Neuroblastoma can be associated with paraneoplastic syndromes. All the following features are paraneoplastic EXCEPT

Correct Answer: B

Rationale: Neuroblastoma, a common childhood cancer, can be associated with paraneoplastic syndromes, which are conditions caused by the production of hormones or antibodies by the tumor. In this question, option B, cerebellar ataxia and increased body coordination, is the correct answer as it is not typically associated with paraneoplastic syndromes seen in neuroblastoma. Uncontrollable jerking movements (option A) can be seen in opsoclonus-myoclonus syndrome, unilateral ptosis, myosis, and anhidrosis (option C) can be seen in Horner syndrome, and profound secretory diarrhea (option D) can be a manifestation of vasoactive intestinal peptide (VIP) secretion, all of which can be paraneoplastic syndromes associated with neuroblastoma. Educationally, understanding the various paraneoplastic syndromes associated with neuroblastoma is crucial for pediatric critical care nurses as they care for children with this condition. Recognizing these syndromes can aid in prompt diagnosis and appropriate management of complications, ultimately improving patient outcomes.

Correct Answer: A

Rationale: In this scenario, the most appropriate nursing action to meet the emotional needs of a dying 10-year-old patient is to answer questions honestly and frankly (Option A). This approach is crucial in providing the child with accurate information about their condition, fostering trust, and helping them process their emotions. Option B, avoiding interruptions by coordinating nursing actions, is not as effective in addressing the emotional needs of a dying child. While coordination is important, it does not directly address the child's need for honesty and emotional support. Option C, encouraging the patient to write in a journal, may be a helpful coping mechanism for some children; however, in this critical situation, direct communication and support from the nursing staff are more immediate and necessary. Option D, providing opportunities for the patient to interact with children of the same age, may not be appropriate for a child who is actively dying. While social interaction is important, addressing the child's emotional needs in a more direct and individualized manner is crucial in this context. Educationally, this question highlights the importance of effective communication, honesty, and emotional support in pediatric palliative care. Nurses play a vital role in providing compassionate care and addressing the unique emotional needs of pediatric patients facing life-limiting illnesses. By understanding and implementing best practices in pediatric palliative care, nurses can help support both the child and their family during this difficult time.

Correct Answer: A

Rationale: The correct answer is A) 4 months. At around 4 months of age, infants develop the ability to visually track and focus on objects, reach out to grasp them, and bring them to their mouths. This milestone is part of their normal development and is known as the "hands to mouth" reflex. Infants explore the world through their senses, including touch and taste, which is why bringing objects to their mouths is a common behavior at this stage. Option B) 5 months is incorrect because by 5 months, infants typically have already developed the ability to grasp and bring objects to their mouths. Option C) 6 months and Option D) 7 months are also incorrect as infants generally achieve this milestone earlier, around 4 to 5 months of age. Understanding the developmental milestones in infants is essential for pediatric nurses and healthcare providers to assess a child's growth and development accurately. Recognizing when an infant should be able to perform certain tasks helps in early identification of any developmental delays or issues that may require intervention or further evaluation. By knowing these milestones, healthcare professionals can provide appropriate support and guidance to families to promote optimal development in children.

Correct Answer: B

Rationale: In this question regarding sleep in pediatric patients, option B is the correct answer: slow-wave sleep is not needed for brain injury protection. Slow-wave sleep, also known as deep sleep, is crucial for physical restoration, growth, and immune function, but it is not specifically linked to brain injury protection. Option A is incorrect because melatonin is indeed secreted in response to the dark-light cycle, regulating the sleep-wake cycle. Option C is incorrect as REM sleep is responsible for vivid dreaming, not just dreaming in general. Option D is incorrect because both REM and non-REM sleep cycles are necessary for a complete, restorative sleep. In an educational context, understanding the different stages of sleep is crucial for healthcare providers caring for pediatric patients. Knowing the functions of each stage helps in assessing sleep patterns, identifying sleep disorders, and providing appropriate interventions. This knowledge is particularly important in critical care settings like pediatric CCRN where optimizing sleep is essential for recovery and overall well-being.

Correct Answer: D

Rationale: In this question, the correct answer is D) 9 months. At around 9 months of age, children typically develop the ability to pull themselves up to a standing position, start using a pincer grasp to pick up small objects, and engage in simple interactive activities like playing pat-a-cake. Option A) 6 months is too early for these milestones to typically occur. At 6 months, infants are usually just starting to sit up without support and exploring objects with their hands in a more primitive grasp. Option B) 7 months is also premature for the described milestones. While infants at 7 months may be able to sit up without support and possibly rake objects with their fingers, they are unlikely to exhibit the skills described in the question. Option C) 8 months is closer to the expected timeline, but children at this age are more likely to be working on crawling or pulling to stand rather than fully engaging in pincer grasp and interactive play activities like pat-a-cake. Understanding typical developmental milestones in children is crucial for pediatric healthcare providers to assess a child's progress and intervene early if delays are suspected. By knowing when these skills are expected to emerge, healthcare professionals can provide appropriate support and guidance to promote healthy development in children.