Nokea
How does gestational diabetes impact fetal development?
- A. Causes macrosomia
- B. Leads to congenital anomalies
- C. Reduces fetal movements
- D. Increases risk of preterm birth
Correct Answer: A
Rationale: The correct answer is A because gestational diabetes can lead to macrosomia, which is excessive fetal growth due to high blood sugar levels in the mother. This occurs as the fetus receives excess glucose from the mother, resulting in increased fat deposition and larger birth weight. Congenital anomalies (B) are not directly caused by gestational diabetes but by genetic or environmental factors. Reduced fetal movements (C) are not a typical effect of gestational diabetes. While gestational diabetes can increase the risk of preterm birth (D), the primary impact on fetal development is macrosomia.
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Jennifer is an RN applicant for a staff nurse position in the surgical ICU. She has had a screening PPD and comes back in 48 hours to have it read. There is a 12-mm induration at the site of injection. A chest radiograph is negative. The AGACNP knows that the next step in Jennifers evaluation and management should include
- A. No further care, because the chest radiograph is negative
- B. Quantiferon serum assay for exposure
- C. Consideration of prophylactic therapy
- D. Beginning therapy for pulmonary TB pending sputum cultures
Correct Answer: C
Rationale: The correct answer is C: Consideration of prophylactic therapy. A 12-mm induration in a healthcare worker is considered positive for PPD. In the absence of active TB on chest radiograph, the next step is to consider prophylactic therapy to prevent the development of active TB. This is based on the guidelines for the management of latent TB infection. Choice A is incorrect as a positive PPD warrants further evaluation regardless of the chest radiograph result. Choice B, the Quantiferon assay, is not the next step after a positive PPD and negative chest radiograph. Choice D, beginning therapy for pulmonary TB pending sputum cultures, is not indicated in this scenario as there is no evidence of active TB.
There are no other abnormal findings. This suggests that Mr. Thornton
- A. Is having anterior wall ischemia
- B. Is having an anterior wall infarction
- C. Has a history of anterior wall NSTEMI
- D. Has a history of anterior wall STEMI
Correct Answer: B
Rationale: The correct answer is B because the absence of any other abnormal findings suggests that Mr. Thornton is currently experiencing an anterior wall infarction. This is indicated by the localized area of myocardial necrosis due to prolonged ischemia. Option A is incorrect because ischemia would typically present with reversible changes rather than necrosis. Option C is incorrect as NSTEMI would show some abnormal findings. Option D is incorrect as STEMI would show more significant ECG changes and enzyme elevation. In summary, the absence of other abnormalities points towards an acute event like an anterior wall infarction.
Prolonged second stage of labor in nulliparous women is labor for more than
- A. 1 hour
- B. 2 hours
- C. 4 hours
- D. 8 hours
Correct Answer: C
Rationale: The correct answer is C: 4 hours. This is based on the definition of prolonged second stage in nulliparous women, which is labor lasting more than 4 hours. This duration is considered abnormal and may lead to increased risk of maternal and fetal complications. Choice A (1 hour) is too short and does not meet the criteria for prolonged second stage. Choice B (2 hours) is also insufficient based on the established timeframe. Choice D (8 hours) exceeds the duration for prolonged second stage, indicating a more advanced stage of labor. Therefore, the most appropriate and accurate timeframe for prolonged second stage in nulliparous women is 4 hours.
Placenta praevia is also referred to as unavoidable haemorrhage because
- A. Bleeding results as the segment prepares for true labour
- B. Bleeding results from pathological processes of the placenta
- C. Bleeding always occurs after a gestation of 37 complete weeks
- D. Of the high morbidity and mortality rate to the mother and neonate
Correct Answer: D
Rationale: The correct answer is D because placenta praevia can lead to life-threatening bleeding during labor due to the placenta partially or completely covering the cervix. This condition poses a high risk of morbidity and mortality to both the mother and the baby.
A: Incorrect. Bleeding in placenta praevia is not related to the segment preparing for labor.
B: Incorrect. While bleeding is due to placental issues, it is specifically due to the placenta's abnormal positioning, not a pathological process.
C: Incorrect. Bleeding can occur before 37 weeks in cases of placenta praevia, and the timing of bleeding is not linked to gestational age.
In mild preeclampsia, the mother has no complaints.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: The correct answer is B: FALSE. In mild preeclampsia, the mother may have symptoms such as mild hypertension, proteinuria, and sometimes mild edema. This indicates that the mother does have complaints, albeit they may be mild. The other choices (A, C, D) are incorrect because in mild preeclampsia, the mother does have complaints, so option A is not true. Options C and D are not applicable as they do not provide any information.