Nokea
A neonate of a smear-negative mother just before birth receives BCG as usual.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: A
Rationale: The correct answer is A: TRUE. This is because BCG vaccination for newborns is recommended even if the mother is smear-negative for tuberculosis, as it helps protect the newborn from severe forms of TB. Smear status of the mother does not impact the need for BCG vaccination in the neonate. Choice B is incorrect as it falsely implies that BCG should not be given in this scenario. Choices C and D are not applicable as they do not provide any information.
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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.
How can a healthcare provider support a woman with hyperemesis gravidarum?
- A. Prescribe anti-nausea medication
- B. Recommend bed rest
- C. Suggest a high-protein diet
- D. Advise on exercise
Correct Answer: A
Rationale: The correct answer is A: Prescribe anti-nausea medication. This is the most appropriate choice to manage hyperemesis gravidarum, a severe form of morning sickness. Anti-nausea medication can help alleviate symptoms and prevent dehydration. Choice B (Recommend bed rest) may not directly address the nausea and vomiting associated with hyperemesis gravidarum. Choice C (Suggest a high-protein diet) and D (Advise on exercise) may not be effective in managing the condition or providing immediate relief from symptoms. Anti-nausea medication is the most evidence-based approach to support a woman with hyperemesis gravidarum.
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.
In which form of hypospadias should circumcision be deferred in order to preserve the prepuce for later surgical repair?
- A. Ventral displacement
- B. Proximal displacement
- C. Midscrotal hypospadias
- D. Meatus proximal to the corona
Correct Answer: A
Rationale: In ventral displacement hypospadias, circumcision should be deferred to preserve prepuce for later surgical repair as the prepuce is needed for reconstruction. The prepuce can be used as a tissue graft to correct the hypospadias. In proximal displacement, the urethral opening is closer to the scrotum, making prepuce preservation less critical. Midscrotal hypospadias and meatus proximal to the corona do not typically involve prepuce preservation for surgical repair.
S. R. is a 51-year-old male patient who is being evaluated for fatigue. Over the last few months he has noticed a marked decrease in activity tolerance. Physical examination reveals a variety of ecchymoses of unknown origin. The CBC is significant for a Hgb of 10.1 gdL, an MCV of 72 fL and a platelet count of 65,000L the remainder of the CBC is normal. Coagulation studies are normal, but bleeding time is prolonged. The AGACNP recognizes that initial management of this patient will include
- A. Avoidance of elective surgery and nonessential medications
- B. Prednisone 60 mg daily until platelets normal
- C. Monoclonal antibody therapy such as rituximab
- D. Splenectomy
Correct Answer: A
Rationale: The correct answer is A: Avoidance of elective surgery and nonessential medications. This is the initial management for a patient with thrombocytopenia and abnormal bleeding time, possibly indicating immune thrombocytopenic purpura (ITP). Avoiding surgery and medications that can worsen thrombocytopenia is crucial to prevent bleeding complications. Prednisone (B) is not the first-line treatment for ITP, especially without confirming the diagnosis. Monoclonal antibody therapy (C) such as rituximab is usually reserved for refractory cases. Splenectomy (D) is considered only if other treatments fail as a last resort.