Nokea
Complications of unrepaired cleft lip and palate include
- A. Pneumonia and retarded growth
- B. Mental retardation and blindness
- C. Failure to thrive and deafness
- D. Impaired speech and convulsions
Correct Answer: D
Rationale: Failure to thrive and impaired speech are common complications due to feeding and developmental issues with cleft lip and palate.
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What is the role of folic acid in pregnancy?
- A. Prevents gestational hypertension
- B. Supports placenta growth
- C. Prevents neural tube defects
- D. Reduces anemia
Correct Answer: C
Rationale: Folic acid is crucial for preventing neural tube defects.
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: D
Rationale: In this scenario, the patient presents with a jagged laceration on his forearm that is still open and requires sutures. The appropriate management for this patient involves local anesthesia to reduce pain, thorough cleansing of the wound to prevent infection, and wound exploration to assess for any foreign bodies that may be present. Suturing the wound is necessary to promote proper healing and reduce the risk of complications. Antibiotic therapy may be indicated if signs of infection are present, but it is not mentioned in the scenario as a primary management step. Tetanus prophylaxis should also be considered given the mechanism of injury involving a dirty object.
The diagnostic factor of polyhydramnious, based on percussion, is
- A. Muffled fetal heart sounds
- B. Presence of a dull sound
- C. Excessive fetal movements
- D. Presence of a fluid thrill
Correct Answer: D
Rationale: Fluid thrill is a key diagnostic sign of polyhydramnious.
On vaginal examination, the findings characteristic of brow presentation include
- A. Presenting diameter is submento-vertical 11.5cm, head partially extended
- B. Back difficult to palpate, fetal heart heard on the same side as the limbs
- C. Presenting diameter is mento-vertical 13.5cm, head partially extended
- D. Presenting diameter is mento-vertical 13.5cm, head completely extended
Correct Answer: A
Rationale: The characteristic presenting diameter in brow presentation is submento-vertical, with the head partially extended.
The AGACNP is receiving report from the recovery room on a patient who just had surgical resection for pheochromocytoma. He knows that which class of drugs should be available immediately to manage hypertensive crisis, a possible consequence of physical manipulation of the adrenal medulla?
- A. Alpha-adrenergic antagonists
- B. Beta-adrenergic antagonists
- C. Intravenous vasodilators
- D. Arteriolar dilators
Correct Answer: C
Rationale: Surgical manipulation of the adrenal medulla during resection of a pheochromocytoma can result in the release of catecholamines leading to a hypertensive crisis. Alpha-adrenergic antagonists, such as phenoxybenzamine or prazosin, are the drugs of choice for managing hypertensive crisis in this situation. These medications block the alpha-adrenergic receptors, leading to vasodilation and lowering of blood pressure. Beta-adrenergic antagonists are contraindicated in this scenario due to the risk of unopposed alpha-adrenergic stimulation that could worsen the hypertension. Intravenous vasodilators and arteriolar dilators may be used as adjunctive therapy but alpha-adrenergic antagonists are the primary agents for managing hypertensive crisis in this context.