Nokea
Sara S. is a 41-year-old patient who has just had a bone marrow transplant. The AGACNP knows that which medication will be used to decrease her risk of graft-versus-host reaction?
- A. Immune globulin
- B. Cyclosporine
- C. Prophylactic antibiotics
- D. Systemic corticosteroids
Correct Answer: A
Rationale: The correct answer is A: Immune globulin. Post bone marrow transplant, immune globulin is used to decrease the risk of graft-versus-host reaction by providing passive immunity. This helps in reducing the chances of the donor's immune cells attacking the recipient's tissues. Immune globulin does not suppress the immune system like cyclosporine (B) or systemic corticosteroids (D) do, which could increase the risk of infections post-transplant. Prophylactic antibiotics (C) are used to prevent infections but do not specifically target graft-versus-host reaction.
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Persistent nausea and vomiting related to pregnancy is indicative of
- A. Morning sickness
- B. Multiple gestation
- C. Hyperemesis gravidarum
- D. Hypertensive disorders
Correct Answer: C
Rationale: The correct answer is C: Hyperemesis gravidarum. This condition is characterized by severe nausea, vomiting, weight loss, dehydration in pregnancy. It is more severe than typical morning sickness (choice A) and is not specific to multiple gestation (choice B). Hypertensive disorders (choice D) typically present with high blood pressure, proteinuria, and edema, not just nausea and vomiting. Hyperemesis gravidarum requires medical intervention due to potential complications from dehydration and malnutrition.
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.
When examining a patient with abdominal pain, the AGACNP knows that tenderness to percussion is analogous to
- A. Tympany
- B. Guarding
- C. Rebound tenderness
- D. Somatic pain
Correct Answer: A
Rationale: The correct answer is A: Tympany. Tenderness to percussion is analogous to tympany as both indicate the presence of gas-filled structures. When a patient experiences tenderness to percussion in the abdomen, it suggests that there is gas or air present in the abdomen, leading to a hollow, drum-like sound upon percussion, which is characteristic of tympany. Guarding (B) is the involuntary contraction of abdominal muscles to protect the underlying organs, not related to percussion. Rebound tenderness (C) is the pain experienced when pressure is released during palpation, not percussion. Somatic pain (D) refers to pain originating from the skin, muscles, or bones, not related to percussion findings.
What is a common cause of oligohydramnios during pregnancy?
- A. Maternal hypertension
- B. Multiple gestations
- C. Premature rupture of membranes
- D. Fetal macrosomia
Correct Answer: C
Rationale: The correct answer is C: Premature rupture of membranes. Oligohydramnios is a condition characterized by low levels of amniotic fluid which can be caused by the premature rupture of membranes, leading to the leakage of amniotic fluid. This condition can result in various complications such as fetal growth restriction and compression of the umbilical cord. Maternal hypertension (choice A) is not a direct cause of oligohydramnios. Multiple gestations (choice B) may lead to polyhydramnios (excessive amniotic fluid) rather than oligohydramnios. Fetal macrosomia (choice D) is associated with increased amniotic fluid levels rather than decreased levels seen in oligohydramnios.
The factor indicative of an abnormal labour pattern on vaginal examination is
- A. The vagina is warm and moist
- B. Cervical canal is long and thick
- C. Cervical canal is short and thin
- D. The vagina is hot and dry
Correct Answer: C
Rationale: Step 1: In normal labor, the cervix undergoes effacement and dilation.
Step 2: A short and thin cervical canal indicates progression towards labor.
Step 3: Long and thick cervical canal suggests a delay in labor progress.
Step 4: Choice C, short and thin cervical canal, is indicative of abnormal labor.
Summary: A, B, and D do not reflect changes in the cervix seen in labor, making them incorrect choices.