Nokea
A 42-year-old woman presents to the emergency department after being raped. The AGACNP examines her and realizes that the patients husband is the rapist. The patient does not want to press charges and wants to return home with her husband. The AGACNPs initial action should be to
- A. Report the physical assault to law enforcement
- B. Have the patient sign a release to go home with her husband
- C. Consult psychiatry for a psych hold
- D. Provide counseling to the patient regarding her options M. R. is a 52-year-old female who presents complaining of significant abdominal pain, which she rates as 8 to 9 on a 1 to 10 scale. The pain has been going on for a matter of hours, and she is afraid it won’t go away on its own. She denies any nausea or vomiting, and she cannot remember precisely when her last bowel movement occurred; probably it was a few days ago. She reports that she is ―always‖ constipated. On physical examination, she is tachycardic but otherwise has normal vital signs; her abdomen is tensely rigid, but no point tenderness to palpation is appreciated. The entire abdomen percusses as tympanic—there is no distinct dullness over the upper quadrants. Bowel sounds are present but hypoactive and intermittent. There is rebound tenderness to palpation. The AGACNP suspects:
Correct Answer: D
Rationale: The correct answer is D: Provide counseling to the patient regarding her options. The AGACNP's initial action should prioritize the patient's well-being and autonomy. Counseling allows the patient to understand her options, including legal, medical, and emotional support. Reporting to law enforcement (A) without the patient's consent violates her autonomy. Having the patient sign a release to go home with her husband (B) disregards the potential danger and trauma she may face. Consulting psychiatry for a psych hold (C) may not address the immediate emotional and physical needs of the patient.
You may also like to solve these questions
How can folic acid supplementation prevent neural tube defects?
- A. By promoting spinal cord closure
- B. By preventing infections
- C. By enhancing fetal growth
- D. By regulating blood sugar levels
Correct Answer: A
Rationale: The correct answer is A because folic acid supplementation plays a crucial role in promoting spinal cord closure during fetal development, preventing neural tube defects. Folic acid helps in the formation of neural tube structures, ensuring proper closure and preventing defects like spina bifida. Choices B, C, and D are incorrect as preventing infections, enhancing fetal growth, and regulating blood sugar levels are not direct mechanisms through which folic acid prevents neural tube defects.
Which one of the following therapies is the MOST incorporated in the management of clients with gestational diabetes?
- A. Therapeutic diet alone
- B. Long acting insulin
- C. Oral hypoglycaemics
- D. Short acting insulin
Correct Answer: D
Rationale: The correct answer is D: Short acting insulin. In gestational diabetes, short acting insulin is preferred as it provides immediate control over blood sugar levels after meals. This is crucial in managing the condition to prevent complications for both the mother and the baby. Therapeutic diet alone (choice A) may not be sufficient to control blood sugar levels, while long-acting insulin (choice B) may not provide the rapid response needed after meals. Oral hypoglycemics (choice C) are generally avoided in pregnancy due to potential risks to the fetus. Therefore, short acting insulin is the most appropriate therapy for managing gestational diabetes effectively.
When counseling a patient about his surgical options for an ulcer that has been refractory to medical therapy, the AGACNP advises the patient that he will need
- A. Lifelong vitamin D replacement
- B. Excision of the ulcer, which produces an 80% cure rate
- C. To eat much smaller, more frequent meals
- D. Some form of vagotomy
Correct Answer: D
Rationale: Correct Answer: D. Some form of vagotomy
Rationale:
1. Vagotomy is a surgical procedure that involves cutting the vagus nerve to reduce acid production in the stomach, which can help in treating ulcers.
2. Vagotomy is often recommended when ulcers are refractory to medical therapy, making it an appropriate surgical option.
3. Lifelong vitamin D replacement (A) is not typically necessary for ulcer treatment. Excision of the ulcer (B) is not a common treatment and does not address the underlying cause. Eating smaller meals (C) may help manage symptoms but is not a surgical option for refractory ulcers.
Which one of the following statements is correct with regards to face presentation?
- A. Majority are classified as primary face presentation
- B. The presenting transverse diameter is the bi-parietal diameter
- C. Majority are classified as secondary face presentation
- D. Locating the anterior fontanelle is diagnostic of the presentation
Correct Answer: C
Rationale: The correct answer is C: Majority are classified as secondary face presentation. In face presentation, the fetal head is hyperextended, presenting the face to the birth canal. Primary face presentation is rare. The bi-parietal diameter is not the presenting diameter in face presentation, as it is in vertex presentation. Locating the anterior fontanelle is not diagnostic of face presentation, as the fontanelles can be difficult to palpate during labor. Therefore, the correct statement is that the majority of face presentations are classified as secondary face presentation.
What are the benefits of ultrasound in monitoring fetal growth?
- A. Detects fetal anomalies
- B. Monitors placental health
- C. Assesses amniotic fluid levels
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Ultrasound in monitoring fetal growth can detect fetal anomalies by visualizing the fetus in real-time. It can also monitor placental health by assessing blood flow and position. Additionally, ultrasound can assess amniotic fluid levels to ensure proper fetal development. Therefore, all the benefits mentioned in choices A, B, and C are valid reasons why ultrasound is essential in monitoring fetal growth.