You are discussing with medical students the role of chemotherapy in malignant germ cell tumors (GCTs); you state that GCTs are sensitive to some types of chemotherapy. Of the following, the MOST effective chemotherapeutic agent in GCTs is

Correct Answer: C

Rationale: In the context of treating malignant germ cell tumors (GCTs), cisplatin is the most effective chemotherapeutic agent due to its high efficacy against these types of tumors. Cisplatin works by causing DNA damage in rapidly dividing cells, which is a characteristic feature of cancer cells. This mechanism of action makes cisplatin particularly effective in targeting and killing cancer cells in GCTs. Vincristine, although commonly used in pediatric cancers, is not as effective in treating GCTs compared to cisplatin. Vincristine works by disrupting the formation of the mitotic spindle in cancer cells, which is not as specific to GCTs as cisplatin. Cyclophosphamide and methotrexate are also commonly used in pediatric oncology, but they are not the most effective agents for treating GCTs. Cyclophosphamide interferes with DNA replication and cell division, while methotrexate inhibits folic acid metabolism in cancer cells. However, their mechanisms of action are not as targeted towards GCTs as cisplatin. In an educational context, understanding the specific chemotherapeutic agents effective against different types of tumors is crucial for providing optimal care to pediatric patients with cancer. Knowing the mechanisms of action of these agents helps healthcare providers make informed decisions when designing treatment plans tailored to the individual needs of each patient.

Correct Answer: A

Rationale: In this question, the correct answer is A) 2 months. Infants typically achieve early head control with a bobbing motion when pulled to sit around this age. This milestone is part of the normal development of infants as they grow and gain strength in their neck muscles. Option B) 3 months is incorrect because by this age, infants should already have achieved head control and be able to actively lift and control their heads without bobbing when pulled to sit. Option C) 4 months is also incorrect as infants should have well-established head control by this age, and the bobbing motion typically occurs earlier in their development. Option D) 6 months is incorrect as by this age, infants should be able to sit with support and have more advanced head control abilities compared to the bobbing motion seen in younger infants. Understanding these developmental milestones is crucial for nurses taking the NCLEX-RN exam as it helps them assess and monitor infant growth and development. It also enables them to identify any potential delays or issues that may need further evaluation or intervention. By knowing these milestones, nurses can provide appropriate care and support to promote optimal development in pediatric patients.

Correct Answer: B

Rationale: The correct answer is B) molar at 6 years. In pediatric dentistry, the first permanent teeth to erupt are the first molars, typically around 6 years of age. These molars are also known as the "6-year molars." This is a critical milestone in a child's dental development as it marks the transition from primary (baby) teeth to permanent teeth. Option A) central incisor at 6 years is incorrect because central incisors are typically the first primary teeth to erupt, not permanent teeth. Option C) premolar lower canine at 6-7 years and D) upper canine at 6-7 years are also incorrect as premolars and canines are typically the second set of permanent teeth to erupt, usually around 10-12 years of age. Understanding the sequence of tooth eruption is important for healthcare professionals, especially pediatric nurses, to provide appropriate anticipatory guidance to parents and caregivers. Knowing the expected timeline of tooth eruption helps in monitoring dental development and identifying any potential issues early on. It also aids in educating parents on proper oral hygiene practices and the importance of regular dental check-ups for their children.

Correct Answer: B

Rationale: The correct answer is B) spastic cerebral palsy. Spastic cerebral palsy is the most common type, affecting around 70-80% of individuals with cerebral palsy. This type is characterized by muscle stiffness and tightness, affecting the ability to move and control limbs. Ataxic cerebral palsy (Option A) is characterized by poor coordination and balance issues, but it is less common than spastic cerebral palsy. Dystonic cerebral palsy (Option C) involves involuntary muscle contractions leading to twisting and repetitive movements. Dyskinetic cerebral palsy (Option D) includes both dystonic and choreoathetoid movements. Understanding the different types of cerebral palsy is crucial for nurses, especially those working with pediatric patients. Recognizing the specific characteristics of each type helps in providing appropriate care and interventions tailored to the individual's needs. In the case of spastic cerebral palsy, interventions may focus on managing muscle tone, improving mobility, and enhancing quality of life for the child and their family.

Correct Answer: E

Rationale: The correct approach to the treatment of a 2-year-old who ingested kerosene and is presenting with symptoms like coughing and tachypnea is to provide supportive care and manage symptoms. Therefore, the best approach is not listed among the options provided. In this scenario, immediate medical attention is crucial to address potential respiratory distress and prevent further complications. Option A) inducing emesis is not recommended due to the risk of aspiration, which can worsen the respiratory symptoms and cause additional harm. Option B) performing nasogastric tube lavage is invasive and not typically indicated in cases of hydrocarbon ingestion. Option C) instilling mineral oil is not supported by evidence and may lead to aspiration or other complications. Option D) administering steroids is not indicated in the acute management of hydrocarbon ingestion in a pediatric patient. Educationally, this question highlights the importance of recognizing the dangers of hydrocarbon ingestion in children and the need for prompt and appropriate medical intervention in such cases. It emphasizes the critical role of healthcare providers in managing pediatric emergencies effectively and underscores the significance of evidence-based practice in pediatric care.