You are examining a 12-year-old female adolescent with a small nevus in the thigh; the mother is concerned regarding the future development of melanoma. All the following findings raise suspicion of melanoma EXCEPT

Correct Answer: E

Rationale: In this scenario, the correct answer is "Easily bleeds" (Option D) as it is the finding that does not raise suspicion of melanoma in a nevus. Explanation: A) An enlarging nevus (Option A) raises suspicion of melanoma as rapid growth can be a sign of malignancy. B) Changing colors (Option B) in a nevus can indicate melanoma as irregular or multiple colors are concerning. C) Irregular margins (Option C) are also a red flag for melanoma as well-defined borders are typical of a benign nevus. Educational Context: It is crucial for healthcare providers, especially pediatric nurses, to be able to differentiate between benign nevi and potentially malignant melanomas. Understanding the key characteristics that raise suspicion of melanoma, such as changes in size, color, and margins, is essential for early detection and appropriate management. By recognizing the concerning features and knowing which findings do not typically indicate melanoma, healthcare professionals can provide accurate information to parents and ensure timely referrals for further evaluation if needed. This knowledge is vital in pediatric care to promote early intervention and improve outcomes for children at risk for skin malignancies.

Correct Answer: D

Rationale: In neuroblastoma, metastatic spread can occur via local invasion or distant hematogenous/lymphatic routes. The LEAST common site of metastases in neuroblastoma is the skin (Option D). The correct answer is D because neuroblastoma typically metastasizes to organs such as the bone marrow, long bones, and lungs due to the nature of the disease. Skin metastases are rare in neuroblastoma compared to other sites. Option A (long bone) is a common site of metastasis in neuroblastoma due to the rich blood supply and bone marrow content, making it a favorable environment for tumor spread. Option B (bone marrow) is also a common site of metastasis as neuroblastoma is an embryonal cancer arising from neural crest cells that can infiltrate the bone marrow. Option C (lung) is another common site of metastasis in neuroblastoma as the lungs receive a high volume of blood flow, allowing cancer cells to potentially spread there. Educationally, understanding the patterns of metastatic spread in neuroblastoma is crucial for nurses preparing for the NCLEX RN Pediatric exam. This knowledge helps in early detection, appropriate staging, and treatment planning for pediatric patients with neuroblastoma. It also highlights the importance of comprehensive assessments and vigilant monitoring for signs of metastases in these patients.

Correct Answer: C

Rationale: In the treatment of malignant germ cell tumors (GCTs), cisplatin is the most effective chemotherapeutic agent. This is because cisplatin is a platinum-based chemotherapy drug that has shown high efficacy in treating GCTs by disrupting DNA synthesis in rapidly dividing cancer cells, leading to cell death. Vincristine (Option A) is not as effective in GCTs compared to cisplatin, as it primarily acts by disrupting microtubule function and is more commonly used in other types of cancers. Cyclophosphamide (Option B) is an alkylating agent that is less specific to GCTs and is not considered the first-line treatment for this type of cancer. Methotrexate (Option D) is a folate antagonist that is also not as effective as cisplatin in treating GCTs. In an educational context, it is important for medical students to understand the mechanism of action of different chemotherapeutic agents and their specific applications in various types of cancers. Understanding the rationale behind choosing cisplatin over other agents for treating GCTs helps students grasp the principles of personalized medicine and evidence-based practice in oncology.

Correct Answer: C

Rationale: In this scenario, option C is correct because post-hydrocele repair, it is normal for the scrotum to be swollen and discolored due to the inflammatory response triggered by the surgical procedure. This swelling and discoloration are expected and typically resolve on their own without the need for intervention. Option A is incorrect because applying a cool compress may not be necessary and could potentially interfere with the body's natural healing process. Option B is incorrect because while hemorrhaging is a concern postoperatively, swelling and discoloration alone do not definitively indicate hemorrhaging without other accompanying signs such as significant pain or changes in vital signs. Option D is incorrect as the need for a position change is not relevant to the findings described in the scenario. Educationally, understanding the normal postoperative course following a hydrocele repair is essential for pediatric nurses to provide safe and effective care to patients. Recognizing expected outcomes helps nurses differentiate between normal healing processes and complications, enabling timely interventions when necessary. It also promotes patient and family education, reassuring them about common postoperative changes and reducing anxiety.

Correct Answer: A

Rationale: Early head control is an important milestone in infant development as it signifies the strengthening of neck muscles and the beginning of postural control. Infants typically achieve early head control with a bobbing motion when pulled to sit around 2 months of age. At this stage, infants are able to briefly support their head and neck against gravity, showing signs of muscle strength and control. Option A, 2 months, is the correct answer because it aligns with the expected developmental timeline for achieving early head control. Infants at 2 months are beginning to develop the necessary muscle strength to lift and control their heads in response to external stimuli. Options B, C, and D are incorrect as they fall outside the typical age range for achieving early head control. By 3 months, infants may start to exhibit more head control but not the specific bobbing motion described in the question. At 4 and 6 months, infants are further along in their development and should have more robust head control, making the bobbing motion less pronounced. Understanding infant developmental milestones is crucial for healthcare professionals working with pediatric populations, including nurses preparing for the NCLEX RN exam. By recognizing these milestones, nurses can assess infant growth and development, identify potential delays or concerns, and provide appropriate interventions and support for optimal outcomes.