Nokea
A clinical feature that is suggestive of hypothermia neonatorum is
- A. Bradycardia
- B. Hyperglycemia
- C. Hypoventilation
- D. Hyperventilation
Correct Answer: A
Rationale: The correct answer is A: Bradycardia. Hypothermia neonatorum is characterized by low body temperature in newborns, which can lead to bradycardia as the heart rate decreases in response to the cold stress. Bradycardia is a common physiological response to hypothermia as the body tries to conserve energy and maintain vital functions. Hyperglycemia, hypoventilation, and hyperventilation are not specific clinical features of hypothermia neonatorum. Hyperglycemia is more commonly associated with conditions like diabetes, hypoventilation could be a sign of respiratory distress, and hyperventilation is usually seen in response to metabolic acidosis or anxiety.
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The AGACNP is receiving report from the recovery room on a patient who just had surgical resection for pheochromocytoma. He knows that which class of drugs should be available immediately to manage hypertensive crisis, a possible consequence of physical manipulation of the adrenal medulla?
- A. Alpha-adrenergic antagonists
- B. Beta-adrenergic antagonists
- C. Intravenous vasodilators
- D. Arteriolar dilators
Correct Answer: D
Rationale: Step-by-step rationale for why D is correct:
1. Arteriolar dilators such as sodium nitroprusside are used to manage hypertensive crisis by rapidly reducing blood pressure.
2. Pheochromocytoma surgery can result in catecholamine release, causing severe hypertension.
3. Arteriolar dilators act directly on blood vessels to lower blood pressure quickly.
4. Alpha-adrenergic antagonists (A) can worsen hypotension, beta-adrenergic antagonists (B) can lead to unopposed alpha-adrenergic effects, and intravenous vasodilators (C) may not act rapidly enough.
Causes of polyhydramnious include:
- A. Congenital abnormalities and chorioangioma
- B. Severe fetal hypoxia and multiple pregnancy
- C. Uncontrolled diabetes mellitus and anaemia
- D. Rhesus D isoimmunisation and post datism
Correct Answer: A
Rationale: The correct answer is A because congenital abnormalities and chorioangioma can lead to increased amniotic fluid accumulation, causing polyhydramnios. Congenital abnormalities can affect fetal swallowing and urine production, leading to fluid buildup. Chorioangioma is a vascular tumor in the placenta that can disrupt normal fluid dynamics.
Choice B is incorrect as severe fetal hypoxia and multiple pregnancy are more likely to cause oligohydramnios, not polyhydramnios. Choice C is incorrect as uncontrolled diabetes mellitus and anemia are associated with macrosomia and not polyhydramnios. Choice D is incorrect because Rhesus D isoimmunisation and postdatism are not typically linked to polyhydramnios.
Inadequate levels of surfactant in a neonate leads to a condition referred to as
- A. Meconium aspiration syndrome
- B. Intranatal pneumonia
- C. Respiratory distress syndrome
- D. Congenital pneumothorax
Correct Answer: C
Rationale: The correct answer is C: Respiratory distress syndrome. Surfactant is essential for reducing surface tension in the alveoli, preventing their collapse. Inadequate levels of surfactant in a neonate result in respiratory distress syndrome. Meconium aspiration syndrome (A) is due to inhalation of meconium by the neonate. Intranatal pneumonia (B) is an infection acquired during birth. Congenital pneumothorax (D) is the presence of air in the pleural space, not directly related to surfactant levels.
How can maternal smoking during pregnancy affect fetal development?
- A. Causes low birth weight
- B. Increases the risk of preterm birth
- C. Affects lung development
- D. All of the above
Correct Answer: D
Rationale: Maternal smoking during pregnancy can affect fetal development in multiple ways. Smoking can cause low birth weight by restricting oxygen and nutrients to the fetus, leading to growth issues. It can also increase the risk of preterm birth due to the harmful chemicals in cigarette smoke. Furthermore, smoking can affect lung development in the fetus, leading to respiratory issues. Therefore, the correct answer is D - All of the above, as maternal smoking can have a comprehensive impact on fetal development, including low birth weight, preterm birth, and lung development issues.
R. R. is a 71-year-old female who presents with left lower quadrant pain that started out as cramping but has become more constant over the last day. She reports constipation over the last few days but admits that for as long as she can remember she has had variable bowel habits. Her vital signs are normal, but physical examination reveals some tenderness in the left lower quadrant. Which diagnostic test is most likely to support the leading differential diagnosis?
- A. CT scan with IV, oral, and rectal contrast
- B. CBC with WBC differential
- C. Colonoscopy
- D. Barium enema
Correct Answer: B
Rationale: The correct answer is B: CBC with WBC differential. This test can help rule out infectious causes of left lower quadrant pain, such as diverticulitis or colitis, by assessing for elevated white blood cell count and left shift. A CT scan (A) with contrast may be indicated if the patient's condition worsens or if initial tests are inconclusive. Colonoscopy (C) is more appropriate for evaluating chronic or intermittent abdominal pain, not acute symptoms. Barium enema (D) is an outdated test and not commonly used for diagnosing acute abdominal pain.