You are evaluating a 6-year-old male child with Langerhans cell histiocytosis (LCH); the parents state that the most common site of bone involvement is

Correct Answer: A

Rationale: The correct answer is A) skull. In Langerhans cell histiocytosis (LCH), the most common site of bone involvement in children is the skull. This condition is characterized by the abnormal proliferation of Langerhans cells, leading to the formation of granulomas in various organs, including bones. The skull is a common site due to the high concentration of Langerhans cells in this area. Option B) vertebra is incorrect because while vertebrae can be involved in LCH, they are not the most common site in pediatric cases. Option C) mandible is also incorrect as it is less commonly affected compared to the skull. Option D) pelvis is an uncommon site for bone involvement in LCH in children. In an educational context, understanding the common sites of bone involvement in Langerhans cell histiocytosis is crucial for pediatric nurses to provide comprehensive care to affected children. Recognizing the typical patterns of disease presentation can aid in early diagnosis and appropriate management, emphasizing the importance of knowledge in pediatric nursing practice.

Correct Answer: A

Rationale: The BEST therapeutic approach for the infant with poorly differentiated neuroblastoma and ipsilateral lymph node involvement is chemotherapy (Option A). Neuroblastoma in infants often presents as a highly malignant tumor, and chemotherapy is the primary treatment modality for disseminated disease. In this case, with microscopic lymph node involvement, systemic treatment like chemotherapy is crucial to target potential metastatic disease. Option B (radiotherapy) is not the best initial therapy for neuroblastoma in infants due to their young age and the potential for long-term side effects on developing tissues. Option C (concomitant chemo-radiotherapy) is not typically used as the primary treatment for neuroblastoma. Option D (chemotherapy followed by radiotherapy) may be considered in cases with high-risk features post-chemotherapy, but initial treatment for an infant with neuroblastoma and lymph node involvement would still be chemotherapy. Educationally, understanding the rationale behind treatment decisions in pediatric oncology is vital for nurses caring for pediatric oncology patients. Chemotherapy is often the cornerstone of treatment for pediatric malignancies, and knowing the appropriate sequencing and combination of therapies is crucial for providing safe and effective care to these vulnerable patients.

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.