In Langerhans cell histiocytosis (LCH), which organ is LEAST likely affected?

Correct Answer: D

Rationale: In Langerhans cell histiocytosis (LCH), the least likely affected organ is the middle nodes, making option D the correct answer. LCH mainly affects tissues such as the skin, bone, and sometimes the ears. The skin is commonly affected in LCH, presenting as skin lesions or rashes. Bone involvement is also common, leading to bone pain, fractures, or swelling. Ears can be affected, causing symptoms like hearing loss or ear discharge. Educationally, understanding the typical organ involvement in LCH is crucial for pediatric nurses to recognize and manage the condition effectively. By knowing that middle nodes are least likely affected, nurses can focus on assessing and monitoring more commonly involved organs like the skin, bones, and ears in pediatric patients with LCH. This knowledge helps in providing comprehensive care and early intervention for these young patients.

Correct Answer: A

Rationale: The correct answer is A) t(4;11) for infantile Acute Lymphoblastic Leukemia (ALL). This translocation results in the fusion of the MLL gene on chromosome 11 with various partner genes. This fusion gene plays a key role in leukemogenesis in infantile ALL. Option B) t(12;21) is associated with a better prognosis in pediatric ALL as it results in the formation of the ETV6-RUNX1 fusion gene, which is more common in childhood ALL. Option C) t(9;22) is characteristic of Chronic Myeloid Leukemia (CML) and not infantile ALL. Option D) t(1;19) is associated with pre-B cell ALL, not infantile ALL. Educationally, understanding chromosomal abnormalities in pediatric malignancies is crucial for nurses caring for pediatric oncology patients. Recognizing specific translocations can guide treatment decisions and help predict outcomes, highlighting the importance of this knowledge in pediatric nursing practice.

Correct Answer: D

Rationale: Tumor lysis syndrome (TLS) is a potentially life-threatening complication that can occur during the treatment of malignancies due to the rapid breakdown of cancer cells leading to metabolic imbalances. In pediatric oncology, Burkitt lymphoma is more likely to manifest TLS compared to other malignancies listed. Burkitt lymphoma is a highly proliferative and fast-growing cancer, characterized by rapid cell turnover. When treatment is initiated, the massive destruction of tumor cells can overwhelm the body's ability to clear the metabolic byproducts, leading to TLS. This is why option D (Burkitt lymphoma) is the correct answer. The other options can be eliminated as they are less commonly associated with TLS in pediatric patients. Acute myelogenous leukemia (AML) and nephroblastoma are not typically linked to TLS due to differences in their pathophysiology and cell turnover rates. Neuroblastoma, although it can cause tumor lysis, is less likely to result in TLS compared to Burkitt lymphoma due to differences in tumor burden and cell turnover dynamics. Understanding which malignancies are more prone to TLS is crucial for pediatric nurses caring for oncology patients. Recognizing the predisposing factors can help in early identification, prompt management, and prevention of TLS-related complications, ultimately improving patient outcomes.

Correct Answer: D

Rationale: In the treatment of high-risk neuroblastoma in children, the current standard of care includes surgery, intensive chemotherapy, and radiation therapy. Allogenic bone marrow transplantation is not a typical part of first-line treatment for neuroblastoma. The correct answer, D, is right because while bone marrow transplantation can be used in certain scenarios, it is not a routine part of initial treatment for high-risk neuroblastoma. Intensive chemotherapy is crucial in targeting rapidly dividing cancer cells, surgery aims to remove the primary tumor, and radiation therapy helps to kill any remaining cancer cells. Option A, surgery, is a necessary component to remove the primary tumor and reduce the tumor burden. Option B, intensive chemotherapy, is essential to target cancer cells throughout the body. Option C, radiation, is used to kill cancer cells and reduce the risk of recurrence. In an educational context, understanding the components of treatment for high-risk neuroblastoma is vital for pediatric nurses to provide comprehensive care to these patients. Knowing the rationale behind each treatment modality helps nurses advocate for their patients and understand the goals of therapy. This knowledge also enables them to identify potential complications and side effects associated with each treatment option.

Correct Answer: D

Rationale: In pediatric oncology, understanding prognostic factors in Wilms tumor is crucial for providing optimal care. In this scenario, the correct answer is D) young age at diagnosis. This is because younger age at diagnosis is actually associated with a more favorable prognosis in Wilms tumor, contrary to the other options. Option A) large tumors are considered an adverse prognostic factor in Wilms tumor due to increased risk of metastasis and complications. Option B) anaplastic histology is associated with a poorer prognosis as it indicates a more aggressive form of the tumor. Option C) loss of heterozygosity at chromosome 1p and 16q is also a negative prognostic factor in Wilms tumor. Educationally, it is important for nurses caring for pediatric oncology patients to be aware of these prognostic factors to assist in providing comprehensive care, educating families, and understanding the treatment implications based on these factors. Understanding these nuances helps nurses in advocating for their young patients and supporting families through the complexities of cancer treatment.