ATI RN
Wongs Essentials of Pediatric Nursing 11th Edition Test Bank Questions
Question 1 of 5
Osteosarcoma is the most common primary malignant bone tumor in children and adolescents; it has multiple subtypes and requires different modalities of treatment including surgery and chemotherapy. Of the following, the subtype of osteosarcoma which is treated by surgery alone is
Correct Answer: D
Rationale: Periosteal osteosarcoma is often treated with surgery alone if margins are clear.
Question 2 of 5
A client comes to the clinic complaining of weight loss, fatigue, and a low-grade fever. Physical examination reveals a slight enlargement of the cervical lymph nodes. To assess possible causes for the fever, it would be most appropriate for the nurse to initially ask: a."Have you bee sexually active lately?" b, "Do you have a sore throat at the present time?"
Correct Answer: A
Rationale: When assessing a client with symptoms of weight loss, fatigue, low-grade fever, and lymphadenopathy (enlarged lymph nodes), it is important to investigate potential causes of infection. In this scenario, considering the client's symptoms and signs, asking if they have been exposed recently to anyone with an infection helps in determining the possibility of an infectious etiology for their symptoms. This question can provide valuable information to guide further assessment and diagnostic evaluation.
Question 3 of 5
A client has cancer that has me tastasized to her bones. She is complaining of increased thirst, polyuria and decreased muscle tone. Her lab values are: Na 139mEq/L, k 4 mEq/L, Cl 103 mEq/L, and Ca 8 mg/dl. What electrolyte imbalance is present?
Correct Answer: C
Rationale: The patient's symptoms of increased thirst, polyuria, decreased muscle tone, and the lab value of high calcium (8 mg/dl) indicate hypercalcemia. Hypercalcemia is commonly seen in cancer patients due to cancer metastasis to the bones, leading to the release of calcium. The other electrolyte levels (sodium, potassium, and chloride) are within normal range, ruling out other electrolyte imbalances. Multiple myeloma is a common malignancy associated with bone metastases and hypercalcemia. Symptoms of hypercalcemia may include thirst, frequent urination, weakness, confusion, and muscle pain. Treatment of hypercalcemia may involve hydration, loop diuretics, bisphosphonates, and addressing the underlying cause.
Question 4 of 5
Which of the following is the most critical intervention needed for a client with myxedema coma?
Correct Answer: A
Rationale: Myxedema coma is a severe form of hypothyroidism that can lead to life-threatening complications, including decreased level of consciousness, hypothermia, respiratory depression, and cardiovascular collapse. Rapid administration of thyroid hormone replacement therapy, such as levothyroxine, is crucial in the management of myxedema coma to reverse the underlying hypothyroid state and improve clinical outcomes. Therefore, administering an oral dose of levothyroxine is the most critical intervention needed for a client with myxedema coma. While warming the client with a warming blanket, measuring intake and output, and maintaining a patent airway are important aspects of care, they are not as directly related to the reversal of the underlying hypothyroid state in myxedema coma as administering levothyroxine.
Question 5 of 5
A patient's serum sodium is within normal range. The nurse estimates that serum osmolality should be:
Correct Answer: C
Rationale: Normal serum osmolality typically ranges between 280 to 295mOsm/kg. Serum osmolality reflects the concentration of solute particles in the blood, including sodium, glucose, and blood urea nitrogen. Sodium is a major determinant of serum osmolality, but it is not the only factor. In this case, since the patient's serum sodium is within the normal range, the nurse can reasonably estimate that the serum osmolality would fall within the normal range of 280 to 295mOsm/kg. Options A, B, and D are outside the typical range for serum osmolality in a healthy individual.