Which is true of a Wilms tumor? (Select all that apply.)

Correct Answer: C

Rationale: In this question about Wilms tumor, option C is correct, while the others are incorrect. Wilms tumor, also known as nephroblastoma, is a type of kidney cancer that primarily affects children. The correct answer, option C, states that it can occur on its own or be associated with congenital anomalies. This is true as Wilms tumor can occur sporadically or in association with certain genetic syndromes like WAGR syndrome. Option A is incorrect because Wilms tumor is not referred to as neuroblastoma. Neuroblastoma is a different type of childhood cancer that arises in immature nerve cells. Option B is incorrect because Wilms tumor is commonly seen in children under the age of 5, not specifically between 2 and 5 years. Option D is also incorrect as Wilms tumor is considered a fast-growing tumor rather than slow-growing, which underscores the importance of early detection and intervention. Educationally, understanding the characteristics and features of pediatric cancers like Wilms tumor is crucial for nurses caring for pediatric patients. Recognizing the signs and symptoms, risk factors, and appropriate nursing interventions for pediatric cancers ensures timely diagnosis and treatment. Nurses play a critical role in supporting children and their families through the challenging journey of cancer diagnosis and treatment, making knowledge of pediatric oncology essential in their practice.

Correct Answer: D

Rationale: In the context of pediatric nursing, understanding the causes of secondary nocturnal enuresis is crucial for providing effective care to children. Secondary nocturnal enuresis refers to the involuntary passage of urine during sleep in a child who previously had established nighttime bladder control. In this scenario, the correct answer is D) psychosocial stressor. Children with secondary nocturnal enuresis may experience psychosocial stressors such as anxiety, emotional disturbances, changes in the family environment, or trauma. These stressors can disrupt the child's normal bladder control mechanisms, leading to bedwetting episodes. Addressing and managing these stressors are essential components of the nursing care plan for a child with secondary nocturnal enuresis. Option A) UTI (urinary tract infection) is not typically associated with secondary nocturnal enuresis unless there are other symptoms present to suggest an infection, such as fever, dysuria, or frequency. Option B) diabetes mellitus and option C) diabetes insipidus are metabolic conditions that may lead to increased urine output but are less likely causes of secondary nocturnal enuresis compared to psychosocial stressors. Educationally, this question highlights the importance of considering psychosocial factors in the assessment and management of pediatric patients with secondary nocturnal enuresis. By understanding the underlying causes, nurses can provide holistic care that addresses both the physical and emotional needs of the child and their family.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) AML M6. Acute Myeloid Leukemia (AML) is the most likely type of leukemia to develop in a 2-year-old child with Down syndrome in the neonatal period. Children with Down syndrome have a higher risk of developing AML compared to other types of leukemia. AML M6 specifically refers to acute erythroleukemia, which is characterized by the presence of both myeloid and erythroid blasts in the bone marrow. Option A, ALL (Acute Lymphoblastic Leukemia), is less likely in this case as Down syndrome is not strongly associated with ALL. Option B, CML (Chronic Myeloid Leukemia), is a chronic leukemia that typically occurs in adults, making it less likely in a 2-year-old child. Option C, AML M1, is a subtype of AML but is less common in children with Down syndrome compared to AML M6. Educationally, understanding the association between Down syndrome and specific types of leukemia is crucial for nursing students caring for pediatric patients. This knowledge helps in early identification, appropriate treatment, and better outcomes for children with Down syndrome who may develop leukemia. It also highlights the importance of personalized care based on both the patient's age and underlying conditions.

Correct Answer: A

Rationale: In this scenario, the best therapeutic approach for the 10-month-old infant with poorly differentiated neuroblastoma and microscopic ipsilateral lymph node involvement is chemotherapy (Option A). Chemotherapy is the preferred treatment for neuroblastoma in young children because it can target cancer cells throughout the body, including those that may have spread beyond the primary tumor site. In this case, the presence of lymph node involvement indicates a higher risk of metastasis, making systemic treatment with chemotherapy crucial. Radiotherapy (Option B) is generally avoided in young children due to the potential long-term side effects on developing tissues and organs. Concomitant chemo-radiotherapy (Option C) may be too aggressive for an infant and can result in serious complications. Chemotherapy followed by radiotherapy (Option D) is not the ideal sequence of treatment in this case as radiotherapy is not the primary choice for neuroblastoma management. Educationally, understanding the rationale behind choosing chemotherapy in pediatric oncology is essential. It highlights the importance of considering age, tumor characteristics, and potential side effects when determining the most appropriate treatment plan for children with cancer. This case emphasizes the importance of individualized, evidence-based care in pediatric oncology to optimize outcomes while minimizing long-term consequences.

Correct Answer: B

Rationale: In understanding the development of hemangiomas in infants, it is important to recognize that the most common risk factor is being a female infant. This is because hemangiomas are more prevalent in girls compared to boys. This gender predisposition is a key factor in the pathogenesis of hemangiomas. Regarding the other options: A) Being a male infant is not a risk factor for the development of hemangiomas, as mentioned earlier, they are more common in female infants. C) Being an infant of a diabetic mother is not a significant risk factor for hemangioma development. While maternal diabetes can have implications for the baby, it is not directly linked to hemangioma development. D) Being delivered by cesarean section is also not a risk factor for hemangioma development. The mode of delivery does not impact the likelihood of developing a hemangioma. In an educational context, understanding the risk factors associated with hemangiomas is crucial for nurses and healthcare providers working with pediatric patients. By knowing that being a female infant is the most common risk factor, healthcare professionals can better assess, monitor, and provide care for infants who may develop hemangiomas. This knowledge can also guide discussions with parents regarding the condition and its management.