The nurse has reviewed the physician's prescriptions for a child ...

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The nurse has reviewed the physician's prescriptions for a child suspected of a diagnosis of neuroblastoma and is preparing to implement diagnostic procedures that will confirm the diag-nosis. The nurse most appropriately prepares to:
 
  1. Collect a 24-hour urine sample.
  2. Perform a neurological assessment.
  3. Assist with a bone marrow aspiration.
  4. Send the child to the radiology department for a chest x-ray.

Question 2

Collagenase (Santyl) is prescribed for a client with a severe burn to the hand. The nurse is providing instructions to the client and spouse regarding wound treatment. Which of the following should the nurse include in the instructions?
 
  1. Apply twice a day, and leave it open to the air.
  2. Apply once a day, and leave it open to the air.
  3. Apply twice a day, and cover it with a sterile dressing.
  4. Apply once a day, and cover it with a sterile dressing.

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Answer to Question 1

1

Rationale: Neuroblastoma is a solid tumor found only in children. It arises from neural crest cells that develop into the sympathetic nervous system and the adrenal medulla. Typically, the tumor infringes on adjacent normal tissue and organs. Neuroblastoma cells may excrete catecholamines and their metabolites. Urine samples will indicate elevated vanillylmandelic acid (VMA) levels. A bone marrow aspiration will assist in determining marrow involvement. A neurological examination and a chest x-ray may be performed but will not confirm the diagnosis.

Answer to Question 2

4

Rationale: Collagenase is used in the treatment of dermal lesions and severe burns. Its action is to dbride the affected area. It is applied once daily and covered with a sterile dressing. Apply twice a day, and leave it open to the air, apply once a day, and leave it open to the air, and apply twice a day, and cover it with a sterile dressing are incorrect application procedures.