Nokea
Clinical diagnosis of polyhydramnios is based on an excessive amount of amniotic fluid exceeding
- A. 1500 ml
- B. 2500 ml
- C. 1900 ml
- D. 3000 ml
Correct Answer: D
Rationale: The correct answer is D: 3000 ml. Polyhydramnios is diagnosed when the amniotic fluid volume exceeds 2000 to 3000 ml. This is because amniotic fluid serves important functions in protecting the fetus and aiding in fetal movements. Having an excessively high volume can lead to complications such as preterm labor, fetal malpresentation, and placental abruption. Choices A, B, and C are incorrect as they do not fall within the range typically used to diagnose polyhydramnios. A: 1500 ml and C: 1900 ml are below the threshold, while B: 2500 ml is at the lower end but still not exceeding the diagnostic range for polyhydramnios.
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Intraperitoneal uterine rupture involves
- A. A tear of endometrium, myometrium & peritoneum
- B. A tear of the endometrium, myometrium & basal layer
- C. A tear of the endometrium, capsular layer & myometrium
- D. A tear of the endometrium, spongy layer & myometrium only
Correct Answer: A
Rationale: The correct answer is A because intraperitoneal uterine rupture involves a tear that goes through all layers of the uterus - endometrium, myometrium, and peritoneum. This type of rupture extends beyond the muscular layer of the uterus and into the peritoneal cavity. Choices B, C, and D are incorrect as they do not include the peritoneum, which is a key component of intraperitoneal uterine rupture. Therefore, choice A is the correct answer as it accurately describes the layers involved in this type of rupture.
Cord presentation is when the
- A. Umbilical cord lies in front of the presenting part after the membranes have ruptured.
- B. Umbilical cord lies in front of the presenting part before membranes have ruptured
- C. Umbilical cord is tied around the fetal neck.
- D. Umbilical cord has prematurely been detached.
Correct Answer: A
Rationale: The correct answer is A because cord presentation occurs when the umbilical cord lies in front of the presenting part after the membranes have ruptured. This can lead to compression of the cord during labor, affecting fetal oxygenation. Option B is incorrect as it describes cord prolapse, where the cord lies in front of the presenting part before membrane rupture. Option C describes nuchal cord, where the cord is wrapped around the fetal neck. Option D describes cord abruption, where the cord detaches prematurely from the placenta.
A patient being monitored post-heart transplant suffers a bradyarrhythmia. The AGACNP knows that which of the following medications is not indicated as part of emergency intervention for bradycardic abnormalities in a posttransplant patient?
- A. Isoproterenol 0.2 to 0.6 mg IV bolus
- B. External pacemaking
- C. Atropine 0.5 mg IV
- D. Epinephrine 1 mg IV
Correct Answer: A
Rationale: The correct answer is A: Isoproterenol 0.2 to 0.6 mg IV bolus. Isoproterenol is a non-selective beta-adrenergic agonist that can worsen graft rejection in heart transplant patients. The appropriate intervention for bradyarrhythmia in posttransplant patients is external pacemaking or pharmacological agents like atropine or epinephrine. Isoproterenol should be avoided due to its potential to stimulate the immune system and increase the risk of rejection. It is crucial to choose interventions that address the bradycardia without compromising the patient's transplant graft.
Chemical diabetes mellitus is a classification based on
- A. Symptom are absent and abnormal specific laboratory results
- B. Presence of symptoms and abnormal specific laboratory results
- C. Previous congenital abnormalities and unexplained stillbirth
- D. Previous birth of a baby weighing >4.3kg and spontaneous abortion
Correct Answer: A
Rationale: The correct answer is A: Symptom are absent and abnormal specific laboratory results. Chemical diabetes mellitus refers to a condition where there are abnormal specific laboratory results indicating diabetes without the presence of any symptoms. This classification is based on objective data from laboratory tests rather than subjective symptoms. Choices B, C, and D are incorrect as they do not align with the definition of chemical diabetes mellitus, which focuses on laboratory results rather than symptoms, congenital abnormalities, or pregnancy outcomes.
The relationship between abdominal pain and vomiting typically can be characterized by saying
- A. When the vomiting precedes pain, the likelihood of surgical abdomen increases appreciably
- B. Conditions that may produce only mild nausea in the younger patient often will cause vomiting in older patients
- C. The majority of surgical abdomens do not produce vomiting as a primary symptom
- D. The presence of bile in vomitus suggests pyloric stenosis
Correct Answer: D
Rationale: Step 1: The presence of bile in vomitus suggests that the vomit originated from the small intestine or stomach, indicating an obstruction in the pyloric region.
Step 2: Pyloric stenosis is a condition characterized by narrowing of the opening from the stomach to the small intestine, leading to projectile vomiting with bile.
Step 3: Therefore, the presence of bile in vomitus suggests pyloric stenosis, making option D the correct answer.
Summary: Option A is incorrect because vomiting preceding pain does not necessarily indicate a surgical abdomen. Option B is incorrect as the severity of symptoms is not solely based on age. Option C is incorrect as some surgical abdomens can present with vomiting as a primary symptom.