Diagnosis of attention deficit/hyperactivity disorder (ADHD) in children up to the age of 16 years requires the presence of at least

Correct Answer: C

Rationale: The correct answer is C) 6 symptoms of inattention or 6 symptoms of hyperactivity-impulsivity for at least 6 months in two or more environments. This criteria is based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) guidelines for diagnosing ADHD in children up to the age of 16 years. Choosing option A) is incorrect because it does not meet the minimum criteria specified in the DSM-5 for the duration of symptoms. Option B) also falls short of the required duration of symptoms. Option D) has the correct number of symptoms but fails to meet the duration criteria. Understanding the diagnostic criteria for ADHD is crucial for healthcare professionals working with children. By knowing the specific symptoms and duration required for diagnosis, healthcare providers can accurately assess and support children with ADHD. This knowledge helps in early identification, intervention, and management of ADHD, leading to better outcomes for affected children.

Correct Answer: B

Rationale: In pediatric oncology, understanding the genetic characteristics of tumors like neuroblastoma is crucial for determining prognosis and guiding treatment. In this scenario, the correct answer is B) hyperdiploidy, which carries a better outcome. Hyperdiploidy refers to the presence of extra copies of chromosomes, which can indicate a less aggressive form of neuroblastoma with a more favorable prognosis. Option A) amplification of the MYCN proto-oncogene is associated with a poor prognosis in neuroblastoma, indicating a higher risk of aggressive tumor behavior. Option C) loss of heterozygosity of 17q chromosome and Option D) loss of 1p chromosome are also genetic alterations associated with high-risk neuroblastoma and poor outcomes. Educationally, understanding the genetic markers of neuroblastoma not only helps in answering questions correctly but also informs clinical practice. Nurses caring for pediatric oncology patients need to grasp these concepts to provide holistic care and support to patients and their families. This knowledge can also aid in patient education and counseling regarding treatment options and expected outcomes.

Correct Answer: C

Rationale: In pediatric oncology, understanding tumor markers like alpha-fetoprotein (AFP) is crucial for diagnosis and monitoring treatment response. The correct answer is C) one year because AFP physiologically falls to normal adult levels around this age. During infancy, AFP levels are naturally elevated, making it challenging to detect abnormalities. By one year of age, the AFP levels typically decrease to adult levels, allowing for accurate interpretation in the context of GCTs. Option A) three months is incorrect because AFP levels are still elevated at this age, reflecting normal infant physiology. Option B) eight months is also incorrect as AFP levels usually remain elevated in infancy. Option D) three years is incorrect as AFP levels should normalize by one year, not three years. Educationally, this question highlights the importance of understanding age-related variations in tumor markers like AFP in pediatric oncology. Recognizing the normal developmental patterns of AFP levels can help healthcare providers differentiate between benign elevations and those indicative of malignant conditions, guiding appropriate clinical management.

Correct Answer: B

Rationale: The correct answer is B) nasopharyngeal T-cell lymphoma. Epstein-Barr virus (EBV) infection is associated with several malignancies due to its ability to transform infected B cells. Burkitt lymphoma, Hodgkin lymphoma, and certain carcinomas are known to be linked to EBV infection. Burkitt lymphoma is a B-cell lymphoma strongly associated with EBV. Hodgkin lymphoma can also be EBV-related, particularly in cases of mixed cellularity subtype. Carcinomas, particularly nasopharyngeal carcinoma, are also linked to EBV infection. In the context of education, understanding the association between EBV and various malignancies is crucial for healthcare professionals, especially those working in pediatric care. This knowledge aids in early detection, appropriate management, and patient education. It also highlights the importance of preventive measures, such as vaccination against EBV where available. By knowing which malignancies are commonly associated with EBV, healthcare providers can offer better care and support to pediatric patients at risk.

Correct Answer: C

Rationale: The correct answer is C) myxopapillary ependymoma. This type of tumor commonly arises from the filum terminale and conus medullaris, which are the exact locations described in the scenario. Myxopapillary ependymomas are slow-growing tumors that predominantly affect the lower spinal cord region, leading to symptoms such as lower limb weakness, sensory deficits, and bladder dysfunction, as seen in the case of this 6-year-old child. Option A) medulloblastoma is incorrect because it is a malignant embryonal tumor that typically arises in the cerebellum, not in the filum terminale or conus medullaris. Option B) anaplastic astrocytoma is incorrect as it is a type of high-grade glioma that arises from astrocytes in the brain, not in the spinal cord. Option D) choroid plexus carcinoma is incorrect because it originates from the choroid plexus within the brain ventricles, not in the spinal cord. Educationally, understanding the specific locations and characteristics of different CNS tumors is crucial for accurate diagnosis and management. This question highlights the importance of recognizing the typical presentation and site of origin of myxopapillary ependymoma in pediatric patients with spinal cord involvement.