The nurse will assess a loss of ability in which of the following areas?

Correct Answer: A

Rationale: The nurse will assess a loss of ability in the area of balance. Balance is an essential component of the physical function that allows individuals to maintain an upright posture and stability during movement. A loss of balance can significantly impact a person's mobility, coordination, and safety. Nurses often assess balance as part of their evaluations to identify any impairments that may affect a patient's independence and daily activities.

Correct Answer: C

Rationale: Before drawing blood from a central venous catheter like a Hickman type, it is essential to ensure that the catheter is patent and free of any clots. Flushing the catheter with a heparinized solution (to prevent clot formation) before withdrawing blood helps clear the catheter and ensures accurate blood sample collection. Removing clots or obstructions from the catheter is crucial to prevent complications and maintain the catheter's function. Therefore, it is important to first flush the catheter with a heparinized solution before drawing blood from it.

Correct Answer: D

Rationale: The correct answer is D) retinoblastoma. Retinoblastoma is least likely to occur in adults compared to children because it is a rare childhood eye cancer that typically affects children under the age of 5. This malignancy arises from the retina and is caused by genetic mutations. A) Acute Lymphoblastic Leukemia (ALL) is a common type of leukemia that can occur in both children and adults. It is more prevalent in children but can also affect adults. B) Osteosarcoma is a type of bone cancer that primarily occurs in children and young adults during periods of rapid bone growth. It is rare in older adults. C) Medulloblastoma is a type of brain cancer that mainly affects children, with peak incidences between 3-4 years old. It is very rare in adults. Educationally, understanding the age-specific prevalence of different malignancies is crucial for healthcare providers, especially those working with pediatric populations. Recognizing the typical age of onset for various cancers helps in early detection, diagnosis, and appropriate management. This knowledge enhances patient care and outcomes by enabling healthcare professionals to provide targeted and specialized care based on the specific needs of pediatric patients.

Correct Answer: D

Rationale: In this case, the correct answer is D) stage IIB. The Ann Arbor Staging system is commonly used to stage Hodgkin lymphoma based on the extent of the disease. In this system, stage I indicates involvement of a single lymph node region or a single extralymphatic organ, while stage II indicates involvement of two or more lymph node regions on the same side of the diaphragm. The additional letter (A or B) indicates the absence (A) or presence (B) of certain symptoms like fever, weight loss, or night sweats. Given that the patient in the question has left cervical and supraclavicular lymph node involvement and drenching night sweats, this corresponds to stage IIB. The presence of lymph node involvement on both sides of the diaphragm classifies the patient as stage II, and the presence of B symptoms (night sweats) further categorizes the patient as stage IIB. The other options are incorrect because they do not accurately reflect the extent of the disease in this particular case. Option A (stage IA) and B (stage IB) suggest limited disease involvement, while option C (stage IIA) would indicate involvement of lymph node regions on the same side of the diaphragm without B symptoms, which does not align with the presented scenario. Educationally, understanding the Ann Arbor Staging system is essential for nurses caring for pediatric patients with Hodgkin lymphoma. This knowledge helps determine the extent of the disease, guide treatment decisions, and monitor response to therapy. It also underscores the importance of recognizing specific symptoms that can impact staging and prognosis in pediatric oncology patients.

Correct Answer: E

Rationale: In the context of pediatric oncology and Wilms tumor, the correct answer is E) none of the above. Wilms tumor, a common childhood kidney cancer, typically presents as a painless abdominal mass. Biopsy is generally contraindicated in suspected cases of Wilms tumor due to the risk of seeding cancer cells during the procedure. Option A) age of 2-3 years is incorrect because Wilms tumor commonly affects children in this age group. Option B) signs of inflammation or infection is incorrect as these are not contraindications for biopsy in suspected Wilms tumor cases. Option C) significant lymph node enlargement radiologically is incorrect as it may be present in cases of advanced Wilms tumor and does not preclude the need for further investigation. Option D) intratumoral calcification radiologically is also not a contraindication for biopsy in suspected Wilms tumor cases. Educationally, it is important for healthcare providers to understand the diagnostic approach to pediatric tumors like Wilms tumor to ensure appropriate management and avoid unnecessary risks associated with biopsies in these cases. Biopsies can lead to complications and should be avoided when clinical and radiological findings strongly suggest Wilms tumor.