Which type of leukemia has been MOST likely developed in a 2-year-old child with Down syndrome in the neonatal period?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) AML M6. The rationale behind this is that children with Down syndrome have a higher risk of developing Acute Myeloid Leukemia (AML) compared to Acute Lymphoblastic Leukemia (ALL) or Chronic Myeloid Leukemia (CML). AML M6, also known as acute megakaryoblastic leukemia, is a type of AML that is more commonly associated with Down syndrome. This specific subtype of AML is characterized by the proliferation of abnormal megakaryoblasts in the bone marrow. Option A) ALL is less likely in this case because children with Down syndrome are more predisposed to AML. Option B) CML is a chronic leukemia and is less common in pediatric patients, especially those with Down syndrome. Option C) AML M1 is another subtype of AML but is not as commonly associated with Down syndrome as AML M6. Educationally, understanding the association between Down syndrome and different types of leukemia is crucial for pediatric nurses as it helps in early detection, appropriate management, and providing comprehensive care to these vulnerable patients. This knowledge also highlights the importance of tailored screening protocols and close monitoring for children with Down syndrome to detect any signs of leukemia early on.

Correct Answer: B

Rationale: The correct answer is B) female infant. Hemangiomas are more common in females, with a female-to-male ratio of about 3:1. This is due to the role of estrogen in the development of these benign tumors. Estrogen has been suggested to promote the growth of hemangiomas, hence the higher prevalence in female infants. Option A) male infant is incorrect as hemangiomas are more commonly seen in females. Option C) infant of diabetic mother is incorrect as there is no established direct link between maternal diabetes and the development of hemangiomas in infants. Option D) infant delivered by cesarean section is incorrect as the mode of delivery does not impact the development of hemangiomas. In an educational context, understanding the risk factors associated with certain conditions, like hemangiomas in this case, is crucial for healthcare providers working with pediatric patients. This knowledge enables healthcare professionals to provide better care, anticipate potential issues, and educate parents about the condition. It also highlights the importance of considering gender-specific factors in pediatric healthcare.

Correct Answer: A

Rationale: The most appropriate nursing intervention for preparing a preschool-aged patient for an injection is option A) allow the patient to administer an injection to a doll. This technique, known as therapeutic play, helps the child understand and become familiar with the procedure in a non-threatening way. Through play, the child can gain a sense of control and mastery over the situation, reducing anxiety and fear associated with the injection. Option B) arranging for the patient to watch a peer receive an injection may inadvertently increase the child's anxiety by witnessing another child in distress. This approach lacks the hands-on involvement and active participation that therapeutic play provides. Option C) having the parents explain the process to the patient may not be as effective as the direct experiential learning gained from administering an injection to a doll. While parental support and education are important, they may not address the child's emotional and psychological needs in the same way that therapeutic play does. Option D) suggesting diversionary activities like singing may help momentarily distract the child, but it does not actively involve the child in the preparation process or address their underlying fears and anxieties about the injection. In an educational context, understanding the rationale behind using therapeutic play in pediatric nursing is crucial for creating a supportive and effective care environment for young patients. By engaging children in hands-on learning experiences that are developmentally appropriate and non-threatening, nurses can help alleviate anxiety, build trust, and empower children to cope with medical procedures in a positive way.

Correct Answer: A

Rationale: In the context of a 6-month-old baby's visuomotor coordination, the BEST implication is the voluntary release of objects (Option A). At this age, babies are developing their fine motor skills and hand-eye coordination. The ability to voluntarily release objects signifies a key milestone in their development, indicating increasing control and coordination over their movements. Option B, comparison ability of small objects, is less relevant in this context as it pertains more to cognitive development rather than visuomotor coordination. While exploring objects (Option C) is important for sensory and cognitive development, it is not directly related to visuomotor coordination, making it a less appropriate choice in this scenario. Autonomy of actions (Option D) is a broad concept that encompasses various aspects of development and is not specific to visuomotor coordination at this age. Educationally, understanding these developmental milestones is crucial for healthcare professionals working with infants and young children. By recognizing the significance of voluntary object release in a 6-month-old, nurses and pediatric healthcare providers can assess and support the child's development appropriately. This knowledge also helps in identifying any potential delays or issues that may require early intervention.

Correct Answer: D

Rationale: The correct answer is D) sleep-onset association disorder. At 4 months old, babies start to develop sleep associations, such as needing to be rocked to sleep. This association can become a behavioral sleep disorder if the baby cannot fall asleep without being rocked. This disorder is common in infants and can lead to sleep disturbances. Option A) early signs of ADHD is incorrect because needing to be rocked to sleep at this age is more likely due to a sleep association issue rather than a sign of ADHD. ADHD typically presents with symptoms of inattention, hyperactivity, and impulsivity, not related to sleep habits. Option B) primary restless legs syndrome is incorrect as this condition is characterized by an uncomfortable sensation in the legs causing an urge to move them, usually worsened at rest and at night. It is not typically associated with needing to be rocked to sleep. Option C) sleep terrors is incorrect as sleep terrors usually occur during non-REM sleep and are more common in older children. Sleep terrors are characterized by sudden awakening with intense fear and confusion, not related to needing to be rocked to sleep. Educationally, understanding common pediatric sleep disorders is crucial for pediatric nurses as they play a vital role in assessing and supporting children's sleep patterns. Recognizing sleep-onset association disorder in infants is important for providing appropriate guidance to parents on sleep hygiene and promoting healthy sleep habits from an early age.