During the routine exam of an infant the parents state a 5th degree family history of adenomatous polyposis. The statement that should be included during the discussion is the infant is at increased risk of colonic adenocarcinoma

Correct Answer: C

Rationale: In this scenario, option C) the infant is at increased risk of hepatoblastoma is the correct statement to include during the discussion. Adenomatous polyposis syndromes, such as familial adenomatous polyposis (FAP), are genetic conditions that predispose individuals to the development of colorectal cancer, particularly colonic adenocarcinoma. Hepatoblastoma, a type of liver cancer, is not directly associated with adenomatous polyposis syndromes. Options A, B, and D are incorrect because they mention different types of cancers that are not typically linked to a family history of adenomatous polyposis. Understanding the specific cancer risks associated with genetic conditions is crucial in pediatric nursing practice to provide accurate information to families and ensure appropriate monitoring and early intervention strategies are in place. By recognizing the increased risk of colonic adenocarcinoma in infants with a family history of adenomatous polyposis, healthcare providers can offer targeted surveillance and potentially life-saving interventions.

Correct Answer: A

Rationale: The correct answer is A) nephroblastoma. In a 2-month-old infant with a left renal mass, nephroblastoma, also known as Wilms tumor, is the most likely diagnosis. Nephroblastoma is the most common renal tumor in children and typically presents with an asymptomatic abdominal mass. It is important to consider this diagnosis in pediatric patients with renal masses, especially in the context of the patient's age and presentation. Option B) neuroblastoma is an incorrect choice in this scenario because neuroblastoma is a tumor of the sympathetic nervous system and is not typically associated with renal masses. Option C) mesoblastic nephroma is less common than nephroblastoma and usually presents in the first few months of life, often with a palpable abdominal mass. Option D) clear cell sarcoma is a rare tumor that typically affects older children and adults, making it less likely in a 2-month-old infant. Educationally, understanding the common pediatric renal tumors and their typical presentations is crucial for healthcare providers working with pediatric populations. Recognizing the age at presentation, common signs and symptoms, and typical imaging findings of these tumors can aid in early diagnosis and appropriate management, ultimately improving patient outcomes.

Correct Answer: A

Rationale: In nasopharyngeal carcinoma, elevated lactate dehydrogenase (LDH) level carries the worst outcome because it is a marker of aggressive disease and poor prognosis. LDH is often elevated in conditions associated with tissue damage or cancer progression, indicating a higher tumor burden and disease severity. Advanced disease and extensive cervical lymph node involvement are also poor prognostic factors, but elevated LDH is a more direct indicator of tumor activity and aggressiveness. Evidence of Epstein-Barr virus (EBV) DNA may be present in nasopharyngeal carcinoma due to its association with the disease, but it does not necessarily correlate with a worse outcome compared to elevated LDH. In an educational context, understanding the significance of different prognostic factors in nasopharyngeal carcinoma is crucial for healthcare providers involved in the care of pediatric patients. Recognizing the impact of elevated LDH on prognosis can help guide treatment decisions and management strategies to improve patient outcomes. It is essential for healthcare professionals to be able to differentiate between various prognostic factors to provide optimal care for pediatric patients with nasopharyngeal carcinoma.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) vitamin B12. A strict vegetarian diet, particularly one that excludes all animal products, can lead to a deficiency in vitamin B12 as it is primarily found in animal-based foods. Vitamin B12 is crucial for neurological function, red blood cell production, and overall growth and development, especially in young children. Option A) niacin, Option B) thiamin, and Option C) vitamin B6 are not the most likely deficiencies in a child following a strict vegetarian diet. While these vitamins are also important for overall health, they are more readily available in plant-based foods or can be synthesized by the body in adequate amounts, compared to vitamin B12 which is primarily found in animal products. From an educational perspective, this question highlights the importance of understanding the specific nutritional considerations for pediatric patients with different dietary patterns. It emphasizes the need for healthcare providers to be aware of potential deficiencies in children following strict vegetarian diets and to provide appropriate guidance and supplementation to ensure optimal health and development.

Correct Answer: A

Rationale: The correct answer is option A: there is no need for further evaluation as 80% recover on their own. Rationale: For a 4-year-old child with stuttering and repetitions of initial sounds, it is important to understand that stuttering is a common developmental issue in early childhood. Research shows that about 80% of children who stutter do recover spontaneously without any intervention as they grow older. Therefore, in most cases, it is best to adopt a "wait and see" approach rather than rushing into unnecessary evaluations or interventions. Option B: Trying to reduce pressures associated with speaking may be helpful in general, but it does not address the specific issue of stuttering in young children. Option C: Referring to an ENT specialist is not necessary for stuttering, as stuttering is a speech and language issue rather than a physical problem related to the ear, nose, and throat. Option D: Referring to a speech therapist can be beneficial if the stuttering persists or worsens over time, but initially, it may not be necessary for a 4-year-old child who is still within the age range for natural recovery. Educational Context: Understanding the normal developmental patterns of speech and language in children is crucial for healthcare providers working with pediatric populations. By recognizing that stuttering is common in early childhood and that a significant percentage of children recover without intervention, healthcare professionals can provide appropriate guidance and support to families without causing unnecessary worry or interventions. Observation, monitoring, and offering support and reassurance to families are often the best initial approaches for young children with stuttering.