Mr. Reyea has expressive aphasia. As a part of a long range planning. The nurse should ;

Correct Answer: A

Rationale: In caring for a patient with expressive aphasia like Mr. Reyea, providing positive feedback when he uses a word correctly is essential for reinforcing and encouraging communication efforts. This positive reinforcement can help boost his confidence and motivation to continue trying to communicate effectively. It is important to support and acknowledge any progress made, as communication difficulties can be frustrating for individuals with aphasia. Waiting for him to verbally state needs regardless of how long it may take, as well as suggesting that he get help at home because the disability is permanent, may not be the most therapeutic or supportive approaches. Helping the family accept that Mr. Reyea cannot participate in verbal communication should not be the primary focus, as there are strategies and therapies that can help improve communication abilities in patients with aphasia.

Correct Answer: A

Rationale: When administering a narcotic analgesic like Morphine, assessing the client's level of alertness and respiratory rate is crucial to monitor for any adverse effects such as respiratory depression. Morphine can cause respiratory depression as one of its side effects, especially in higher doses. By assessing the client's respiratory rate and level of alertness before administering the medication, the nurse can ensure the client's safety and take appropriate action if any signs of respiratory depression occur. This assessment is essential in preventing potential complications and ensuring the client's well-being during pain management.

Correct Answer: A

Rationale: Bacterial meningitis is considered the most significant form of meningitis because it is a serious, life-threatening condition that requires immediate medical attention. Bacterial meningitis is caused by bacteria infecting the protective membranes covering the brain and spinal cord. It can lead to complications such as brain damage, hearing loss, and even death if not treated promptly with antibiotics. Bacterial meningitis is more severe than viral or aseptic meningitis, hence why it is considered the most significant form.

Correct Answer: D

Rationale: The correct answer is D) hepatoblastoma, as this type of malignancy is least likely to occur in a 10-month-old infant. Hepatoblastoma is a rare liver cancer that typically occurs in young children, with the highest incidence in children under the age of 3. While hepatoblastoma can occur in infancy, it is less common compared to other malignancies in this age group. Option A) neuroblastoma is a common malignancy in infants and young children, arising from neural crest cells. Option B) nephroblastoma, also known as Wilms tumor, is a kidney cancer that primarily affects children. Option C) retinoblastoma is a tumor of the retina that often presents in young children. In an educational context, understanding the typical age range and common malignancies in pediatric patients is crucial for healthcare providers working in pediatrics. Recognizing the age patterns and common types of cancers in children can aid in early detection, prompt intervention, and improved outcomes. Awareness of the likelihood of specific malignancies in different age groups helps guide clinical decision-making and appropriate diagnostic workup in pediatric oncology.

Correct Answer: B

Rationale: In pediatric oncology, understanding the impact of radiotherapy on children with brain tumors is crucial. The correct answer, option B, stating that late neurological sequelae post radiotherapy are more severe in children less than 3 years old, aligns with the knowledge that younger children have developing brains that are more vulnerable to the effects of radiation. Option A is incorrect because craniospinal irradiation, while encompassing a larger area, is associated with more acute rather than late neurological complications. Option C, concomitant chemo-radiotherapy, may increase the overall toxicity but doesn't specifically correlate with increased late neurological sequelae. Option D is incorrect as the severity of late neurological sequelae is not determined by tumor grade. Educationally, this question underscores the importance of considering age as a factor in the risk assessment of late effects of radiotherapy in pediatric patients with medulloblastoma. It highlights the need for personalized treatment approaches based on age-related vulnerabilities in pediatric oncology. Understanding these nuances can help healthcare providers tailor discussions with parents to address concerns and make informed treatment decisions.