Nokea
a woman who is pregnant is undergoing an amniocentesis. during the test, elevated levels of AFP are found. this indicate to which of the following conditions :
- A. CP
- B. spina bifida
- C. down syndrome
- D. hydrocephalus
Correct Answer: B
Rationale: Elevated levels of AFP (alpha-fetoprotein) in the amniotic fluid during an amniocentesis often indicate neural tube defects, such as spina bifida. Spina bifida is a condition where the spinal cord does not develop properly, leading to a range of possible issues depending on the severity of the defect. In this case, the elevated AFP levels point towards a higher likelihood of spina bifida rather than other conditions like CP (cerebral palsy), Down syndrome, or hydrocephalus.
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Assume you are evaluating the specificity of the indirect fluorescence antibody test for rapid diagnosis of Campylobacter enteritis. The number of normal persons tested is 150 and the test is positive in 30 persons. The specificity of this test is
- A. 20%
- B. 40%
- C. 60%
- D. 80%
Correct Answer: D
Rationale: Specificity = (True negatives / Total normals) * 100 = [(150 - 30) / 150] * 100 = 80%.
Hemolytic disease is suspected in a mother's second newborn. Which factor is important in understanding how this could develop?
- A. The mother's first child was Rh positive.
- B. The mother is Rh positive.
- C. Both parents have type O blood.
- D. RhIG (RhoGAM) was given to the mother during her first pregnancy.
Correct Answer: A
Rationale: Hemolytic disease of the newborn, also known as erythroblastosis fetalis, is a condition in which a mother's antibodies attack the red blood cells of the unborn baby. This most commonly occurs due to Rh incompatibility. The mother produces Rh antibodies during her first pregnancy with an Rh positive baby. During subsequent pregnancies with an Rh positive baby, these antibodies can cross the placenta and attack the baby's red blood cells, leading to hemolytic disease. Therefore, if the mother's first child was Rh positive, it increases the risk of hemolytic disease in subsequent pregnancies if the babies are also Rh positive.
Nurse Christine is planning a client education program for sickle cell disease (SCD) in children; which of the following interventions would be included in the care plan?
- A. Health teaching to help reduce sickling crises
- B. Avoidance of the use of opioids
- C. Administration of an anticoagulant to prevent sickling
- D. Observation of the imposed fluid restriction
Correct Answer: A
Rationale: The most appropriate intervention to include in the client education program for sickle cell disease (SCD) in children is health teaching to help reduce sickling crises. Education plays a crucial role in managing SCD, and teaching children and their families about strategies to prevent sickling crises can significantly improve health outcomes. This may include advising on proper hydration, avoiding extreme temperatures, maintaining a healthy lifestyle, recognizing the early signs of a crisis, and seeking prompt medical attention when necessary. By providing education on ways to reduce sickling crises, Nurse Christine can empower the children and their families to better manage the condition and improve quality of life.
The nurse is reviewing the medication history of a new preoperative patient who is nil by mouth (NPO). The nurse notes that the patient has been on long-term oral steroid therapy. The nurse understands that which of the following is the reason that steroids cannot be abruptly stopped?
- A. Higher steroid levels are needed during
- B. Malignant hypertension will occur.
- C. Respiratory failure will result.
- D. Malignant hyperthermia will result.
Correct Answer: A
Rationale: Steroids should not be abruptly stopped, especially in patients on long-term therapy, because higher steroid levels are needed during stress. Abruptly stopping steroids can lead to adrenal insufficiency and a life-threatening condition called adrenal crisis. Patients undergoing surgery or experiencing significant stress require higher doses of steroids to prevent adrenal crisis. It is important for healthcare providers to monitor and adjust steroid doses accordingly during stressful situations such as surgery.
The nurse understands that which of the ff. is a side effect most likely to be reported by patients receiving enalapril maleate (Vasotec)?
- A. Acne
- B. Diarrhea
- C. Cough
- D. Heartburn
Correct Answer: C
Rationale: The most common side effect reported by patients receiving enalapril maleate (Vasotec) is a persistent dry cough. This cough is due to the medication's effect on bradykinin levels in the body, leading to irritation of the respiratory tract and causing the cough. While other side effects such as diarrhea and heartburn may occur, cough is the most frequently reported side effect associated with enalapril maleate. Acne is not a commonly reported side effect of this medication.