A 2 year old patient presents to the pediatric emergency room with pallor, fatigue, petechiae, and unexplained fevers on and off for 4 weeks. The CBC shows an elevated white blood cell count. The blood smear shows a highly elevated number of Lymphoblasts. The nurse would suspect this type of pediatric cancer.
Acute Lymphoblastic Leukemia (ALL)
Hodgkin's Lymphoma
Acute Myelogenous Leukemia (AML)
Non-Hodgkin's Lymphoma
The Correct Answer is A
Rationale:
A. Acute Lymphoblastic Leukemia (ALL): ALL is the most common pediatric cancer, typically affecting children between the ages of 2 and 5. Clinical signs include pallor, fatigue, petechiae, recurrent fevers, and bone marrow suppression. A CBC often shows elevated WBCs with a predominance of immature lymphoblasts on a peripheral smear.
B. Hodgkin's Lymphoma: This cancer usually presents in older children and adolescents, often with painless cervical lymphadenopathy, night sweats, fever, and weight loss. It does not typically present with massive lymphoblast proliferation in peripheral blood, as seen in this case.
C. Acute Myelogenous Leukemia (AML): AML is more common in adults but can occur in children. It presents with similar symptoms of bone marrow failure but is characterized by myeloblasts rather than lymphoblasts on the blood smear.
D. Non-Hodgkin's Lymphoma: Pediatric non-Hodgkin's lymphoma often presents with rapidly enlarging lymph nodes, mediastinal mass, or abdominal symptoms. It is not primarily a bone marrow disease and would not typically show high lymphoblast counts in the peripheral blood.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Development of rheumatic fever: Rheumatic fever is a serious delayed autoimmune complication that can follow untreated or inadequately treated streptococcal pharyngitis. It affects the heart, joints, and nervous system, making its assessment essential at follow-up.
B. Infection that may cause a tooth abscess: A tooth abscess is not related to streptococcal pharyngitis. Dental infections stem from poor oral hygiene or dental trauma, rather than streptococcal throat infections.
C. Nephrosis of the kidney: Post-streptococcal glomerulonephritis, not nephrosis, is a potential renal complication of streptococcal infection, characterized by inflammation of the kidney’s filtering units rather than nephrotic syndrome.
D. Swollen lymph nodes that obstruct the airway: While lymphadenopathy can occur with throat infections, obstruction of the airway by swollen nodes is rare. Airway obstruction would more likely result from severe tonsillar swelling or abscess formation rather than lymph node enlargement alone.
Correct Answer is A
Explanation
Rationale:
A: Measles (rubeola): Koplik spots are small, bluish-white lesions with a red base that appear on the buccal mucosa, typically near the molars. They are a hallmark sign of measles and usually appear 1–2 days before the characteristic maculopapular rash develops. Their presence strongly supports a measles diagnosis in a symptomatic child.
B: Chicken pox: This viral illness caused by varicella-zoster virus is characterized by a vesicular rash in various stages of healing, beginning on the trunk and spreading outward. Oral lesions may occur but they are vesicular, not the pinpoint bluish-white lesions.
C: Exanthema subitum (roseola): Caused most often by human herpesvirus 6, roseola presents with high fever followed by a sudden pink maculopapular rash after the fever subsides. Koplik spots are not associated with this illness.
D: Rubella: Also known as German measles, rubella presents with a fine pink rash, lymphadenopathy, and mild symptoms. There are no Koplik spots; instead, enanthem is rare and nonspecific if present
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