Tumor lysis syndrome is a common complication during treatment of pediatric malignancies. Which malignancy is more likely to manifest such complication?

Correct Answer: D

Rationale: Tumor lysis syndrome (TLS) is a potentially life-threatening complication that can occur during the treatment of malignancies due to the rapid breakdown of cancer cells leading to metabolic imbalances. In pediatric oncology, Burkitt lymphoma is more likely to manifest TLS compared to other malignancies listed. Burkitt lymphoma is a highly proliferative and fast-growing cancer, characterized by rapid cell turnover. When treatment is initiated, the massive destruction of tumor cells can overwhelm the body's ability to clear the metabolic byproducts, leading to TLS. This is why option D (Burkitt lymphoma) is the correct answer. The other options can be eliminated as they are less commonly associated with TLS in pediatric patients. Acute myelogenous leukemia (AML) and nephroblastoma are not typically linked to TLS due to differences in their pathophysiology and cell turnover rates. Neuroblastoma, although it can cause tumor lysis, is less likely to result in TLS compared to Burkitt lymphoma due to differences in tumor burden and cell turnover dynamics. Understanding which malignancies are more prone to TLS is crucial for pediatric nurses caring for oncology patients. Recognizing the predisposing factors can help in early identification, prompt management, and prevention of TLS-related complications, ultimately improving patient outcomes.

Correct Answer: D

Rationale: In pediatric oncology, understanding prognostic factors in Wilms tumor is crucial for providing optimal care. In this scenario, the correct answer is D) young age at diagnosis. This is because younger age at diagnosis is actually associated with a more favorable prognosis in Wilms tumor, contrary to the other options. Option A) large tumors are considered an adverse prognostic factor in Wilms tumor due to increased risk of metastasis and complications. Option B) anaplastic histology is associated with a poorer prognosis as it indicates a more aggressive form of the tumor. Option C) loss of heterozygosity at chromosome 1p and 16q is also a negative prognostic factor in Wilms tumor. Educationally, it is important for nurses caring for pediatric oncology patients to be aware of these prognostic factors to assist in providing comprehensive care, educating families, and understanding the treatment implications based on these factors. Understanding these nuances helps nurses in advocating for their young patients and supporting families through the complexities of cancer treatment.

Correct Answer: D

Rationale: In pediatric nursing, understanding the manifestations of cutaneous hemangiomas and their potential internal organ involvement is crucial for providing optimal care. The correct answer, option D - liver, is the most common site of visceral involvement by hemangiomas in infants. This is due to the fact that the liver is a common location for hemangiomas to develop internally, leading to potential complications such as hepatic dysfunction or hemodynamic disturbances. Option A - brain, may seem plausible due to the serious nature of brain involvement, but in reality, visceral hemangiomas rarely affect the brain compared to the liver. Option B - heart, is less common than liver involvement and typically presents with different clinical signs. Option C - lung, is also less common than liver involvement in cases of visceral hemangiomas. Educationally, this question reinforces the importance of recognizing patterns of visceral involvement in infants with cutaneous hemangiomas. Understanding the common sites of internal organ involvement helps nurses and healthcare providers to monitor and manage these patients effectively, ensuring early detection and intervention when necessary. It also highlights the need for a comprehensive assessment approach in pediatric nursing to address both visible and potential internal manifestations of various conditions.

Correct Answer: E

Rationale: In this scenario, the correct answer is option E, none of the findings raise suspicion of melanoma. This question assesses the student's understanding of the characteristics of melanoma in pediatric patients. Explanation: A) An enlarging nevus is concerning as it can be a sign of melanoma. Melanomas often grow in size over time. B) Changing colors in a nevus can be indicative of melanoma. Variegated colors are a warning sign. C) Irregular margins are a classic feature of melanoma. Well-defined borders are typical of benign nevi. D) A nevus that easily bleeds can be a sign of melanoma, as melanomas are prone to bleeding due to their abnormal blood supply. Educational context: It is crucial for pediatric nurses to recognize the signs of potential skin malignancies like melanoma in children. Understanding the specific characteristics of melanoma helps in early detection and intervention, leading to better outcomes for patients. Nurses play a key role in educating parents about monitoring moles and seeking medical evaluation if concerning changes are noted. This question reinforces the importance of vigilance and knowledge in pediatric dermatological assessments.

Correct Answer: C

Rationale: The correct answer is C) the patient can receive volume expanders. In the scenario described, the parents' religious beliefs prohibit blood transfusions. As a pediatric nurse, it is crucial to respect the parents' beliefs while also ensuring the best care for the child. Volume expanders are a suitable alternative to blood transfusions in cases where increasing the circulating blood volume is necessary. They help maintain blood pressure and tissue perfusion without violating the parents' wishes. Option A is incorrect because in an emergency situation where immediate intervention is required to save the child's life, parental consent may not be necessary, but it is important to respect the parents' beliefs whenever possible. Option B is incorrect as it imposes a specific restriction on blood donation sources, which may not align with the parents' preferences or beliefs. As an educator, it is essential to teach nursing students about the importance of cultural and religious sensitivity in providing care to pediatric patients and involving families in decision-making processes to the extent possible while ensuring patient safety and well-being.