Which statement best reflects the role of the therapeutic relationship in fostering positive behaviors in children?

Correct Answer: A

Rationale: In pediatric nursing, establishing a therapeutic relationship with a child is crucial for fostering positive behaviors and promoting overall well-being. Option A, "It may be used as an intervention strategy to help a child with positive behaviors," is the correct answer because the therapeutic relationship between the nurse and the child forms the foundation for trust, communication, and collaboration. Through this relationship, the nurse can provide support, guidance, and encouragement to help the child develop and maintain positive behaviors. Option B, stating that the relationship with parents or teachers is more important, is incorrect because while the support of parents and teachers is valuable, the unique bond between the nurse and the child plays a significant role in addressing the child's specific healthcare needs and promoting positive behaviors. Option C, suggesting that the therapeutic relationship is not essential for the child's behaviors, is incorrect as well. A positive therapeutic relationship has been shown to improve outcomes in pediatric healthcare by enhancing compliance with treatment plans, reducing anxiety, and promoting emotional well-being. Option D, claiming that children will not pay attention to the therapist, is also incorrect. When a nurse establishes a trusting and supportive relationship with a child, the child is more likely to engage in therapeutic activities and interventions. In the educational context, understanding the importance of therapeutic relationships in pediatric nursing is essential for nurses to provide holistic care to children. By recognizing the impact of these relationships on children's behaviors and well-being, nurses can tailor their interactions to promote positive outcomes and establish a foundation of trust and support with their pediatric patients.

Correct Answer: A

Rationale: In pediatric acute lymphoblastic leukemia (ALL), the chromosomal abnormality t(9;22), also known as the Philadelphia chromosome, carries the highest risk of relapse despite intensive chemotherapy. This is because it is associated with the BCR-ABL fusion gene, which confers a poorer prognosis and resistance to treatment compared to other chromosomal abnormalities. Option B, t(4;11), is associated with MLL rearrangements and has a generally poor prognosis, but it does not carry as high a risk of relapse as t(9;22) in childhood ALL. Option C, hypodiploidy, is also a high-risk feature in childhood ALL, but it does not have as consistently poor outcomes in terms of relapse risk as t(9;22). Option D, t(1;19), is associated with the E2A-PBX1 fusion gene and is considered an intermediate risk factor in childhood ALL. While it may have a higher risk of relapse compared to standard-risk ALL, it is not as high as the risk associated with t(9;22). In an educational context, understanding the impact of specific chromosomal abnormalities on the prognosis of childhood ALL is crucial for healthcare providers involved in the care of pediatric oncology patients. Knowing which abnormalities carry a higher risk of relapse can help guide treatment decisions and monitoring strategies to improve patient outcomes. It also underscores the importance of tailoring treatment approaches based on the molecular characteristics of the leukemia to optimize therapeutic efficacy and minimize the risk of relapse.

Correct Answer: A

Rationale: The correct answer is A) age less than 10 years. In pediatric patients, age less than 10 years is considered a risk factor for extraneural metastasis in primary brain tumors. Younger age is associated with a higher likelihood of tumor spread beyond the central nervous system. Option B) female gender is not a known risk factor for extraneural metastasis in primary brain tumors. Gender does not play a significant role in predicting the likelihood of extraneural spread. Option C) ventriculoperitoneal (VP) shunt insertion is a treatment procedure for managing hydrocephalus and is not directly linked to an increased risk of extraneural metastasis in primary brain tumors. Option D) supratentorial tumor location does not predict extraneural metastasis risk. Tumor location may impact symptoms and treatment options but is not a primary factor in determining the likelihood of metastasis. Educationally, understanding risk factors for extraneural metastasis in pediatric brain tumors is crucial for healthcare providers involved in the care of these patients. This knowledge can guide treatment decisions, surveillance strategies, and discussions with families regarding prognosis and potential outcomes.

Correct Answer: B

Rationale: In this scenario, the best confirmatory diagnostic evaluation for a suspected case of retinoblastoma in a 10-month-old infant is option B: examination under general anesthesia by an experienced ophthalmologist. Retinoblastoma is a serious eye cancer that primarily affects young children. An examination under anesthesia allows for a thorough evaluation of the eye, including detailed visualization of the retina and assessment of the extent of the tumor. This method is crucial in confirming the diagnosis of retinoblastoma as it provides a comprehensive view of the affected eye and allows for necessary interventions to be planned. Option A, indirect ophthalmoscopy with slit-lamp examination, may not provide an adequate view of the entire retina, especially in a young child who may not cooperate fully during the examination. Orbital ultrasonography (option C) may be helpful in some cases but is not as definitive as an examination under anesthesia. Brain MRI (option D) is not the most appropriate test for diagnosing retinoblastoma as it focuses on the brain rather than the eye. In an educational context, understanding the importance of selecting the most appropriate diagnostic test for specific conditions is critical in providing optimal patient care. In the case of retinoblastoma, prompt and accurate diagnosis is essential for initiating timely treatment and improving outcomes for the child. Educating healthcare providers on the significance of specialized evaluations, such as examination under anesthesia by an experienced ophthalmologist, can help ensure proper management of pediatric eye conditions.

Correct Answer: C

Rationale: In this scenario, option C) the infant is at increased risk of hepatoblastoma is the correct statement to include during the discussion. Adenomatous polyposis syndromes, such as familial adenomatous polyposis (FAP), are genetic conditions that predispose individuals to the development of colorectal cancer, particularly colonic adenocarcinoma. Hepatoblastoma, a type of liver cancer, is not directly associated with adenomatous polyposis syndromes. Options A, B, and D are incorrect because they mention different types of cancers that are not typically linked to a family history of adenomatous polyposis. Understanding the specific cancer risks associated with genetic conditions is crucial in pediatric nursing practice to provide accurate information to families and ensure appropriate monitoring and early intervention strategies are in place. By recognizing the increased risk of colonic adenocarcinoma in infants with a family history of adenomatous polyposis, healthcare providers can offer targeted surveillance and potentially life-saving interventions.