A specific clinical feature of respiratory distress syndrome includes
- A. Grunting on inspiration
- B. Grunting on expiration
- C. Flaring of the nostrils
- D. Neonatal tachycardia
Correct Answer: B
Rationale: The correct answer is B: Grunting on expiration. In respiratory distress syndrome, the infant may exhibit grunting on expiration due to the difficulty in maintaining lung inflation during exhalation. This is a compensatory mechanism to increase functional residual capacity. Grunting on inspiration (choice A) may be seen in other respiratory conditions. Flaring of the nostrils (choice C) is a sign of increased work of breathing but is not specific to respiratory distress syndrome. Neonatal tachycardia (choice D) can be a nonspecific sign of distress and is not a specific feature of respiratory distress syndrome.
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The relationship between abdominal pain and vomiting typically can be characterized by saying
- A. When the vomiting precedes pain, the likelihood of surgical abdomen increases appreciably
- B. Conditions that may produce only mild nausea in the younger patient often will cause vomiting in older patients
- C. The majority of surgical abdomens do not produce vomiting as a primary symptom
- D. The presence of bile in vomitus suggests pyloric stenosis
Correct Answer: D
Rationale: Step 1: The presence of bile in vomitus suggests that the vomit originated from the small intestine or stomach, indicating an obstruction in the pyloric region.
Step 2: Pyloric stenosis is a condition characterized by narrowing of the opening from the stomach to the small intestine, leading to projectile vomiting with bile.
Step 3: Therefore, the presence of bile in vomitus suggests pyloric stenosis, making option D the correct answer.
Summary: Option A is incorrect because vomiting preceding pain does not necessarily indicate a surgical abdomen. Option B is incorrect as the severity of symptoms is not solely based on age. Option C is incorrect as some surgical abdomens can present with vomiting as a primary symptom.
Trial of scar is likely to have an auspicious outcome if the
- A. Estimated fetal weight is below 3500 grams
- B. Maternal body mass index is estimated at 27.5
- C. Gestational age is approximately 42 weeks
- D. Maternal age is approximately 42 years
Correct Answer: A
Rationale: The correct answer is A because an estimated fetal weight below 3500 grams indicates a lower risk of complications during childbirth. Higher fetal weight increases the likelihood of shoulder dystocia and birth injuries. Maternal body mass index, gestational age, and maternal age do not directly impact the likelihood of a favorable outcome during a trial of scar.
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.
Non-infective mastitis is associated with
- A. Cellulitis
- B. Flat nipples
- C. Bifid nipples
- D. Adenitis
Correct Answer: D
Rationale: Non-infective mastitis is associated with adenitis because it refers to inflammation of breast tissue without an infection. Adenitis specifically involves inflammation of the lymph nodes, which can be a common cause of non-infective mastitis. Cellulitis (A) is an infection of the skin and tissues beneath the skin, not specific to mastitis. Flat (B) and bifid (C) nipples are anatomical variations that do not directly relate to the inflammation of breast tissue.
Psychosocial adversities are among the predisposing factors of puerperal psychosis.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: T
Rationale: Step-by-step rationale:
1. Puerperal psychosis is a severe mental health condition occurring postpartum.
2. Psychosocial adversities, such as stress or lack of social support, can trigger or exacerbate mental health issues.
3. Therefore, psychosocial adversities can be predisposing factors for puerperal psychosis.
4. Option A (TRUE) is correct as it aligns with the established relationship between psychosocial factors and mental health.
Summary: Option A is correct because psychosocial adversities can indeed contribute to the development of puerperal psychosis, making it a relevant predisposing factor. Options B, C, and D are incorrect as they do not provide any rationale or evidence to support their validity.