One of the following may be effective in calming a crying infant with colic

Correct Answer: C

Rationale: In pediatric nursing, it is crucial to understand how to manage common issues like colic in infants. The correct answer to the question about calming a crying infant with colic is option C, simethicone. Simethicone is an over-the-counter medication that helps to reduce gas bubbles in the stomach and intestines, which can alleviate discomfort and fussiness in colicky infants. Option A, diphenhydramine, is an antihistamine that is not recommended for infants with colic due to its sedative effects, which may not address the underlying cause of colic and can pose risks to infants. Phenobarbital (option B) is a central nervous system depressant that is not indicated for colic and can be harmful in infants. Lactase (option D) is an enzyme that helps in digesting lactose and is not typically used to manage colic symptoms. Educationally, understanding the appropriate interventions for colic in infants is essential for pediatric nurses. By choosing the correct answer, nurses can provide safe and effective care, promoting the well-being of infants and supporting their families. It is important to prioritize evidence-based interventions like simethicone over potentially harmful or ineffective options to ensure optimal outcomes for pediatric patients.

Correct Answer: A

Rationale: In pediatric oncology, it is crucial to understand the risk factors for central nervous system (CNS) relapse in children with acute lymphoblastic leukemia (ALL) to provide optimal care. In this scenario, option A, the first traumatic lumbar puncture (LP), is the least likely to increase the risk of CNS relapse in children with ALL. The rationale behind this is that the first traumatic LP is a common procedure done to assess for CNS involvement in ALL patients. While it may cause temporary discomfort and minor complications, it does not directly contribute to an increased risk of CNS relapse. On the other hand, options B, C, and D are known risk factors for CNS relapse in ALL. Option B, T-cell leukemia, is associated with a higher risk of CNS relapse compared to B-cell leukemia due to its biological characteristics. Option C, cranial nerve involvement at diagnosis, indicates a more advanced disease stage and a higher likelihood of CNS relapse. Option D, the presence of lymphoblasts in the cerebrospinal fluid (CSF) at any time during treatment, is a significant indicator of CNS disease and poses a higher risk of relapse in the CNS. Educationally, understanding these risk factors is crucial for healthcare providers caring for pediatric patients with ALL. By differentiating between factors that increase the risk of CNS relapse and those that do not, healthcare professionals can tailor their treatment strategies and monitoring protocols to improve patient outcomes and quality of life.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) myxopapillary ependymoma. Myxopapillary ependymomas are typically slow-growing tumors that arise in the filum terminale and conus medullaris region of the spinal cord, which explains the symptoms of bilateral thigh pain, motor weakness, sensory deficits in the lower limbs, and bladder dysfunction in the 6-year-old child. These tumors are commonly associated with this specific location in the spinal cord. Regarding the incorrect options: A) Medulloblastoma is a malignant brain tumor that arises in the cerebellum, not in the spinal cord as seen in this case. B) Anaplastic astrocytoma is a type of brain tumor that arises from astrocytes in the brain, not in the spinal cord. D) Choroid plexus carcinoma is a rare and aggressive brain tumor that arises in the choroid plexus of the brain, not in the spinal cord. Educational context: Understanding the specific locations where different CNS tumors arise is crucial in pediatric nursing practice to accurately assess and manage symptoms in pediatric patients. This knowledge helps in differentiating between various tumor types based on clinical presentations and imaging findings, leading to timely diagnosis and appropriate treatment interventions.

Correct Answer: D

Rationale: In pediatric nursing, understanding childhood primary brain stem tumors is crucial for providing effective care. The correct answer is D) diffuse intrinsic. Diffuse intrinsic pontine glioma (DIPG), a type of diffuse intrinsic tumor, carries the worst prognosis due to its location in the brain stem, specifically the pons. This location makes surgical removal nearly impossible, leading to poor outcomes. Option A) focal dorsally exophytic tumors may have a better prognosis as they are more accessible for surgical intervention compared to diffuse intrinsic tumors. Option B) cervicomedullary diffuse intrinsic tumors, although diffuse intrinsic, are not as common as pontine gliomas and may have slightly different prognostic outcomes, making them a less definitive answer. Option C) none of the above is incorrect as there is a tumor type, diffuse intrinsic, known for its poor prognosis based on location. Educationally, this question highlights the importance of understanding the impact of tumor location on prognosis in pediatric brain tumors. It emphasizes the need for nurses to be knowledgeable about different tumor types and their implications for patient outcomes to provide holistic care to pediatric oncology patients.

Correct Answer: E

Rationale: In this question, the correct answer is E, which is not listed as an option. Renal cell carcinoma (RCC) in children is indeed a rare condition, accounting for less than 5% of all renal tumors. The other options listed in the question are all true statements regarding RCC in children. Option A is correct because patients with RCC may present with symptoms such as frank hematuria, flank pain, and/or a palpable mass. Option B is also correct as RCC can be asymptomatic and may be incidentally detected. Option C is true as RCC in children has the potential to metastasize to various organs including the lungs, bone, liver, and brain. Option D is also accurate as RCC can be associated with von Hippel-Lindau disease, a genetic disorder that predisposes individuals to various tumors, including RCC. Educationally, understanding the presentation, diagnosis, and associations of RCC in children is crucial for healthcare providers working in pediatric oncology or nephrology. Recognizing the signs and symptoms, risk factors, and potential metastatic sites can aid in early detection, appropriate management, and improved outcomes for pediatric patients with RCC.