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: In this question, the correct answer is A) the prevalence of the disease for those populations is 1.48%. This is because prevalence refers to the total number of individuals with a disease within a population at a specific time. In this case, the prevalence is not provided or calculable from the information given. Option B is incorrect because sensitivity of a test is the ability of the test to correctly identify those with the disease, which is calculated as the true positive rate (20/30 = 67%). Option C is incorrect because specificity of a test is the ability of the test to correctly identify those without the disease, which is calculated as the true negative rate (1820/2000 = 91%). Option D is incorrect because the positive predictive value is the likelihood that a positive test result truly indicates the presence of the disease, which is calculated as true positives / (true positives + false positives) = 20 / (20 + 180) = 10%. In an educational context, understanding concepts like sensitivity, specificity, prevalence, and predictive values is crucial for healthcare professionals to interpret diagnostic test results accurately and make informed clinical decisions. It helps in avoiding unnecessary treatments or missing out on necessary interventions.

Correct Answer: A

Rationale: The most appropriate investigation to clinch the diagnosis in this scenario is A) Bone marrow aspiration. Rationale: - Bone marrow aspiration is necessary to diagnose conditions like aplastic anemia or leukemia, which can present with symptoms of fever, bruises, anemia, and thrombocytopenia in a pediatric patient. - Reticulocyte count (Option B) would help determine if the bone marrow is responding adequately to the anemia but is not the primary investigation to clinch the diagnosis. - Bleeding time (Option C) and PT & APTT (Option D) are more related to assessing coagulation factors and platelet function, which are not the primary concerns in this case of unexplained anemia and thrombocytopenia in a child. Educational Context: Understanding the importance of appropriate diagnostic investigations in pediatric patients is crucial for nurses to provide safe and effective care. In this case, recognizing the significance of bone marrow aspiration in diagnosing serious hematological conditions highlights the need for thorough assessment and diagnostic reasoning skills in pediatric nursing practice.

Correct Answer: B

Rationale: In the context of pediatric nursing, fostering a child's sense of autonomy is crucial for their emotional and psychological well-being. Option B, allowing the child to have a doll for medical play, is the correct choice because it empowers the child to express herself, role-play, and gain a sense of control over her healthcare experience. This activity promotes a sense of independence and reduces anxiety by allowing the child to familiarize herself with medical procedures in a non-threatening way. Option A, allowing the child to choose the time for taking oral antibiotics, while important for promoting autonomy, may not be developmentally appropriate for a 3-year-old due to their limited understanding of time concepts. Option C, allowing the child to administer her own medication, poses safety risks as young children lack the cognitive and motor skills required for accurate dosing. Option D, allowing the child to watch videos, though appropriate for entertainment and distraction, does not directly promote the child's active participation and control over her care. Educationally, understanding the developmental stages of children is essential for providing age-appropriate care that respects their autonomy and promotes positive coping mechanisms during healthcare experiences. By choosing activities that empower children to make choices within safe boundaries, nurses can support their emotional well-being and foster a positive healthcare environment.

Correct Answer: C

Rationale: The best response to the parents' question regarding their 8-day-old's vital signs 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 the normal heart rate range for a neonate. In newborns, a heart rate of 170 beats per minute (bpm) is considered elevated and requires further evaluation by healthcare providers. Option A is incorrect because the blood pressure provided (85/52) is actually low for a neonate, not elevated. Option B is incorrect because the temperature of 99°F is within the normal range for a newborn and is not elevated. Option D is incorrect because a respiratory rate of 44 breaths per minute is also within the normal range for a newborn and not elevated. Educationally, it is important for nursing students to understand the normal vital sign ranges for different age groups, especially neonates, as deviations from these ranges can indicate underlying health issues. Providing accurate information to parents about their child's vital signs helps build trust and ensures appropriate care is provided. Understanding these nuances in vital signs is crucial for pediatric nursing practice.

Correct Answer: C

Rationale: In this question regarding Wilms tumor, option C is correct because Wilms tumor can occur on its own or be associated with congenital anomalies, such as WAGR syndrome. This knowledge is crucial for nurses caring for pediatric patients as it helps in early detection and appropriate management. Option A is incorrect because a Wilms tumor is not referred to as neuroblastoma; neuroblastoma is a separate type of cancer that affects nerve tissue. Option B is incorrect as Wilms tumor is most commonly seen in children under the age of 5, with peak incidence around 3 years old. Option D is incorrect because Wilms tumor is actually a fast-growing tumor originating from the kidneys, not a slow-growing one. Understanding the characteristics of Wilms tumor is important for nurses working in pediatric oncology to provide optimal care, educate families about the condition, and recognize associated anomalies that may impact treatment decisions. Nurses need to be knowledgeable about pediatric cancers to effectively support patients and families through diagnosis, treatment, and survivorship.