The nurse would monitor the client for which of the following?

Correct Answer: A

Rationale: Trousseau's sign is a clinical sign characterized by carpal spasm induced by inflating a blood pressure cuff above the systolic pressure for a few minutes. It is indicative of hypocalcemia, specifically low calcium levels in the blood. Therefore, the nurse would monitor the client for Trousseau's sign to assess for potential hypocalcemia. This could prompt the healthcare provider to order further diagnostic tests or interventions to address the underlying calcium imbalance. Options B, C, and D do not directly relate to monitoring for Trousseau's sign.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) AML M6. Acute Myeloid Leukemia (AML) subtype M6, also known as erythroleukemia, is most commonly associated with Down syndrome in children. Children with Down syndrome have a higher risk of developing AML compared to other types of leukemia. This subtype presents in the neonatal period and is more prevalent in this specific population. Option A) ALL (Acute Lymphoblastic Leukemia) is less commonly associated with Down syndrome, making it less likely in this case. Option B) CML (Chronic Myeloid Leukemia) is also less common in children, especially in the neonatal period. Option C) AML M1 is not typically seen in infants with Down syndrome, as AML M6 is the more common subtype associated with this population. Educationally, understanding the specific types of leukemia associated with certain populations, such as children with Down syndrome, is crucial for healthcare providers. This knowledge aids in early identification, appropriate treatment, and better outcomes for patients. By linking specific subtypes to certain populations, healthcare professionals can tailor their care and monitoring effectively.

Correct Answer: A

Rationale: In the case of a 10-month-old boy with a poorly differentiated neuroblastoma and microscopic ipsilateral lymph node involvement, the BEST therapeutic approach is chemotherapy (Option A). The rationale behind this choice lies in the fact that neuroblastoma is a highly chemo-sensitive tumor in children. Chemotherapy is the preferred initial treatment as it can target cancer cells throughout the body, including those that may have spread beyond the primary tumor site. In this case, the microscopic lymph node involvement indicates the potential for spread, making systemic treatment like chemotherapy crucial. The other options are suboptimal for several reasons: - Radiotherapy (Option B) is generally avoided in young children due to the potential for long-term side effects on developing organs and tissues. - Concomitant chemo-radiotherapy (Option C) may be too aggressive for an infant and is not the standard of care for this type of cancer in this age group. - Chemotherapy followed by radiotherapy (Option D) is not recommended as upfront chemotherapy is the preferred initial treatment for neuroblastoma to target systemic disease. In an educational context, understanding the rationale behind treatment choices in pediatric oncology is crucial for nurses caring for pediatric cancer patients. It is essential to prioritize treatments that offer the best chance of cure while minimizing long-term side effects, especially in young patients where organ development is ongoing. This question highlights the importance of tailoring treatment plans to the specific characteristics of pediatric cancers to optimize outcomes.

Correct Answer: B

Rationale: The correct answer is B) female infant. Hemangiomas are more common in female infants. This is due to the influence of estrogen, as estrogen has been shown to promote the growth of hemangiomas. Female infants have higher levels of estrogen compared to male infants, which predisposes them to developing hemangiomas. Option A) male infant is incorrect because, as mentioned, hemangiomas are more common in female infants. Option C) infant of diabetic mother is incorrect as there is no direct association between diabetes in the mother and the development of hemangiomas in the infant. Option D) infant delivered by cesarean section is incorrect because the mode of delivery does not impact the development of hemangiomas. In an educational context, understanding the risk factors associated with hemangiomas is crucial for nursing students caring for pediatric patients. This knowledge allows nurses to provide appropriate care and education to families of infants with hemangiomas. Understanding the role of estrogen in the development of hemangiomas is important in assessing and managing these benign tumors effectively.

Correct Answer: C

Rationale: In pediatric oncology, Acute Lymphoblastic Leukemia (ALL) is the most common type of childhood cancer. Understanding the factors that contribute to poor outcomes in children with ALL is crucial for providing effective care. Option C, hyperdiploidy chromosomal abnormality, is not associated with a poor outcome in children with ALL. In fact, hyperdiploidy is considered a favorable prognostic factor, as it is linked to a better response to treatment and improved survival rates. On the other hand, options A, B, and D are all factors that can contribute to a poor outcome in children with ALL. Children younger than 1 year or older than 10 years tend to have a less favorable prognosis due to the challenges in treatment and higher risk of complications. T-cell immunophenotype is associated with a poorer response to standard ALL therapy, leading to a higher risk of relapse. An initial leukocyte count of > 50,000 is indicative of high disease burden and is linked to a poorer prognosis. Educationally, knowing these risk factors helps healthcare providers tailor treatment plans and support strategies for children with ALL. By understanding the impact of different factors on outcomes, healthcare professionals can optimize care and improve the chances of successful treatment for their pediatric patients with ALL.