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A client diagnosed with gestational diabetes at 24 weeks is scheduled for ANC care every
- A. Weekly up to 28 weeks
- B. Two weekly up to 28 weeks
- C. Four weekly up to 28 weeks
- D. Three weekly up to 28 weeks
Correct Answer: C
Rationale: The correct answer is C: Four weekly up to 28 weeks. Gestational diabetes requires close monitoring of blood sugar levels and fetal well-being. ANC care every four weeks up to 28 weeks ensures proper management and early detection of any complications. Weekly or two weekly visits (options A and B) may be too frequent and unnecessary at this stage unless there are specific concerns. Three weekly visits (option D) may not provide adequate monitoring intervals. Therefore, option C is the most appropriate choice for the optimal management of gestational diabetes at this stage of pregnancy.
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In laryngeal stridor, the noise is more marked during
- A. Inspiration
- B. Expiration
- C. Feeding
- D. Play
Correct Answer: A
Rationale: The correct answer is A: Inspiration. Laryngeal stridor is caused by narrowed or obstructed airway, resulting in noisy breathing. During inspiration, the air is drawn through the narrowed larynx, causing the stridor sound. During expiration, the air is leaving the body, so the noise may not be as prominent. Choices C and D, feeding and play, are unrelated to the respiratory process and do not affect the presence of laryngeal stridor.
In deep transverse arrest,
- A. The occipito-frontal diameter is caught at the bispinous diameter of the pelvic outlet
- B. The sub-occipito-bregmatic diameter is caught at the bispinous diameter of pelvic outlet
- C. The resulting outcome is usually a face to pubis delivery
- D. The sagittal suture is found at the oblique diameter of the pelvis
Correct Answer: D
Rationale: The correct answer is D because in deep transverse arrest, the sagittal suture of the fetal head is typically aligned with the oblique diameter of the pelvis, causing an obstruction in the descent of the baby. This alignment leads to a difficult labor scenario where the baby's head cannot pass through the pelvis due to the mismatch in diameters. Choices A, B, and C are incorrect because they do not accurately describe the specific anatomical alignment that characterizes deep transverse arrest. Choice A refers to occipito-frontal diameter, choice B refers to sub-occipito-bregmatic diameter, and choice C mentions a face to pubis delivery, which are not the defining features of deep transverse arrest.
What are common complications of multiple gestations?
- A. Premature labor
- B. Twin-to-twin transfusion syndrome
- C. Preeclampsia
- D. All of the above
Correct Answer: D
Rationale: The correct answer is D: All of the above. Multiple gestations are at higher risk for complications such as premature labor, where contractions start before 37 weeks, leading to preterm birth. Twin-to-twin transfusion syndrome can occur in identical twins sharing a placenta, causing unequal blood flow. Preeclampsia, characterized by high blood pressure and organ damage, is more common in multiple pregnancies. Therefore, all choices A, B, and C are correct as they are common complications associated with multiple gestations.
Hypoplastic left heart syndrome is characterized by underdevelopment of
- A. Pulmonary veins, ventricles and aortic valve
- B. Left ventricle, atrium and pulmonary vessels
- C. Aortic arch, venacava and right atrium
- D. Left ventricle, aortic valve and arch
Correct Answer: D
Rationale: Rationale:
1. Hypoplastic left heart syndrome involves underdevelopment of the left ventricle, aortic valve, and aortic arch.
2. The left ventricle is essential for pumping oxygenated blood to the body.
3. Aortic valve controls blood flow from the left ventricle to the aorta.
4. Aortic arch connects the ascending and descending aorta.
Summary:
A - Incorrect, as it includes pulmonary veins not related to hypoplastic left heart syndrome.
B - Incorrect, as it includes structures not primarily affected in this condition.
C - Incorrect, as it does not involve structures related to the left side of the heart.
The AGACNP is evaluating a patient who reportedly fell down a flight of steps. Her history is significant for several emergency room visits, but she denies any significant medical conditions. Some documentation in her chart indicates that she may have been subjected to physical abuse. Today she presents with a periorbital ecchymosis of the left eye and swelling in the left side of the face. Her neurologic examination is within normal limits. Which head imaging study would be most useful in assessing for findings consistent with a history of abuse?
- A. Radiographs
- B. CT scan without contrast
- C. MRI
- D. PET scan
Correct Answer: B
Rationale: The correct answer is B: CT scan without contrast. A CT scan is the most useful imaging study in assessing for findings consistent with a history of abuse in this patient. CT scan is preferred for acute trauma to the head as it provides detailed images of the brain, skull, and facial bones. It can detect acute hemorrhages, fractures, or other signs of trauma. In this case, the patient's presentation with periorbital ecchymosis and facial swelling raises suspicion for traumatic injury, which can be assessed effectively with a CT scan.
Radiographs (choice A) are not as sensitive as CT scans in detecting subtle fractures or soft tissue injuries in the head and face. MRI (choice C) is not typically used in acute trauma assessment and may not provide timely information needed in this case. PET scan (choice D) is not indicated for evaluating traumatic head injuries and is more commonly used for assessing metabolic and functional activity in the body.