Of the following, the MOST likely cause of constipation is

Correct Answer: C

Rationale: In this question, the correct answer is C) functional constipation. Functional constipation is the most likely cause of constipation in children because it is a common issue in pediatric populations. Functional constipation is typically due to factors such as diet, lack of fluids, lack of physical activity, and behavioral issues like ignoring the urge to have a bowel movement. Hypothyroidism (Option A) can cause constipation in children, but it is less common compared to functional constipation. Hirschsprung disease (Option B) is a congenital condition where nerve cells are missing in the large intestine, leading to severe constipation, usually in infants. Celiac disease (Option D) can cause gastrointestinal symptoms, including diarrhea, but it is not a typical cause of constipation in children. In an educational context, understanding the common causes of pediatric constipation is crucial for nurses working in pediatric settings. Recognizing the differences between these conditions helps nurses provide appropriate care and interventions for children experiencing constipation. By knowing the signs and symptoms associated with each condition, nurses can collaborate effectively with healthcare providers to ensure accurate diagnosis and treatment for pediatric patients.

Correct Answer: E

Rationale: In the context of pediatric oncology, high-risk neuroblastoma is an aggressive form of cancer with poor survival rates. The current treatment modalities for this condition aim to aggressively target and eradicate the cancer cells. The correct answer, option E (immunotherapy), is an essential component of the treatment regimen for high-risk neuroblastoma. Immunotherapy uses the body's immune system to help fight cancer and has shown promising results in improving survival rates in children with this condition. Option A, surgery, is often used to remove the primary tumor in neuroblastoma. However, neuroblastoma is known for its high recurrence rates even after surgery, hence surgery alone is not sufficient for treatment. Option B, intensive chemotherapy, is a standard treatment for high-risk neuroblastoma to kill cancer cells. Chemotherapy is typically used in combination with other modalities for a more comprehensive approach. Option C, radiation therapy, may be used in neuroblastoma treatment to target and shrink tumors. However, it is often avoided in young children due to potential long-term side effects on developing organs. Option D, allogeneic bone marrow transplantation, is not a standard treatment for high-risk neuroblastoma. While it may be considered in certain cases, it is not a primary treatment modality for this condition. In an educational context, understanding the rationale behind each treatment option is crucial for nurses caring for pediatric oncology patients. It helps them comprehend the holistic approach to managing high-risk neuroblastoma and the importance of multidisciplinary collaboration in providing optimal care for these vulnerable patients.

Correct Answer: D

Rationale: The correct answer is D) liver. In infants with multiple cutaneous hemangiomas, the most common site of visceral involvement by hemangiomas is the liver. This is known as hepatic hemangiomas. These benign vascular tumors in the liver are often asymptomatic and can regress over time. Option A) brain is less common in cases of cutaneous hemangiomas. Brain involvement can occur but is not as frequent as liver involvement. Option B) heart involvement by hemangiomas is rare in comparison to liver involvement. Cardiac hemangiomas are uncommon and usually present differently from cutaneous hemangiomas. Option C) lung involvement by hemangiomas is also less common than liver involvement. Pulmonary hemangiomas are rare and may not typically be the first consideration in cases of cutaneous hemangiomas. Understanding the common sites of visceral involvement in hemangiomas is crucial in pediatric nursing to provide appropriate care and monitoring for these patients. Recognizing the liver as the most common site can help in early detection and management of hepatic hemangiomas in infants with cutaneous hemangiomas.

Correct Answer: A

Rationale: The correct answer is A) t(9;22) for the chromosomal abnormality of childhood ALL that carries the highest risk of relapse despite intensive chemotherapy. This abnormality is known as the Philadelphia chromosome, resulting from a translocation between chromosomes 9 and 22. This translocation leads to the formation of the BCR-ABL fusion gene, which is a hallmark of a more aggressive form of ALL. Option B) t(4;11) is associated with MLL rearrangements and has a relatively poor prognosis, but it is not as strongly linked to high relapse rates as the Philadelphia chromosome. Option C) hypodiploidy is a chromosomal abnormality associated with high-risk ALL due to the presence of fewer than 44 chromosomes. However, it does not carry as high a risk of relapse as the Philadelphia chromosome. Option D) t(1;19) is associated with the TCF3-PBX1 fusion gene and is considered a favorable risk factor in childhood ALL, with a lower risk of relapse compared to the Philadelphia chromosome. Understanding the prognostic significance of different chromosomal abnormalities in childhood ALL is crucial for pediatric nurses and healthcare professionals involved in the care of these patients. Recognizing high-risk factors like the Philadelphia chromosome can inform treatment decisions and monitoring strategies to improve patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) age less than 10 years. Extraneural metastasis in primary brain tumors is a rare occurrence, but it is more likely to happen in younger children, particularly those under the age of 10. This is due to the increased vascularity and rapid growth of brain tumors in this age group, which can facilitate the spread of cancer cells to other parts of the body. Option B) female gender and option D) supratentorial tumor are not considered risk factors for extraneural metastasis in primary brain tumors. Gender is not typically associated with an increased risk of metastasis in this context, and the location of the tumor (supratentorial) does not necessarily predict the likelihood of extraneural spread. Option C) ventriculoperitoneal (VP) shunt insertion is not directly related to an increased risk of extraneural metastasis. While VP shunt insertion is a common procedure in managing certain types of brain tumors, it is not a known risk factor for the spread of cancer cells outside the central nervous system. In an educational context, understanding the risk factors for extraneural metastasis in pediatric brain tumors is crucial for healthcare providers working with pediatric oncology patients. Recognizing the factors that can increase the likelihood of cancer spread allows for more targeted monitoring and treatment strategies to improve patient outcomes. It is important to stay informed about current research and evidence-based practices in pediatric oncology to provide the best care for these vulnerable patients.