Children with severe traumatic brain injury (TBI) may experience autonomic dysfunction characterized by all the following EXCEPT

Correct Answer: D

Rationale: In the context of pediatric traumatic brain injury (TBI), it is crucial for nurses and healthcare providers to understand the manifestations of autonomic dysfunction in children. In this case, the correct answer is D) lowered blood pressure. Autonomic dysfunction in severe pediatric TBI often leads to a state of autonomic dysregulation where the body's normal physiological responses are disrupted. Elevated temperature, heart rate, and respiratory rate are common manifestations of autonomic dysfunction in response to TBI. However, lowered blood pressure is not typically associated with autonomic dysfunction in this context. Understanding these signs and symptoms is vital for healthcare professionals caring for children with TBI as it can guide appropriate interventions and treatments. Monitoring these vital signs closely can help in early recognition of autonomic dysfunction and prompt management to prevent further complications. This knowledge is essential for pediatric critical care nurses, especially those preparing for the CCRN exam, as it directly impacts patient outcomes and quality of care provided.

Correct Answer: A

Rationale: The correct answer is A) type 6. The human papillomavirus (HPV) is a known risk factor for cervical carcinomas. Types 16 and 18 are the most common high-risk HPV types associated with cervical cancer. Type 31 is also considered a high-risk type. However, type 6 is classified as a low-risk HPV type and is not associated with cervical malignancy. Educational Context: Understanding the association between HPV types and cervical cancer is crucial for healthcare professionals, especially in pediatric care where prevention and early detection are key. By knowing which HPV types are high-risk for cervical cancer, healthcare providers can better inform and educate their patients about vaccination, screening, and early intervention strategies. This knowledge is essential for nurses, nurse practitioners, and physicians working in pediatric settings to provide comprehensive care and promote preventive health practices.

Correct Answer: A

Rationale: In pediatric oncology, chemotherapy plays a vital role in the treatment of many CNS tumors. The correct answer is A) pilocytic astrocytoma. Pilocytic astrocytomas are generally low-grade tumors that are typically slow-growing and well-differentiated. They are often surgically resectable and have a good prognosis. Due to their characteristics, they are less responsive to chemotherapy compared to other more aggressive CNS tumors. Option B) craniopharyngioma is a benign tumor that is usually treated with a combination of surgery and radiation therapy. Chemotherapy is not typically the first-line treatment for craniopharyngiomas. Option C) pineoblastoma is a highly malignant and aggressive brain tumor that does respond to chemotherapy. Chemotherapy is an essential component of the treatment regimen for pineoblastomas. Option D) supratentorial primitive neuroectodermal tumors (SPNETs) are aggressive malignant brain tumors that are typically treated with a combination of surgery, radiation therapy, and chemotherapy. Chemotherapy is effective in the treatment of SPNETs. In an educational context, understanding the role of chemotherapy in the treatment of pediatric CNS tumors is crucial for healthcare professionals caring for pediatric patients with cancer. Knowing the specific tumor types that are more or less responsive to chemotherapy helps in tailoring treatment plans and managing patient expectations regarding outcomes and side effects of treatment.

Correct Answer: D

Rationale: The correct answer is D) periosteal. Periosteal osteosarcoma is a subtype that is typically treated with surgery alone. Unlike other subtypes such as fibroblastic, chondroblastic, and parosteal osteosarcoma which often require a combination of surgery and chemotherapy, periosteal osteosarcoma is a low-grade tumor that can often be effectively treated through surgical resection alone. Fibroblastic and chondroblastic osteosarcomas are more aggressive subtypes that usually necessitate a multimodal approach involving surgery and chemotherapy to achieve the best outcomes. Parosteal osteosarcoma, although less common, also typically requires a combination of surgery and chemotherapy due to its location and characteristics. In an educational context, understanding the different subtypes of osteosarcoma and their respective treatment modalities is crucial for healthcare providers working with pediatric oncology patients. This knowledge helps in making informed decisions regarding treatment planning and providing optimal care to patients with osteosarcoma. By differentiating the subtypes and their treatment approaches, healthcare professionals can tailor interventions to individual patient needs, improving outcomes and quality of life.

Correct Answer: C

Rationale: In understanding why etoposide is the most likely cause of secondary acute myelogenous leukemia (AML) in the 9-year-old boy, we need to consider the drug's mechanism of action. Etoposide is a topoisomerase II inhibitor, which can lead to DNA damage and chromosomal translocations associated with the development of secondary malignancies like AML. Regarding the other options: A) Cyclophosphamide is alkylating agent associated with secondary malignancies but less commonly linked to AML compared to etoposide. B) Vincristine is a microtubule inhibitor and is not typically associated with secondary AML. D) Doxorubicin is an anthracycline that can cause secondary leukemias, but etoposide has a stronger association with AML development. Educationally, this question highlights the importance of understanding the long-term effects of chemotherapy in pediatric oncology patients. Healthcare providers need to be aware of the potential risks associated with different chemotherapeutic agents to provide comprehensive care and long-term surveillance for these vulnerable patients.