A nurse notes in a patient's medical record high levels of ...

[folubunmi]

A nurse notes in a patient's medical record high levels of vanillymandelic acid (VMA). Based on this information, which condition does the nurse prepare to educate the patient and family about?
 
  A.
  Ewing's sarcoma
  B.
  Hodgkin's lymphoma
  C.
  Neuroblastoma
  D.
  Wilms' tumor

Question 2

A clinic nurse notes that a child brought in for a physical has swelling and bruising around the eyes. The patient denies any trauma and the parent reports no environmental allergies. Which assessment is most important?
 
  A.
  Auscultate lungs bilaterally.
  B.
  Inspect skin on the back.
  C.
  Palpate abdomen and neck.
  D.
  Percuss abdomen and flank.

[johnpizzaz]

Answer to Question 1

ANS: C
VMA and homovanillic acid (HVA) are tests used to measure the level of catecholamine metabolites in the urine. Neuroblastomas typically secrete catecholamines, so high levels of either substance are indicative of neuroblastoma.

Answer to Question 2

ANS: C
Swelling and bruising around the face and eyes is often seen in children with neuroblastoma. Most commonly the tumor can be found by palpation of the abdomen or neck, where the tumor will present as a hard, painless mass that crosses the midline.