Nokea
A characteristic of monozygotic twins is that
- A. They are always of the same sex
- B. They share a similar fingerprint pattern
- C. They have different blood groups
- D. Superfetation is a common finding
Correct Answer: A
Rationale: The correct answer is A: They are always of the same sex. This is because monozygotic twins, also known as identical twins, develop from a single fertilized egg that splits into two embryos. As a result, they share the same genetic material and are always of the same sex.
Choice B is incorrect because fingerprint patterns are not determined by genetics and can vary even between identical twins. Choice C is incorrect because monozygotic twins share the same blood type since they have the same genetic makeup. Choice D is incorrect as superfetation, the occurrence of multiple pregnancies in the same uterus but from different ovulations, is extremely rare and not a common finding in monozygotic twins.
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A patient admitted for management of sepsis is critically ill and wants to talk with a hospital representative about donating her organs if she dies. She has a fairly complex medical history that includes traumatic brain injury, breast cancer, and dialysis-dependent renal failure. The patient is advised that she is ineligible to donate due to her
- A. Renal failure
- B. Traumatic brain injury
- C. Gram negative infection
- D. Breast cancer
Correct Answer: D
Rationale: The correct answer is D: Breast cancer. The patient's breast cancer is the reason she is ineligible to donate organs. Breast cancer is a contraindication for organ donation due to the risk of cancer transmission to the recipient. Traumatic brain injury (choice B) and renal failure (choice A) are not absolute contraindications to organ donation. Gram-negative infection (choice C) may temporarily disqualify the patient but can be treated, unlike breast cancer. In summary, breast cancer poses the highest risk of organ recipient harm compared to the other medical conditions listed.
Which one of the following signs is indicative of possible shoulder dystocia during delivery?
- A. Failure of internal rotation of the head
- B. Fetal head retracts against the perineum
- C. Gentle traction aids in effecting the delivery
- D. The occiput slowly restitutes towards the left side
Correct Answer: B
Rationale: The correct answer is B: Fetal head retracts against the perineum. This sign indicates possible shoulder dystocia as it suggests the baby's shoulders are impacted and unable to pass through the birth canal. The retraction of the fetal head against the perineum is a classic sign of shoulder dystocia, which requires specific maneuvers to dislodge the shoulders and facilitate delivery.
A: Failure of internal rotation of the head is not specific to shoulder dystocia.
C: Gentle traction should not be applied in cases of shoulder dystocia as it can worsen the situation.
D: The occiput restituting towards the left side is not a sign of shoulder dystocia, as it refers to the rotation of the fetal head during delivery.
Cardiac disease grade 1 is also known as
- A. Organic disease
- B. Mitral stenosis
- C. Ventricular failure
- D. Vascular disease
Correct Answer: A
Rationale: Grade 1 cardiac disease refers to early-stage or mild heart conditions that are not yet severe. Choice A, "Organic disease," is the correct answer as it encompasses a broad category of structural heart abnormalities. Mitral stenosis (B) and ventricular failure (C) are specific conditions that can be present in cardiac disease but do not represent the general term for grade 1. Vascular disease (D) primarily refers to conditions affecting blood vessels, not the heart itself. In summary, choice A is correct because it is a comprehensive term that includes various structural heart abnormalities typically found in grade 1 cardiac disease, while the other choices are either too specific or unrelated to the concept of grade 1 cardiac disease.
The AGACNP is rounding on a patient following splenectomy for idiopathic thrombocytopenia purpura. On postoperative day 2, a review of the laboratory studies is expected to reveal
- A. Increased MCV
- B. Increased Hgb
- C. Increased platelets
- D. Increased albumin
Correct Answer: A
Rationale: The correct answer is A: Increased MCV. Following splenectomy, there is a compensatory increase in red blood cell production, leading to an increase in Mean Corpuscular Volume (MCV) due to the release of larger, younger red blood cells into circulation. This is known as stress erythropoiesis.
Summary:
B: Increased Hgb - Hgb levels may not necessarily increase post-splenectomy as it depends on factors such as bleeding or hydration status.
C: Increased platelets - Platelet count is not expected to increase immediately post-splenectomy.
D: Increased albumin - Albumin levels are not directly influenced by splenectomy for idiopathic thrombocytopenia purpura.
Traumatic diaphragmatic hernias present in both acute and chronic forms. Patients with a more chronic form are most likely to be present with
- A. Respiratory insufficiency
- B. Sepsis
- C. Bowel obstruction
- D. Anemia
Correct Answer: A
Rationale: The correct answer is A: Respiratory insufficiency. Chronic traumatic diaphragmatic hernias can lead to gradual compromise of respiratory function due to herniation of abdominal contents into the chest cavity, causing compression of the lungs and reduced lung capacity. This results in symptoms such as dyspnea, cough, and chest pain. Sepsis (B) is more commonly associated with acute traumatic diaphragmatic hernias. Bowel obstruction (C) is a possible complication but typically presents with acute symptoms like abdominal pain and distension. Anemia (D) is not a common presentation of diaphragmatic hernias.