The nurse knows which of the following statements about TPN and peripheral parenteral nutrition is true?

Correct Answer: C

Rationale: The statement that is true about TPN and peripheral parenteral nutrition (PPN) is that TPN is often given to those with fluid restrictions, whereas PPN is used for those without constraints on their fluid intake. This is because TPN is a hypertonic solution that can cause fluid overload if given in large volumes, so it's typically reserved for patients who have fluid restrictions. On the other hand, PPN is a less concentrated solution that can be safely administered to patients without fluid restrictions.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) etoposide. Etoposide is known to have the potential to cause secondary AML as a late effect of cancer therapy. This is due to its ability to induce chromosomal translocations and gene mutations that can lead to the development of secondary malignancies like AML. A) Cyclophosphamide is commonly used in chemotherapy regimens but is not typically associated with secondary AML as much as etoposide. B) Vincristine is a vinca alkaloid that is more commonly associated with peripheral neuropathy rather than secondary AML. D) Doxorubicin is an anthracycline that is known for cardiotoxicity rather than causing secondary AML. It is essential for healthcare providers to be aware of the potential long-term side effects of chemotherapeutic agents in pediatric patients to monitor and manage their care effectively. Understanding the specific risks associated with each drug helps in making informed decisions regarding treatment and follow-up care.

Correct Answer: D

Rationale: In anaplastic large cell lymphoma (ALCL), primary mediastinal involvement is more specific than other types of non-Hodgkin lymphoma. ALCL commonly presents with a mass in the mediastinum, which is a distinguishing feature. This is due to the overexpression of the protein ALK (anaplastic lymphoma kinase) in ALCL, leading to this unique presentation. Option A, primary bone marrow involvement, is more common in other types of lymphomas like acute lymphoblastic leukemia. Option B, intestinal involvement, is typically seen in intestinal lymphomas and not specific to ALCL. Option C, CNS involvement, is more characteristic of primary CNS lymphoma rather than ALCL. In an educational context, understanding these specific manifestations of different types of lymphomas is crucial for accurate diagnosis and appropriate management. By knowing these distinctions, healthcare providers can better interpret clinical presentations and select the most effective treatment strategies. This knowledge enhances patient care and outcomes in pediatric oncology.

Correct Answer: B

Rationale: In the case of a 2-year-old child with a ruptured Wilms tumor, the BEST therapeutic approach is concomitant chemotherapy-radiotherapy (Option B). This approach is the most appropriate because Wilms tumor is a type of kidney cancer that is common in children, and a multidisciplinary treatment plan involving both chemotherapy and radiotherapy has been shown to be effective in managing this condition. Radiotherapy alone (Option A) may not be sufficient to address the extent of the tumor and its potential spread. Another surgery (Option C) would not be the primary treatment at this stage, as the tumor has already ruptured. Observation (Option D) would be inappropriate as immediate intervention is needed to address the tumor and prevent further complications. Educationally, understanding the treatment modalities for pediatric tumors is crucial for healthcare providers working in pediatric oncology. It is essential to recognize the optimal treatment strategies for different types of childhood cancers to provide the best care and outcomes for pediatric patients. By choosing concomitant chemotherapy-radiotherapy in this scenario, healthcare providers can ensure a comprehensive approach to managing Wilms tumor in the child, leading to improved chances of successful treatment and long-term survival.

Correct Answer: C

Rationale: In discussing papillary thyroid carcinoma (PTC) with parents of a 12-year-old girl, the statement that should be included is "supraphysiologic levothyroxine therapy is required during long-term follow-up" (Option C). This is the correct answer because PTC often requires thyroid hormone suppression therapy to prevent recurrence or progression of the disease. Option A is incorrect because PTC generally has a good prognosis with a high survival rate. Option B is incorrect as follicular thyroid carcinoma (FTC), not PTC, may sometimes require radioactive iodine therapy. Option D is incorrect as calcitonin/carcinogenic antigen monitoring is not typically necessary for PTC but may be relevant for other types of thyroid cancer. Educationally, it is important for healthcare providers to understand the nuances of managing thyroid cancer in pediatric patients. By emphasizing the need for supraphysiologic levothyroxine therapy in long-term follow-up, providers can ensure optimal management and outcomes for these young patients. This knowledge helps in providing comprehensive and accurate information to parents, empowering them to make informed decisions regarding their child's healthcare.