursing, understanding the manifestations of cutaneous hemangiomas and their potential internal organ involvement is crucial for providing optimal care. The correct answer, option D - liver, is the most common site of visceral involvement by hemangiomas in infants. This is due to the fact that the liver is a common location for hemangiomas to develop internally, leading to potential complications such as hepatic dysfunction or hemodynamic disturbances. Option A - brain, may seem plausible due to the serious nature of brain involvement, but in reality, visceral hemangiomas rarely affect the brain compared to the liver. Option B - heart, is less common than liver involvement and typically presents with different clinical signs. Option C - lung, is also less common than liver involvement in cases of visceral hemangiomas. Educationally, this question reinforces the importance of recognizing patterns of visceral involvement in infants with cutaneous hemangiomas. Understanding the common sites of internal organ involvement helps nurses and healthcare providers to monitor and manage these patients effectively, ensuring early detection and intervention when necessary. It also highlights the need for a comprehensive assessment approach in pediatric nursing to address both visible and potential internal manifestations of various conditions.

Correct Answer: E

Rationale: In this scenario, the correct answer is option E, none of the findings raise suspicion of melanoma. This question assesses the student's understanding of the characteristics of melanoma in pediatric patients. Explanation: A) An enlarging nevus is concerning as it can be a sign of melanoma. Melanomas often grow in size over time. B) Changing colors in a nevus can be indicative of melanoma. Variegated colors are a warning sign. C) Irregular margins are a classic feature of melanoma. Well-defined borders are typical of benign nevi. D) A nevus that easily bleeds can be a sign of melanoma, as melanomas are prone to bleeding due to their abnormal blood supply. Educational context: It is crucial for pediatric nurses to recognize the signs of potential skin malignancies like melanoma in children. Understanding the specific characteristics of melanoma helps in early detection and intervention, leading to better outcomes for patients. Nurses play a key role in educating parents about monitoring moles and seeking medical evaluation if concerning changes are noted. This question reinforces the importance of vigilance and knowledge in pediatric dermatological assessments.

Correct Answer: C

Rationale: The correct answer is C) the patient can receive volume expanders. In the scenario described, the parents' religious beliefs prohibit blood transfusions. As a pediatric nurse, it is crucial to respect the parents' beliefs while also ensuring the best care for the child. Volume expanders are a suitable alternative to blood transfusions in cases where increasing the circulating blood volume is necessary. They help maintain blood pressure and tissue perfusion without violating the parents' wishes. Option A is incorrect because in an emergency situation where immediate intervention is required to save the child's life, parental consent may not be necessary, but it is important to respect the parents' beliefs whenever possible. Option B is incorrect as it imposes a specific restriction on blood donation sources, which may not align with the parents' preferences or beliefs. As an educator, it is essential to teach nursing students about the importance of cultural and religious sensitivity in providing care to pediatric patients and involving families in decision-making processes to the extent possible while ensuring patient safety and well-being.

Correct Answer: D

Rationale: In this scenario, the correct answer is option D) fluid overload or pulmonary edema. When caring for a pediatric patient with septic shock and administering fluid resuscitation, the nurse should monitor for signs of fluid overload, which can lead to pulmonary edema. This is a potential complication of rapid fluid administration in patients with septic shock. Pulmonary edema presents with symptoms such as respiratory distress, crackles on lung auscultation, and increased work of breathing. Option A) a heart rate of 50 beats/min is not directly related to fluid overload or pulmonary edema. In septic shock, tachycardia is a common finding due to the body's response to infection. Option B) a temperature of 102°F (38.9°C) is indicative of an ongoing infection and inflammatory response, which are expected in septic shock. It is not a specific sign of fluid overload. Option C) reports of leg pain could indicate muscle pain, joint issues, or poor perfusion, but it is not a typical sign of fluid overload or pulmonary edema. Educationally, this question highlights the importance of recognizing potential complications of fluid resuscitation in pediatric patients with septic shock. It emphasizes the need for close monitoring and assessment to detect early signs of fluid overload, which can impact the patient's respiratory status and overall outcome. Nurses must be vigilant in assessing for both desired effects and potential adverse reactions to interventions such as fluid resuscitation in critically ill pediatric patients.