Nokea
The baby dies immediately after birth due to the presence of
- A. Pulmonary stenosis
- B. Aortic coarctation
- C. Truncus arteriosus
- D. Ductus arteriosus
Correct Answer: C
Rationale: The correct answer is C: Truncus arteriosus. In this condition, there is a single large vessel arising from the heart that gives rise to the systemic, pulmonary, and coronary arteries. This results in mixing of oxygenated and deoxygenated blood, leading to severe cyanosis and inadequate oxygenation of the body, causing immediate death after birth.
A: Pulmonary stenosis and B: Aortic coarctation typically do not cause immediate death after birth.
D: Ductus arteriosus is a normal fetal structure that closes shortly after birth and its presence would not directly cause immediate death.
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A patient who has been in the intensive care unit for 17 days develops hyponatremic hyperosmolality. The patient weighs 132 lb (59.9 kg), is intubated, and is receiving mechanical ventilation. The serum osmolality is 320 mOsmL kg H2O. Clinical signs include tachycardia and hypotension. The adult-gerontology acute care nurse practitioners initial treatment is to
- A. reduce serum osmolality by infusing a 5% dextrose in 0.2% sodium chloride solution
- B. reduce serum sodium concentration by infusing a 0.45% sodium chloride solution
- C. replenish volume by infusing a 0.9% sodium chloride solution
- D. replenish volume by infusing a 5% dextrose in water solution.
Correct Answer: B
Rationale: The correct answer is B: reduce serum sodium concentration by infusing a 0.45% sodium chloride solution. In hyponatremic hyperosmolality, the primary goal is to correct the low serum sodium levels. A 0.45% sodium chloride solution is hypotonic, which helps to slowly correct the serum sodium concentration without causing rapid shifts in osmolality. Infusing a hypotonic solution will gradually increase the serum sodium levels, addressing the underlying issue. Choices A, C, and D are incorrect because they do not directly address the low serum sodium levels, which is essential in treating hyponatremic hyperosmolality. Infusing a 5% dextrose in 0.2% sodium chloride solution (Choice A) or a 5% dextrose in water solution (Choice D) would not correct the low sodium levels. Replenishing volume with a 0.9% sodium chloride solution (Choice C) would not directly
Which of the following statements is true with respect to adrenal tumors that produce gender symptoms?
- A. Feminizing adrenal tumors are almost always carcinomas
- B. Feminizing adrenal tumors are the most common type of adrenal tumor
- C. Virilizing tumors in women are most often localized to the adrenal cortex
- D. Virilizing adrenal tumors are more likely to be malignant in children
Correct Answer: D
Rationale: The correct answer is D because virilizing adrenal tumors are more likely to be malignant in children. This is due to the fact that virilizing tumors can be associated with conditions like adrenocortical carcinoma, which is a malignant tumor. In contrast, feminizing adrenal tumors are not always carcinomas (choice A) and are not the most common type of adrenal tumor (choice B). Additionally, virilizing tumors in women can be localized to different parts of the adrenal gland, not just the cortex (choice C). Therefore, choice D is the most accurate statement among the options provided.
A student AGACNP just beginning his clinical rotation is observing his preceptor perform a physical survey on a patient who is brought in following a serious motor vehicle accident. The student observes that the physical examination includes rectovaginal examination, inspection of the urethral meatus, and palpation of the pelvic landmarks. The student knows the patient is being assessed for
- A. Peritoneal bleeding
- B. Retroperitoneal bleeding
- C. Paresthesia
- D. Pelvic fracture
Correct Answer: B
Rationale: The correct answer is B: Retroperitoneal bleeding. The physical survey described focuses on assessing for internal bleeding within the retroperitoneal space following a serious motor vehicle accident. The rectovaginal examination, inspection of the urethral meatus, and palpation of pelvic landmarks help evaluate for signs of pelvic fracture and internal bleeding. These assessments help identify potential sources of retroperitoneal bleeding, which can be a life-threatening complication of trauma. Peritoneal bleeding (choice A) involves bleeding within the abdominal cavity, which is less likely in this scenario. Paresthesia (choice C) refers to abnormal sensations like tingling or numbness, which are not typically assessed through physical examination in this context. Pelvic fracture (choice D) is a possible outcome of trauma but does not directly assess for retroperitoneal bleeding.
A major predisposing factor to cardiac disease in pregnancy includes
- A. Rheumatic heart disease
- B. Notable peripheral oedema
- C. Easy fatiguability
- D. Basal crepitation
Correct Answer: A
Rationale: The correct answer is A: Rheumatic heart disease. This is because rheumatic heart disease is a known risk factor for cardiac complications during pregnancy due to the strain pregnancy places on the heart. Choice B, notable peripheral edema, is a symptom of heart failure but not a predisposing factor. Choice C, easy fatiguability, is a non-specific symptom and not a direct predisposing factor. Choice D, basal crepitation, is a sign of possible lung pathology and not directly related to cardiac disease in pregnancy. Therefore, the correct answer is A as it directly relates to an increased risk of cardiac issues during pregnancy.
The commonly used inhalational analgesia during labour is
- A. Entonox
- B. Trilene
- C. Oxygen
- D. Nitrous oxide
Correct Answer: A
Rationale: The correct answer is A: Entonox. Entonox, a mixture of nitrous oxide and oxygen, is commonly used for inhalational analgesia during labor due to its fast-acting and safe properties. Nitrous oxide provides pain relief without affecting the baby's heart rate or causing sedation. Trilene (B) is not commonly used during labor due to potential side effects on the baby. Oxygen (C) is not an analgesic but is often used in conjunction with Entonox. Nitrous oxide (D) is the active component in Entonox and is the primary analgesic agent in this mixture.