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According to the American College of Cardiology Foundation and the American Heart Association (ACCFAHA), the recommendation regarding antiplatelet therapy in patients with cardiovascular disease preoperatively is that
- A. Antiplatelet therapy should be held for 10 days preoperatively
- B. Cardiac consultation is required before an operation in patients who are on antiplatelet therapy
- C. Medications should be continued unless concerns about hemostasis are significant
- D. Antiplatelet therapy should be initiated in all high-risk cardiac procedures
Correct Answer: B
Rationale: Step-by-step rationale for why choice B is correct:
1. The ACCF/AHA recommends cardiac consultation before an operation for patients on antiplatelet therapy to assess the risk of bleeding versus thrombotic events.
2. Cardiac consultation helps determine the necessity of continuing, modifying, or stopping antiplatelet therapy.
3. This individualized approach ensures optimal perioperative management based on the patient's cardiovascular risk profile.
4. Choice A is incorrect as stopping antiplatelet therapy for 10 days can increase the risk of thrombotic events.
5. Choice C is incorrect as it oversimplifies the decision-making process without considering the patient's specific risks.
6. Choice D is incorrect because initiating antiplatelet therapy in all high-risk cardiac procedures may not be necessary for every patient.
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The PRIORITY health message to share with a client in the recovery room immediately following cesarean section includes
- A. Frequent coughing & deep breathing
- B. Importance of perineal self-care
- C. Importance of early ambulation
- D. Signs of puerperal infections
Correct Answer: C
Rationale: The correct answer is C: Importance of early ambulation. After a cesarean section, early ambulation is crucial to prevent complications like blood clots and promote circulation. It helps prevent post-operative complications. Choice A is important for respiratory health but not the priority right after surgery. Choice B focuses on perineal care which is important but not the immediate priority. Choice D is important, but recognizing signs of infection can wait until the client is more stable. Early ambulation is key to preventing complications and aiding in recovery.
Mother-to-child transmission of TB organisms never occurs during labor.
- A. TRUE
- B. FALSE
- C. -
- D. -
Correct Answer: B
Rationale: Step 1: TB can be transmitted through respiratory droplets, not just during labor.
Step 2: Mother with active TB can transmit the bacteria to the child during childbirth.
Step 3: Therefore, the statement that mother-to-child transmission never occurs during labor is false.
Summary: Choice B is correct because TB transmission can occur during labor, making Choice A incorrect. Choices C and D are irrelevant.
The main diagnostic feature of puerperal pyrexia is
- A. Fever ≥ 38°C for three consecutive occasions
- B. Fever ≥ 38°C for three days continuously
- C. Fever ≥ 38°C for three weeks continuously
- D. Fever ≥ 38°C for six days occasionally
Correct Answer: A
Rationale: The correct answer is A: Fever ≥ 38°C for three consecutive occasions. Puerperal pyrexia is defined as fever occurring after childbirth. The key diagnostic feature is the presence of fever (≥ 38°C) on three consecutive occasions, indicating a persistent infection. Choice B is incorrect because it doesn't specify the need for consecutive occasions. Choice C is incorrect as it extends the duration of fever to three weeks, which is too long for typical puerperal pyrexia. Choice D is incorrect as it mentions "occasionally" instead of "consecutively," which is not indicative of a consistent fever pattern seen in puerperal pyrexia.
When caring for a mother following an assisted vaginal delivery, it’s MOST important to remember that
- A. A vacuum extractor is safer than forceps because it causes less trauma to the baby & the mother’s perineum
- B. The baby will develop a cephalhematoma as a result of the instrumentation which is a normal expected outcome
- C. The use of instruments during the birth process is a fairly rare occurrence for women
- D. Additional nursing interventions are needed to ensure an uncomplicated postpartum
Correct Answer: D
Rationale: The correct answer is D because additional nursing interventions are necessary to ensure an uncomplicated postpartum period. After an assisted vaginal delivery, the mother may experience increased pain, perineal trauma, and a higher risk of postpartum hemorrhage. Nursing interventions such as pain management, wound care, monitoring for signs of infection, and emotional support are crucial for the mother's recovery.
A is incorrect because both vacuum extractors and forceps can cause trauma to the baby and mother's perineum, and the safety of one over the other depends on various factors.
B is incorrect as the development of a cephalhematoma is not a normal expected outcome of assisted vaginal delivery and should be monitored and managed appropriately if it occurs.
C is incorrect as the use of instruments during childbirth, while not as common as spontaneous vaginal deliveries, is not rare and can be necessary in certain situations to ensure the safety of the mother and baby.
How does the maternal microbiome influence the health of the fetus during pregnancy?
- A. By increasing fetal weight
- B. By altering immune development
- C. By reducing placental oxygen levels
- D. By enhancing amniotic fluid
Correct Answer: B
Rationale: The correct answer is B: By altering immune development. The maternal microbiome plays a crucial role in shaping the fetal immune system during pregnancy. Microbes in the mother's body can influence the development of the fetus's immune system through various mechanisms, such as immune cells crossing the placenta. This interaction helps the fetus develop tolerance to maternal antigens.
Choice A (By increasing fetal weight) is incorrect because the maternal microbiome's influence is not primarily related to weight gain. Choice C (By reducing placental oxygen levels) is incorrect as it does not directly relate to the immune system development. Choice D (By enhancing amniotic fluid) is incorrect as the main influence is on the immune system rather than amniotic fluid enhancement.