Nokea
The main feature in the initial stage of shock is
- A. Cyanosis
- B. Tachycardia
- C. Sweat beads
- D. Hypotension
Correct Answer: B
Rationale: The correct answer is B: Tachycardia. In the initial stage of shock, the body tries to compensate for decreased perfusion by increasing heart rate to maintain blood flow to vital organs. Cyanosis (A) is a late sign of shock due to inadequate oxygenation. Sweat beads (C) are a non-specific response and not a defining feature of shock. Hypotension (D) typically occurs in the later stages of shock as the body's compensatory mechanisms start to fail. Tachycardia is the earliest and most consistent sign of shock, reflecting the body's attempt to maintain cardiac output.
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In the majority of cases, the first clinical manifestation of physiologic stress ulcer is
- A. Epigastric pain
- B. Change in mental status
- C. Fever
- D. Hemorrhage
Correct Answer: C
Rationale: The correct answer is C: Fever. The first clinical manifestation of physiologic stress ulcer is often a fever due to the body's response to stress. This is because stress can trigger an inflammatory response, leading to an increase in body temperature. Epigastric pain (choice A) is more commonly associated with peptic ulcers. Change in mental status (choice B) is not a typical early symptom of physiologic stress ulcer. Hemorrhage (choice D) is a severe complication that can occur later in the course of the disease, but it is not typically the first clinical manifestation.
Justin F. is seen in the emergency department with an 8-cm jagged laceration on the dorsal surface of his right forearm. He says he was working with his brother-in-law yesterday morning building a deck on the back of his home. A pile of wooden planks fell on top of him, and he sustained a variety of cuts and superficial injuries. He cleaned the wound with soap and water but didnt want to go to the emergency room because he didnt want to risk being in the waiting room for hours. He wrapped up his arm and went back to work, and then took a normal shower and went to bed last night. This morning the cut on his arm was still flapping open, and he realized he needed sutures. The appropriate management of this patient includes
- A. Proper cleansing and covering of the laceration, along with antibiotic therapy
- B. Local anesthesia, cleansing, and wound exploration for foreign bodies
- C. Local anesthesia, cleansing, and suture repair
- D. Cleansing, covering, antibiotic therapy, and tetanus prophylaxis
Correct Answer: C
Rationale: The correct answer is C: Local anesthesia, cleansing, and suture repair.
1. Local anesthesia is needed to numb the area before suturing.
2. Cleansing is necessary to prevent infection and remove debris.
3. Suture repair is required for a jagged laceration to promote proper wound healing and minimize scarring.
Other choices are incorrect:
A: Antibiotic therapy is not indicated for clean, non-infected wounds like this laceration.
B: Wound exploration for foreign bodies is not necessary in this case as the mechanism of injury is known and there is no indication of foreign bodies.
D: Tetanus prophylaxis is important but not directly related to the immediate management of the laceration.
Neonatal injury to nerve roots C8 & T1 causes one of the following
- A. Erb’s palsy
- B. Klumpke’s palsy
- C. Phrenic injury
- D. Radial palsy
Correct Answer: B
Rationale: The correct answer is B: Klumpke's palsy. Neonatal injury to nerve roots C8 & T1 leads to Klumpke's palsy, characterized by paralysis of the lower arm and hand muscles. This occurs due to damage to the lower trunk of the brachial plexus. Erb's palsy (choice A) involves C5 & C6 nerve roots, causing weakness in the shoulder and upper arm. Phrenic injury (choice C) affects the diaphragm, leading to breathing difficulties. Radial palsy (choice D) results from damage to the radial nerve, causing wrist drop and weakness in forearm muscles. Klumpke's palsy specifically matches the description of injury to nerve roots C8 & T1.
What is the significance of skin-to-skin contact after birth?
- A. Stabilizes baby’s temperature
- B. Promotes bonding
- C. Regulates baby’s heartbeat
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D because skin-to-skin contact after birth offers multiple benefits. Firstly, it helps stabilize the baby's temperature by utilizing the parent's body heat. Secondly, it promotes bonding between the parent and baby through physical closeness and touch. Finally, it can regulate the baby's heartbeat by providing a calming and reassuring environment. Therefore, all of the above choices are correct in highlighting the significance of skin-to-skin contact after birth.
A client is declared fit for a vaginal birth after cesarean section if
- A. Her previous C/S was due to cephalopelvic disproportion
- B. The current pregnancy is confirmed a multiple pregnancy
- C. Previous delivery was via cesarean section
- D. Previous delivery was via spontaneous vertex delivery
Correct Answer: D
Rationale: The correct answer is D because a client is declared fit for a vaginal birth after cesarean section if their previous delivery was via spontaneous vertex delivery. This indicates that the client has successfully given birth vaginally before, reducing the risk associated with a vaginal birth after cesarean section.
A, B, and C are incorrect:
A: Cephalopelvic disproportion was the reason for the previous C/S, indicating potential difficulty in vaginal delivery.
B: Confirmation of a multiple pregnancy does not impact the client's eligibility for a vaginal birth after cesarean section.
C: Previous cesarean section does not necessarily mean the client is fit for a vaginal birth after cesarean section.