You are assigned to evaluate the outcome of fecal occult blood test as a screening test for patients with bowel cancer. The total number of patients who underwent the test is 2030; in those whom the disease is confirmed are 30. The results of fecal occult blood test are as follows: in 20 patients who has a confirmed bowel cancer (truly positive), and in 180 patients who don't have the disease (falsely positive); in 10 patients who truly has the disease (falsely negative), and in 1820 patients who are not affected by the disease (truly negative). All the following statements are true EXCEPT

Correct Answer: A

Rationale: The correct answer is A) the prevalence of the disease for those population is 1.48%. This statement is incorrect because the prevalence of the disease is not calculated based on the results of the screening test but on the total number of individuals in the population who actually have the disease, regardless of the test results. Option B) the sensitivity of the test is 67% is correct because sensitivity measures the ability of the test to correctly identify those with the disease (true positive rate). Option C) the specificity of the test is 91% is correct because specificity measures the ability of the test to correctly identify those without the disease (true negative rate). Option D) the positive predictive value is 20% is correct because positive predictive value indicates the probability that individuals with a positive test result actually have the disease. Educationally, understanding these concepts is crucial for healthcare professionals to interpret diagnostic test results accurately and make informed decisions regarding patient care. Sensitivity, specificity, and predictive values are essential parameters in evaluating the performance of diagnostic tests and are fundamental in clinical practice.

Correct Answer: A

Rationale: The most appropriate investigation to clinch the diagnosis in this scenario is option A) Bone marrow aspiration. In a 10-year-old girl presenting with fever, bruises, pallor, low Hb, low TLC, and low platelets, the clinical picture is suggestive of a hematologic disorder such as aplastic anemia, leukemia, or immune thrombocytopenic purpura (ITP). Bone marrow aspiration is crucial in diagnosing these conditions as it allows for the assessment of the bone marrow cellularity, morphology, and presence of abnormal cells. In this case, it can help identify the underlying cause of the pancytopenia and thrombocytopenia seen in the patient. The other options (B) Reticulocyte count, (C) Bleeding time, and (D) PT and APTT are not the most appropriate investigations in this context. Reticulocyte count is useful in evaluating bone marrow response to anemia, bleeding time assesses platelet function, and PT and APTT are coagulation studies. However, given the clinical presentation of pancytopenia and thrombocytopenia, bone marrow aspiration is the investigation of choice to determine the underlying hematologic disorder. In an educational context, understanding the rationale behind selecting the appropriate investigation based on the clinical presentation is essential for nurses to provide safe and effective care to pediatric patients. It highlights the importance of critical thinking, clinical reasoning, and evidence-based practice in nursing assessment and decision-making.

Correct Answer: B

Rationale: In this scenario, the correct action to foster the child's sense of autonomy is option B, allowing the child to have a doll for medical play. This choice promotes the child's independence and control over her healthcare experience. Giving the child a doll for medical play allows her to mimic and process her hospitalization experience, empowering her to express emotions and gain a sense of mastery over the situation. Option A, allowing the child to choose the time for oral antibiotics, may not be developmentally appropriate for a 3-year-old as it involves complex decision-making that may cause anxiety rather than promote autonomy. Option C, allowing the child to self-administer medication, is unsafe due to the child's young age and lack of proper understanding of medication administration. Option D, allowing the child to watch videos, does not directly involve the child in her care or promote her active participation and autonomy. Educationally, understanding the importance of fostering autonomy in pediatric care is crucial for nurses. Children need opportunities to make choices and participate in their care to develop a sense of control and confidence. Providing developmentally appropriate activities like medical play can have a positive impact on a child's hospital experience and overall well-being.

Correct Answer: C

Rationale: The best response to the parents' inquiry is option C: "The heart rate is elevated; normal for a neonate is 90-160 bpm." This response is correct because it provides accurate information about normal vital signs for a neonate. In pediatrics, it is crucial to understand the normal vital sign ranges for different age groups to identify deviations early and intervene promptly. Option A is incorrect because the blood pressure provided falls within the normal range for a neonate. Option B is incorrect as the temperature of 99°F is within the normal range for an infant. Option D is also incorrect as a respiratory rate of 44 is within the normal range for a neonate. Educationally, this question highlights the importance of knowing normal vital sign ranges for pediatric patients. Understanding these ranges enables healthcare providers to assess and monitor patients effectively, leading to early detection of abnormalities and timely interventions to ensure optimal patient outcomes. This rationale emphasizes the significance of accurate assessment and interpretation of vital signs in pediatric nursing practice.

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.