A 3-year-old child is diagnosed with neuroblastoma after presenting with a mass in the abdomen, abnormal eye movements, and swelling of the face. Which of the following is the most common site of origin for neuroblastoma in children?
Liver
Brain
Kidneys
Adrenal glands
The Correct Answer is D
A. Liver is incorrect because the liver is not the primary site of neuroblastoma. While the liver can become involved through metastasis, the tumor originates elsewhere along the sympathetic chain.
B. Brain is incorrect because neuroblastoma develops from peripheral sympathetic tissue, not the central nervous system. Brain tumors in children are a separate category of malignancies.
C. Kidneys is incorrect. Although neuroblastoma can present as an abdominal mass that seems near the kidneys, the tumor originates from the adrenal glands, not the renal tissue itself. Wilms’ tumor, not neuroblastoma, arises from the kidneys in children.
D. Adrenal glands is correct. Approximately 40% of neuroblastomas originate in the adrenal medulla, located above the kidneys. Other tumors may arise along the sympathetic chain, including the chest, neck, and pelvis. The adrenal origin explains why children may present with abdominal masses, abdominal pain, or systemic symptoms. Metastatic spread can cause periorbital ecchymosis (“raccoon eyes”), proptosis, and facial edema, as seen in this child, reflecting tumor spread to orbital bones and lymphatic structures.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Oral agents are often effective for treatment is incorrect because type 1 diabetes is characterized by autoimmune destruction of pancreatic beta cells, leading to absolute insulin deficiency. Insulin therapy, not oral hypoglycemic agents, is required.
B. Age at onset is usually younger than 18 years is correct because immune-mediated type 1 diabetes typically develops in children and adolescents, although it can occur at any age. This is the classic age group for presentation of type 1 diabetes.
C. Onset is gradual is incorrect because type 1 diabetes usually has a rapid onset of symptoms, such as polyuria, polydipsia, weight loss, and fatigue, over weeks to months.
D. Ketoacidosis is infrequent is incorrect because diabetic ketoacidosis (DKA) is a common presenting feature in children with type 1 diabetes, especially at initial diagnosis, due to absolute insulin deficiency.
Correct Answer is D
Explanation
A. Coarctation of the Aorta is incorrect because this defect causes obstruction of blood flow from the left ventricle to the aorta. It is a pressure load problem (left ventricular hypertension) rather than a left-to-right shunt, and it does not primarily increase pulmonary blood flow.
B. Tetralogy of Fallot is incorrect because this is a cyanotic defect characterized by right-to-left shunting due to pulmonary stenosis and a VSD. Pulmonary blood flow is often decreased rather than increased.
C. Transposition of the Great Arteries is incorrect because this is a cyanotic defect in which the aorta arises from the right ventricle and the pulmonary artery from the left ventricle, resulting in parallel circulation. Pulmonary blood flow is not increased by a left-to-right shunt.
D. Ventricular Septal Defect (VSD) is correct because it is a acyanotic defect that allows blood to flow from the left ventricle (higher pressure) to the right ventricle (lower pressure). This left-to-right shunt increases pulmonary blood flow, which can lead to symptoms such as tachypnea, poor weight gain, and frequent respiratory infections. VSDs are the most common congenital heart defect in infants.
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