The nurse should include which of the following in preprocedure teaching for a patient scheduled for carotid angiography?

Correct Answer: C

Rationale: It is important for the nurse to include in preprocedure teaching for a patient scheduled for carotid angiography the information that the patient may feel a burning sensation when the dye is injected. This information helps prepare the patient for a common sensation during the procedure, reducing anxiety and promoting patient understanding and cooperation. Providing this education enhances the patient's overall experience and enables them to better cope with the procedure. The other options are not accurate or complete in providing necessary preprocedure information for the patient.

Correct Answer: A

Rationale: The best initial action for the nurse to take when a client is experiencing hyperventilation is to try to have the client breathe slower. This is because hyperventilation is often caused by rapid, shallow breathing and slowing down the breathing pattern can help restore normal gas exchange and alleviate symptoms. Providing oxygen via a nasal cannula or administering sodium bicarbonate would not directly address the underlying issue of hyperventilation. Monitoring fluid balance is important for overall assessment but not the priority when dealing with acute respiratory distress due to hyperventilation.

Correct Answer: C

Rationale: In pediatric primary care, enuresis (bedwetting) is a common concern. The correct answer is C) urinalysis. This test is recommended for most children with enuresis because it helps to rule out urinary tract infections, diabetes insipidus, and other urinary tract abnormalities that could be contributing to the bedwetting. Option A) blood sugar is not the most appropriate test for evaluating enuresis unless there are specific symptoms or risk factors indicating the need for assessing blood glucose levels. Option B) serum electrolytes are also not routinely indicated for evaluating enuresis unless there are specific concerns such as dehydration or electrolyte imbalances. Option D) abdominal sonography is not typically recommended as an initial test for enuresis unless there are specific signs or symptoms suggesting the need for evaluating the abdominal organs. Educationally, understanding the rationale behind the recommended tests for enuresis in children is crucial for primary care providers to make informed decisions regarding the diagnostic workup of this common pediatric issue. By knowing when to order a urinalysis and when other tests are not necessary, healthcare professionals can provide efficient and effective care for children experiencing enuresis.

Correct Answer: A

Rationale: In this case, the correct approach is option A) intensive chemotherapy. Acute myeloproliferative disorder in a 20-day-old infant with elevated white blood count, anemia, and blast cells indicates a need for aggressive treatment to target the rapidly proliferating abnormal cells. Intensive chemotherapy aims to reduce the abnormal cell burden quickly, restore normal blood cell production, and improve outcomes. Option B) low dose chemotherapy pulses may not be sufficient to effectively target the aggressive nature of acute myeloproliferative disorder in this scenario. Bone marrow transplantation (option C) is not typically the first-line treatment for acute myeloproliferative disorders in infants and carries significant risks. Close follow-up (option D) is inadequate given the severity of the condition and the need for immediate intervention. From an educational perspective, understanding the rationale behind treatment decisions in pediatric oncology is crucial for healthcare providers working in primary care settings. It is essential to grasp the urgency of appropriate management strategies in pediatric oncology to optimize patient outcomes and prevent disease progression. This case underscores the importance of prompt recognition and treatment of hematologic disorders in infants to ensure the best possible prognosis.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) stage IV S. This infant's presentation aligns with stage IV neuroblastoma according to the international neuroblastoma staging system. The presence of a massive abdominal mass, subcutaneous nodules, bone marrow involvement, and absence of N-myc oncogene amplification are indicative of a high-risk, advanced-stage disease. Option A) stage I is incorrect because this stage is characterized by a localized tumor without dissemination. Option B) stage II A is also incorrect as it involves unilateral tumor with incomplete resection. Option C) stage III is not applicable as it typically includes unresectable tumor in patients older than 1 year. Educationally, understanding the staging of neuroblastoma is crucial for healthcare providers working in pediatric care. Recognizing the features associated with each stage is vital for appropriate risk stratification, treatment planning, and prognostication. This case underscores the importance of considering multiple factors in determining the stage of neuroblastoma to guide optimal management strategies.