Nursing Elites

1. A sixteen-year-old boy is diagnosed with osteosarcoma. What information should the nurse know regarding the treatment plan?

• A. Amputation of the affected extremity is rarely necessary.
• B. Intensive radiation is the primary treatment modality.
• C. Treatment usually consists of surgery and chemotherapy.
• D. Bone marrow transplantation is the preferred option for long-term survival.

Correct answer: C

Rationale: Osteosarcoma is typically treated with a combination of surgery and chemotherapy. This approach aims to remove the tumor and reduce the risk of metastasis. Amputation of the affected extremity may be necessary in some cases to ensure complete removal of the tumor. Intensive radiation is not the primary treatment for osteosarcoma, and bone marrow transplantation is not the standard treatment for this type of cancer.

2. The mother of a 6-month-old infant has returned to work and is expressing breast milk to be frozen. She asks for directions on how to safely thaw the breast milk in the microwave. What should the nurse recommend?

• A. Heat only 10 oz or more.
• B. Do not thaw or heat breast milk in a microwave oven.
• C. Always leave the bottle top uncovered to allow heat to escape.
• D. Shake the bottle vigorously for at least 30 seconds after heating.

Correct answer: B

Rationale: Thawing or heating breast milk in a microwave is not recommended because it can create hot spots that may burn the infant and destroy essential nutrients.

3. A school-age child is admitted to the pediatric unit with a vaso-occlusive crisis. Which of these should be included in the nursing plan of care?

• A. Correction of alkalosis
• B. Pain management and administration of heparin
• C. Adequate oxygenation and replacement of factor VIII to correct the sickling
• D. Adequate hydration, oxygenation, and pain management

Correct answer: D

Rationale: The correct answer is D. Vaso-occlusive crises in sickle cell anemia require a comprehensive approach that includes adequate hydration to reduce blood viscosity, oxygenation to prevent further sickling of red blood cells, and aggressive pain management. This approach helps improve tissue perfusion and manage pain effectively. Choices A, B, and C are incorrect. Correction of alkalosis is not a priority in vaso-occlusive crisis management. Administration of heparin is not indicated as it can increase the risk of bleeding in sickle cell patients. Factor VIII replacement is not relevant to sickle cell anemia as it is a treatment for hemophilia, not sickle cell disease.

4. As children grow and develop, their style of play changes. Which play style is seen in the preschooler?

• A. Solitary
• B. Associative
• C. Cooperative
• D. Parallel

Correct answer: B

Rationale: The correct answer is B: Associative. Associative play is common in preschoolers, where children engage in separate activities but interact by sharing toys and talking with each other. This stage is characterized by more social interaction than solitary play (option A), where children play alone without interacting with others. Cooperative play (option C) involves children working together towards a common goal, which is typically seen in older children. Parallel play (option D) is when children play alongside each other but do not actively engage with one another, which is more common in toddlers.

5. What may be a clinical manifestation of failure to thrive (FTT) in a 13-month-old include?

• A. Irregularity in activities of daily living
• B. Preferring solid food to milk or formula
• C. Weight that is at or below the 10th percentile
• D. Appropriate achievement of developmental landmarks

Correct answer: C

Rationale: FTT is characterized by weight that falls below the 10th percentile, often accompanied by delayed developmental milestones and poor feeding habits. Regularity in activities and preference for solid food over milk or formula are less commonly associated with FTT.

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