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 E, which is not listed in the options provided. However, to address the question within the given options: A) An enlarging nevus could be indicative of melanoma as melanomas often grow in size over time. B) Changing colors in a nevus can also be a sign of melanoma as it may indicate irregular pigment distribution. C) Irregular margins on a nevus are concerning for melanoma as well, as melanomas often have uneven or blurred borders. D) A nevus that easily bleeds is a worrisome sign as melanomas can be fragile and prone to bleeding. In this case, the option "D) easily bleeds" would raise suspicion of melanoma. Melanomas are known to be fragile and can bleed easily upon minor trauma. Therefore, the correct option in this context would be D. Educational context: It is crucial for healthcare providers to be aware of the signs and symptoms of skin conditions, especially melanoma, in pediatric patients. Recognizing concerning features in nevi can aid in early detection and appropriate management of potential skin cancers, emphasizing the importance of regular skin assessments and patient education on skin health and cancer prevention.

Correct Answer: D

Rationale: In neuroblastoma, the LEAST common site of metastases is the skin (Option D). This is because neuroblastoma typically metastasizes to sites such as the long bones (Option A), bone marrow (Option B), and lungs (Option C) before involving the skin. Metastases to the long bones are common due to their rich vascular supply, making them a favorable site for tumor spread. Bone marrow involvement is also common in neuroblastoma due to its hematopoietic nature and proximity to the primary tumor site. Additionally, neuroblastoma frequently metastasizes to the lungs, likely due to the direct hematogenous spread from the primary tumor. Understanding the pattern of metastases in neuroblastoma is crucial for nurses preparing for the NCLEX RN exam as it helps in differentiating between common and uncommon sites of spread. This knowledge can aid in early detection of metastatic disease and appropriate treatment planning for pediatric patients with neuroblastoma.

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: C

Rationale: The correct answer is C) normal, and indicate no need for intervention. In a pediatric patient who has undergone a hydrocele repair, swelling and discoloration of the scrotum are expected postoperative findings. This is due to the surgical procedure and the body's natural response to trauma. It is essential for the nurse to recognize these expected postoperative changes to provide appropriate care and prevent unnecessary interventions. Option A) suggesting the need for a cool compress is incorrect because applying cold therapy to the scrotum can potentially cause vasoconstriction and impair blood flow, which is not advisable in this situation. Option B) indicating the presence of hemorrhaging is incorrect as some degree of swelling and discoloration is normal after a hydrocele repair and does not necessarily indicate hemorrhage. Option D) stating the need for a position change is also incorrect as the swelling and discoloration in this case do not require a change in position but rather observation and reassurance to the patient and family. Educationally, understanding the expected postoperative findings following specific pediatric procedures is crucial for providing safe and effective nursing care. This knowledge helps nurses differentiate between normal and abnormal findings, thus guiding appropriate interventions and preventing unnecessary alarm or actions that could potentially harm the 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.