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, current protocols involve a multimodal approach that includes surgery, intensive chemotherapy, and radiation therapy. Allogeneic bone marrow transplantation is not a standard part of the treatment regimen for high-risk neuroblastoma in children. The correct answer, D, is not a part of the standard treatment because allogeneic bone marrow transplantation has not demonstrated significant efficacy in improving outcomes for children with high-risk neuroblastoma. While bone marrow transplantation may be considered in certain cases or in research settings, it is not a routine part of the established treatment guidelines for this condition. Surgery is often used to remove the primary tumor and any metastatic sites, while intensive chemotherapy and radiation therapy are aimed at eradicating remaining cancer cells. These modalities have been shown to improve survival rates in children with high-risk neuroblastoma. In an educational context, understanding the rationale behind each treatment modality is crucial for healthcare providers caring for pediatric oncology patients. It is important to be aware of the current evidence-based practices to provide the best possible care and outcomes for children with high-risk neuroblastoma. By knowing which treatments are standard and which are not, healthcare professionals can make informed decisions and advocate for the most effective therapies for their young patients.

Correct Answer: D

Rationale: In pediatric nursing, it is crucial to understand the implications of various conditions on both the surface and internal organs of young patients. In this case, the correct answer is D) liver. Hemangiomas are benign tumors composed of blood vessels. While cutaneous hemangiomas are common in infants, they can also affect internal organs. The liver is the most common site of visceral involvement by hemangiomas in infants. Option A) brain is less common for hemangioma involvement compared to the liver in infants. Option B) heart is also less frequently affected by hemangiomas than the liver. Option C) lung involvement by hemangiomas is rare in infants compared to hepatic involvement. Understanding the common sites of visceral involvement by hemangiomas is essential for pediatric nurses to monitor and provide appropriate care for infants with these conditions. Pediatric nurses must be knowledgeable about the potential complications and manifestations of hemangiomas in infants to ensure early detection and intervention. Recognizing the most common sites of visceral involvement, such as the liver, enables nurses to collaborate effectively with healthcare providers in managing these cases and promoting optimal outcomes for pediatric patients.

Correct Answer: E

Rationale: In this case, the correct answer is "E) easily bleeds." This option does not raise suspicion of melanoma because bleeding is not typically a characteristic feature of melanoma. Melanomas usually present with specific signs that help differentiate them from benign nevi. Option A, an enlarging nevus, is concerning for melanoma as melanomas often grow in size. Option B, changing colors, is also a red flag as melanomas can exhibit various colors within the lesion. Option C, irregular margins, is another classic sign of melanoma as benign nevi typically have smooth, well-defined borders. Educationally, it is crucial for nurses to understand the key characteristics of melanoma to differentiate it from benign skin lesions. Assessing nevi in pediatric patients requires a keen eye for changes that may indicate malignancy. By knowing these distinguishing features, nurses can provide appropriate guidance and referrals for further evaluation to ensure early detection and treatment if necessary.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) the patient can receive volume expanders. This is because Jehovah's Witnesses do not accept blood transfusions due to religious beliefs, but they do accept other blood products and treatments that do not involve direct blood transfusion. Volume expanders, such as saline solutions, can be used to help maintain blood volume and circulation in the patient without contradicting the parents' wishes. Option A is incorrect because in an emergency, obtaining parental approval for medical interventions is still essential, even if it may delay treatment. Option B is incorrect as Jehovah's Witnesses typically do not distinguish between blood from family members and others when it comes to transfusions. It is important for pediatric nurses to respect and accommodate the religious beliefs of patients and families while ensuring that appropriate alternative treatments are provided to meet the patient's medical needs. This case highlights the significance of cultural competence and ethical considerations in pediatric nursing practice.

Correct Answer: D

Rationale: In the case of a 12-year-old patient with septic shock, the pediatric nurse should be vigilant for signs of fluid overload or pulmonary edema as potential complications of fluid resuscitation. Septic shock often leads to capillary leak syndrome, causing fluid to shift from the vascular space into the interstitial space, potentially leading to fluid overload. This can manifest as increased work of breathing, crackles in the lungs, and decreased oxygen saturation. Option A, a heart rate of 50 beats/min, is not indicative of fluid overload but rather bradycardia, which can be a sign of impending cardiovascular collapse in septic shock. Option B, a temperature of 102°F (38.9°C), is a common symptom of infection and sepsis, not necessarily a direct result of fluid resuscitation. Option C, reports of leg pain, could indicate compartment syndrome or ischemia but is not directly related to fluid resuscitation complications. Understanding the potential complications of fluid resuscitation in pediatric patients with septic shock is crucial for pediatric nurses to provide timely interventions and prevent further deterioration. Monitoring for signs of fluid overload or pulmonary edema, such as respiratory distress, crackles, and decreased oxygen saturation, is vital for ensuring patient safety and optimal outcomes in this critical condition.