Nokea
According to the American College of Surgeons (ACS) and the National Surgical Quality Improvement Program (NSQIP) guidelines for preoperative evaluation of the geriatric patient, the preoperative evaluation should include all of the following except
- A. Cognitive ability
- B. Functional status
- C. Competency assessment
- D. Frailty score
Correct Answer: A
Rationale: Step-by-step rationale:
1. Cognitive ability is important for decision-making during surgery.
2. Functional status helps assess the patient's ability to recover post-surgery.
3. Competency assessment ensures the patient can consent to surgery.
4. Frailty score predicts surgical outcomes in geriatric patients.
5. Cognitive ability is not typically assessed preoperatively in the ACS/NSQIP guidelines.
Summary:
- A: Cognitive ability is not typically part of preoperative evaluation.
- B: Functional status is important for post-surgery recovery.
- C: Competency assessment is crucial for informed consent.
- D: Frailty score helps predict surgical outcomes in geriatric patients.
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The PRIORITY action to take when nursing a neonate on phototherapy is to
- A. Turn the neonate every six hours routinely
- B. Encourage mother to discontinue breastfeeding
- C. Notify physician if the skin turns bronze-colored
- D. Check the neonate’s vital signs every 2-4 hourly
Correct Answer: D
Rationale: The correct answer is D: Check the neonate’s vital signs every 2-4 hourly. This is the priority action because neonates undergoing phototherapy are at risk for dehydration and temperature instability. Monitoring vital signs regularly helps to detect any signs of dehydration, such as decreased urine output or increased heart rate, and ensures timely intervention.
Explanation for other choices:
A: Turning the neonate every six hours routinely is important for preventing pressure ulcers but is not the priority when compared to monitoring vital signs for potential complications.
B: Encouraging the mother to discontinue breastfeeding is incorrect as breastmilk provides essential nutrients and hydration, which are important for neonates, even during phototherapy.
C: Notifying the physician if the skin turns bronze-colored is important to address a potential adverse reaction to phototherapy but does not take precedence over monitoring vital signs for immediate concerns.
How can folic acid supplementation prevent neural tube defects?
- A. By promoting spinal cord closure
- B. By preventing infections
- C. By enhancing fetal growth
- D. By regulating blood sugar levels
Correct Answer: A
Rationale: The correct answer is A because folic acid supplementation plays a crucial role in promoting spinal cord closure during fetal development, preventing neural tube defects. Folic acid helps in the formation of neural tube structures, ensuring proper closure and preventing defects like spina bifida. Choices B, C, and D are incorrect as preventing infections, enhancing fetal growth, and regulating blood sugar levels are not direct mechanisms through which folic acid prevents neural tube defects.
The main feature of Hyperemesis gravidarum is
- A. Pallor or cyanosis of mucous membrane
- B. Inability to eat or retain food all through
- C. Weakness because of severe state of shock
- D. Smaller fundal height compared to dates
Correct Answer: B
Rationale: Step 1: Hyperemesis gravidarum is characterized by severe nausea and vomiting during pregnancy.
Step 2: Inability to eat or retain food all through is a hallmark feature due to excessive vomiting.
Step 3: This leads to dehydration, electrolyte imbalances, and weight loss.
Step 4: Pallor, cyanosis, weakness, and smaller fundal height are not specific to hyperemesis gravidarum.
Summary: Choice B is correct as it directly relates to the primary symptom of excessive vomiting in hyperemesis gravidarum, while the other choices are not specific to this condition.
Chemical diabetes mellitus is a classification based on
- A. Symptom are absent and abnormal specific laboratory results
- B. Presence of symptoms and abnormal specific laboratory results
- C. Previous congenital abnormalities and unexplained stillbirth
- D. Previous birth of a baby weighing >4.3kg and spontaneous abortion
Correct Answer: A
Rationale: The correct answer is A: Symptom are absent and abnormal specific laboratory results. Chemical diabetes mellitus refers to a condition where there are abnormal specific laboratory results indicating diabetes without the presence of any symptoms. This classification is based on objective data from laboratory tests rather than subjective symptoms. Choices B, C, and D are incorrect as they do not align with the definition of chemical diabetes mellitus, which focuses on laboratory results rather than symptoms, congenital abnormalities, or pregnancy outcomes.
Cord presentation is when the
- A. Umbilical cord lies in front of the presenting part after the membranes have ruptured.
- B. Umbilical cord lies in front of the presenting part before membranes have ruptured
- C. Umbilical cord is tied around the fetal neck.
- D. Umbilical cord has prematurely been detached.
Correct Answer: A
Rationale: The correct answer is A because cord presentation occurs when the umbilical cord lies in front of the presenting part after the membranes have ruptured. This can lead to compression of the cord during labor, affecting fetal oxygenation. Option B is incorrect as it describes cord prolapse, where the cord lies in front of the presenting part before membrane rupture. Option C describes nuchal cord, where the cord is wrapped around the fetal neck. Option D describes cord abruption, where the cord detaches prematurely from the placenta.