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A fetal associated risk of prolonged pregnancy includes
- A. Fetal macrosomia
- B. Placental dysfunction
- C. Cesarean section
- D. Shoulder dystocia
Correct Answer: A
Rationale: The correct answer is A: Fetal macrosomia. Prolonged pregnancy increases the risk of fetal macrosomia due to continued fetal growth beyond the normal term. This can lead to complications during delivery, such as shoulder dystocia and birth injuries. Placental dysfunction and cesarean section are possible outcomes of prolonged pregnancy but are not directly associated with fetal risks in this context. Shoulder dystocia is a potential complication of fetal macrosomia but is not a direct fetal risk of prolonged pregnancy.
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Hepatic encephalopathy is a clinical syndrome seen in patients with chronic liver disease its presentation may range from mild personality changes, to psychosis, to coma. The primary chemical mediators of hepatic encephalopathy include all of the following except
- A. Gamma-aminobutyric acid (GABA)
- B. Ammonia
- C. False neurotransmitters
- D. Serotonin
Correct Answer: B
Rationale: The correct answer is B: Ammonia. Ammonia is a primary chemical mediator of hepatic encephalopathy. In patients with chronic liver disease, the liver's ability to detoxify ammonia is compromised, leading to its accumulation in the bloodstream and subsequent neurotoxic effects causing encephalopathy. Gamma-aminobutyric acid (GABA), false neurotransmitters, and serotonin are all implicated in the pathophysiology of hepatic encephalopathy. GABA is involved in neurotransmission, false neurotransmitters are substances that disrupt normal neurotransmission, and serotonin levels are altered in hepatic encephalopathy.
The type of heat loss that is prevented by keeping the NBU temperature warm & warm wrapping of the neonates is
- A. Convection
- B. Conduction
- C. Evaporation
- D. Radiation
Correct Answer: B
Rationale: The correct answer is B: Conduction. Conduction is the transfer of heat through direct contact. By keeping the neonatal unit warm and wrapping neonates in warm blankets, heat loss through direct contact with surfaces is minimized. Convection involves heat transfer through air or fluid movement, not relevant in this scenario. Evaporation is the process of heat loss through moisture evaporation from the skin, not applicable here. Radiation is heat transfer through electromagnetic waves, which can be prevented by warm wrapping but not the primary focus in this context.
Pubiotomy is
- A. Access to the lower uterine segment by dissection of tissues around the peritoneum
- B. A surgical procedure in which the cartilage of the pubic symphysis is divided
- C. Ligating of the pubic bones in case they are invaded by cancerous cells
- D. Dissection of the perineal tissues to hasten the perineal phase of labor
Correct Answer: B
Rationale: The correct answer is B: A surgical procedure in which the cartilage of the pubic symphysis is divided. Pubiotomy involves cutting the pubic symphysis cartilage to widen the pelvic outlet during difficult childbirth. This procedure helps facilitate labor by increasing the pelvic diameter. Choices A, C, and D are incorrect because they do not accurately describe pubiotomy. Choice A refers to accessing the lower uterine segment, choice C involves ligating pubic bones for cancer, and choice D pertains to perineal tissue dissection during labor, which are unrelated to pubiotomy.
Which one of the following signs is indicative of possible shoulder dystocia during delivery?
- A. Failure of internal rotation of the head
- B. Fetal head retracts against the perineum
- C. Gentle traction aids in effecting the delivery
- D. The occiput slowly restitutes towards the left side
Correct Answer: B
Rationale: The correct answer is B: Fetal head retracts against the perineum. This sign indicates possible shoulder dystocia as it suggests the baby's shoulders are impacted and unable to pass through the birth canal. The retraction of the fetal head against the perineum is a classic sign of shoulder dystocia, which requires specific maneuvers to dislodge the shoulders and facilitate delivery.
A: Failure of internal rotation of the head is not specific to shoulder dystocia.
C: Gentle traction should not be applied in cases of shoulder dystocia as it can worsen the situation.
D: The occiput restituting towards the left side is not a sign of shoulder dystocia, as it refers to the rotation of the fetal head during delivery.
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 Downloaded by: basil7kl | basil7kl@gmail.com Distribution of this document is illegal Stuvia.com - The Marketplace to Buy and Sell your Study Material
Correct Answer: D
Rationale: The correct initial action for the AGACNP is to provide counseling to the patient regarding her options (Choice D). This is important to ensure the patient's safety, well-being, and autonomy. Counseling will allow the patient to explore her feelings, understand her options, and make an informed decision about her next steps. Reporting the physical assault to law enforcement (Choice A) should only be done with the patient's consent to respect her wishes. Having the patient sign a release to go home with her husband (Choice B) could potentially put the patient at risk of further harm. Consulting psychiatry for a psych hold (Choice C) may not be appropriate unless the patient is deemed a danger to herself or others.