Which chromosomal abnormality is often characteristic of infantile ALL?

Correct Answer: A

Rationale: In pediatric nursing, understanding chromosomal abnormalities associated with different conditions is crucial for providing comprehensive care to young patients. In this case, the correct answer is option A) t(4;11), which is often characteristic of infantile Acute Lymphoblastic Leukemia (ALL). The translocation t(4;11) results in the fusion of the MLL gene on chromosome 11 with various partner genes, leading to the development of infantile ALL. This genetic abnormality is commonly seen in infants with ALL and has implications for prognosis and treatment planning. Option B) t(12;21) is associated with a better prognosis in pediatric ALL, known as the ETV6-RUNX1 fusion gene. Option C) t(9;22) is characteristic of Chronic Myeloid Leukemia (CML), not infantile ALL. Option D) t(1;19) is associated with pre-B cell ALL in children but is not specific to infantile ALL. Educationally, understanding these chromosomal abnormalities helps nurses and healthcare providers in early identification, appropriate treatment selection, and patient/family education. It enhances clinical reasoning skills and improves patient outcomes through personalized care based on genetic markers.

Correct Answer: D

Rationale: The correct answer is D) liver. When examining an infant with cutaneous hemangiomas, the most common site of visceral involvement is the liver. This is due to the fact that hepatic hemangiomas are the most common type of liver tumor in infancy. The liver has a rich blood supply, making it a common site for hemangiomas to develop. Option A) brain is less common for visceral involvement by hemangiomas compared to the liver. Hemangiomas in the brain can be serious but are not as common as hepatic involvement. Option B) heart is not a common site for visceral involvement by hemangiomas in infants. While heart hemangiomas can occur, they are less frequent than liver involvement. Option C) lung is also less common for visceral involvement by hemangiomas. Pulmonary hemangiomas are rare and not as prevalent as hepatic hemangiomas in infants. Educationally, understanding the common sites of visceral involvement by hemangiomas is crucial for pediatric nurses. Recognizing the most common sites helps in early identification, appropriate monitoring, and timely intervention to ensure optimal patient outcomes. This knowledge enhances the nurse's ability to provide comprehensive care for infants with hemangiomas.

Correct Answer: A

Rationale: In pediatric oncology, understanding chromosomal abnormalities associated with childhood acute lymphoblastic leukemia (ALL) is crucial. The correct answer is A) t(9;22), also known as the Philadelphia chromosome. This abnormality involves a translocation between chromosomes 9 and 22, resulting in the BCR-ABL fusion gene. This genetic alteration leads to a more aggressive disease course and is associated with a higher risk of relapse despite intensive chemotherapy. Option B) t(4;11) refers to the MLL gene rearrangement, which is associated with an intermediate risk of relapse in childhood ALL. While it is a poor prognostic indicator, it does not carry as high a risk of relapse as the Philadelphia chromosome. Option C) hypodiploidy, characterized by fewer than 44 chromosomes, is associated with a very high-risk subtype of childhood ALL. Children with hypodiploidy often have a poor response to therapy but do not specifically carry the highest risk of relapse compared to the Philadelphia chromosome. Option D) t(1;19) refers to the E2A-PBX1 fusion gene. This genetic abnormality is associated with a favorable prognosis in childhood ALL and is not linked to the highest risk of relapse compared to the Philadelphia chromosome. Educationally, understanding the significance of different chromosomal abnormalities in childhood ALL is essential for nurses caring for pediatric oncology patients. Recognizing these genetic markers can help healthcare providers tailor treatment plans, monitor for potential complications, and educate patients and families about the disease course and prognosis.

Correct Answer: A

Rationale: The correct answer is A) age less than 10 years. Pediatric patients under the age of 10 years are more likely to have extraneural metastasis in primary brain tumors due to the higher rate of tumor dissemination in younger age groups. This is because younger patients have a more permeable blood-brain barrier, which allows for easier spread of tumor cells to other parts of the body. Option B) female gender is incorrect because gender is not a significant risk factor for extraneural metastasis in primary brain tumors. Tumor characteristics and age are more influential factors. Option C) ventriculoperitoneal (VP) shunt insertion is not a direct risk factor for extraneural metastasis. While shunt insertion may be associated with certain complications, it is not a primary factor in tumor metastasis. Option D) supratentorial tumor is not the most likely risk factor for extraneural metastasis. Tumor location does play a role in the prognosis and treatment of brain tumors, but age is a more significant factor in predicting extraneural metastasis. In an educational context, understanding the risk factors for extraneural metastasis in pediatric brain tumors is crucial for nurses caring for these patients. Knowledge of these risk factors can guide nursing assessments, patient education, and treatment planning to provide comprehensive care and support for pediatric patients with brain tumors. Regular monitoring and early detection of metastasis risk factors can help improve patient outcomes and quality of life.

Correct Answer: B

Rationale: The correct answer is B) examination under general anesthesia by an experienced ophthalmologist. This procedure is the best confirmatory diagnostic evaluation for retinoblastoma in a 10-month-old infant with a white pupillary reflex. Retinoblastoma is a rare and aggressive eye cancer that primarily affects young children. Diagnosis is often made through a comprehensive eye exam under anesthesia, allowing for a thorough evaluation of the retina to confirm the presence of tumors. This method provides a detailed view of the eye and allows for necessary interventions to be planned accordingly. Option A, indirect ophthalmoscopy with slit-lamp examination, may not provide an adequate view of the entire retina, especially in infants, leading to potential missed diagnoses. Orbital ultrasonography (Option C) may not be as definitive in confirming retinoblastoma as a direct examination. Brain MRI (Option D) is not the primary diagnostic tool for retinoblastoma as it focuses on the brain rather than the eye. In an educational context, understanding the importance of a thorough diagnostic evaluation in pediatric patients is crucial for early detection and intervention in conditions like retinoblastoma. By selecting the correct confirmatory diagnostic test, healthcare providers can ensure timely and appropriate management of the child's condition, ultimately leading to better outcomes and quality of life.