Epstein-Barr virus (EBV) infection is more likely to be associated with all the following malignancies EXCEPT

Correct Answer: B

Rationale: In pediatric nursing practice, understanding the associations between Epstein-Barr virus (EBV) infection and malignancies is crucial for providing comprehensive care to patients. The correct answer, option B, is nasopharyngeal T-cell lymphoma. This is because EBV is strongly linked to the development of Burkitt lymphoma, carcinoma, and Hodgkin lymphoma, but not nasopharyngeal T-cell lymphoma. Burkitt lymphoma is a known malignancy associated with EBV due to the virus' ability to immortalize B-cells. Carcinoma, although less common, has also been linked to EBV infection, particularly in nasopharyngeal and gastric cancers. Hodgkin lymphoma is another malignancy where EBV has been implicated, especially in immunocompromised individuals. Educationally, this question reinforces the importance of understanding the relationship between viral infections such as EBV and the development of different malignancies in pediatric patients. It highlights the need for nurses to be aware of these associations to provide appropriate care, monitor for signs and symptoms, and collaborate effectively with the healthcare team to ensure optimal patient outcomes.

Correct Answer: C

Rationale: The correct answer is C) myxopapillary ependymoma. In this scenario, the child presents with symptoms suggestive of a tumor in the filum terminale and conus medullaris region, which is characteristic of myxopapillary ependymoma. This tumor arises from the ependymal cells lining the spinal cord and is commonly found in the lower spinal cord region. Option A) medulloblastoma is a malignant brain tumor commonly found in the cerebellum, not in the spinal cord. Option B) anaplastic astrocytoma is a high-grade glioma that typically arises in the brain, not in the spinal cord. Option D) choroid plexus carcinoma is a rare tumor arising from the choroid plexus in the brain, not in the spinal cord. Educationally, understanding the specific characteristics and locations of different CNS tumors is crucial for accurate diagnosis and management in pediatric nursing practice. Recognizing the typical presentations of various tumors helps healthcare providers make informed decisions regarding treatment and care for pediatric patients with CNS tumors.

Correct Answer: D

Rationale: In pediatric nursing, understanding childhood brain tumors is crucial for providing appropriate care. The correct answer is D) diffuse intrinsic. Diffuse intrinsic pontine gliomas (DIPG) are highly aggressive brain tumors located in the brain stem, specifically in the pons. These tumors are known for their infiltrative nature, making them challenging to treat and leading to a poor prognosis. Option A) focal dorsally exophytic tumors are typically less aggressive and have a better prognosis compared to diffuse intrinsic tumors. These tumors can be surgically accessible and may have better treatment outcomes. Option B) cervicomedullary diffuse intrinsic tumors are also aggressive but are located in a different region of the brain stem compared to DIPG. While they are serious, DIPG tumors are generally associated with the worst prognosis due to their location and characteristics. Option C) none of the above is incorrect as the prognosis of childhood brain stem tumors does indeed vary based on the tumor type and location. Educationally, nurses need to be aware of the different types of childhood brain tumors and their prognoses to provide optimal care to pediatric patients and support their families. Understanding the implications of tumor location on prognosis helps nurses communicate effectively with healthcare teams and families, guiding decision-making and promoting holistic care for pediatric patients with brain tumors.

Correct Answer: E

Rationale: The correct answer is E because it is the one that does not accurately describe renal cell carcinoma (RCC) in children. In pediatric cases, RCC is not associated with von Hippel-Lindau disease, which is more commonly seen in adults. Option A is correct as patients with RCC in children can present with symptoms like hematuria, flank pain, and a palpable mass. Option B is also accurate since RCC can be asymptomatic and incidentally detected on imaging studies. Option C is true as RCC in children has a propensity to metastasize to the lungs, bone, liver, and brain. Educationally, understanding the presentation and characteristics of RCC in children is crucial for pediatric nurses to provide timely and appropriate care. Recognizing the differences between RCC in children and adults, such as the absence of von Hippel-Lindau disease association, helps in accurate diagnosis and management. This knowledge ensures comprehensive care and support for pediatric patients with RCC.

Correct Answer: B

Rationale: In pediatric osteosarcoma, the worst prognostic factor among the options given is poor histologic response to treatment (Option B). This is because a poor response to treatment indicates that the tumor is more aggressive and less likely to be effectively controlled or eradicated. A good histologic response is associated with better outcomes, including higher rates of survival and lower risk of recurrence. Option A (primary pelvic bone tumor) is not as poor a prognostic factor as poor histologic response because the primary tumor's location alone does not necessarily dictate the response to treatment or overall prognosis. Osteosarcoma can occur in various bones, and while pelvic tumors may present challenges due to the proximity to vital structures, they are not inherently associated with worse outcomes. Option C (bony metastases at the time of diagnosis) is also a serious factor but not as detrimental as a poor histologic response. Metastases indicate disease spread, which can complicate treatment, but response to therapy still plays a significant role in determining outcomes. Option D (lung metastases at the time of diagnosis) is a negative prognostic factor but is not as critical as poor histologic response. Lung metastases are common in osteosarcoma and can impact prognosis, but the response to treatment remains a crucial determinant of overall success. Educationally, understanding prognostic factors in pediatric osteosarcoma is vital for nurses caring for pediatric oncology patients. Recognizing the significance of histologic response can guide nursing assessments, interventions, and patient education efforts. Nurses play a key role in monitoring treatment responses, managing side effects, and supporting patients and families through the challenges of osteosarcoma treatment.