Nokea
Aims of exchange transfusion procedure includes:
- A. Cure of haemolysis and restoration of hemoglobin level
- B. Cure of hypoxia and removal of all toxic materials
- C. Stabilization of baby’s immune system and liver functions
- D. Control of haemolysis and restoration of hemoglobin level
Correct Answer: D
Rationale: The correct answer is D because exchange transfusion aims to control hemolysis by removing the damaged red blood cells and replacing them with healthy ones, thus restoring hemoglobin levels. This procedure does not cure haemolysis or hypoxia entirely, nor does it stabilize the immune system or liver functions. It specifically targets controlling hemolysis and restoring hemoglobin levels to improve the patient's condition.
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A patient being monitored post-heart transplant suffers a bradyarrhythmia. The AGACNP knows that which of the following medications is not indicated as part of emergency intervention for bradycardic abnormalities in a posttransplant patient?
- A. Isoproterenol 0.2 to 0.6 mg IV bolus
- B. External pacemaking
- C. Atropine 0.5 mg IV
- D. Epinephrine 1 mg IV
Correct Answer: A
Rationale: The correct answer is A: Isoproterenol 0.2 to 0.6 mg IV bolus. Isoproterenol is a non-selective beta-adrenergic agonist that can worsen graft rejection in heart transplant patients. The appropriate intervention for bradyarrhythmia in posttransplant patients is external pacemaking or pharmacological agents like atropine or epinephrine. Isoproterenol should be avoided due to its potential to stimulate the immune system and increase the risk of rejection. It is crucial to choose interventions that address the bradycardia without compromising the patient's transplant graft.
Mr. Novello is an 81-year old male patient who presents with crampy abdominal pain in the hypogastrum and a vague history as to his last normal bowel movement. Physical examination reveals distention and high-pitched bowel sounds. The patient says he has never has this kind of problem before and denies any history of abdominal surgery. Abdominal radiographs reveal a frame pattern of colonic distention. The AGACNP considers
- A. A stimulant laxative to relieve bowel contents
- B. Carcinoma of the bowel as a leading diagnosis
- C. Decompression of the colon with rectal tube
- D. Angiography to rule out mesenteric ischemia
Correct Answer: C
Rationale: The correct answer is C: Decompression of the colon with rectal tube. This is the most appropriate intervention for a patient with acute colonic pseudo-obstruction (ACPO), also known as Ogilvie's syndrome. In this condition, there is colonic distention without an actual mechanical obstruction, leading to symptoms like abdominal pain, distention, and high-pitched bowel sounds. Decompression with a rectal tube can help relieve the distention and prevent complications like perforation.
Choice A (stimulant laxative) is incorrect because ACPO is not due to simple constipation, so laxatives would not be effective. Choice B (carcinoma of the bowel) is unlikely given the acute onset and lack of risk factors. Choice D (angiography for mesenteric ischemia) is not indicated in this case as there are no signs of acute ischemia.
In summary, the correct choice is C because it directly addresses the underlying issue of colonic distention in
There are no other abnormal findings. This suggests that Mr. Thornton
- A. Is having anterior wall ischemia
- B. Is having an anterior wall infarction
- C. Has a history of anterior wall NSTEMI
- D. Has a history of anterior wall STEMI
Correct Answer: B
Rationale: The correct answer is B because the absence of any other abnormal findings suggests that Mr. Thornton is currently experiencing an anterior wall infarction. This is indicated by the localized area of myocardial necrosis due to prolonged ischemia. Option A is incorrect because ischemia would typically present with reversible changes rather than necrosis. Option C is incorrect as NSTEMI would show some abnormal findings. Option D is incorrect as STEMI would show more significant ECG changes and enzyme elevation. In summary, the absence of other abnormalities points towards an acute event like an anterior wall infarction.
Which one of the following therapies is the MOST incorporated in the management of clients with gestational diabetes?
- A. Therapeutic diet alone
- B. Long acting insulin
- C. Oral hypoglycaemics
- D. Short acting insulin
Correct Answer: D
Rationale: The correct answer is D: Short acting insulin. In gestational diabetes, short acting insulin is preferred as it provides immediate control over blood sugar levels after meals. This is crucial in managing the condition to prevent complications for both the mother and the baby. Therapeutic diet alone (choice A) may not be sufficient to control blood sugar levels, while long-acting insulin (choice B) may not provide the rapid response needed after meals. Oral hypoglycemics (choice C) are generally avoided in pregnancy due to potential risks to the fetus. Therefore, short acting insulin is the most appropriate therapy for managing gestational diabetes effectively.
Clinical diagnosis of polyhydramnios is based on an excessive amount of amniotic fluid exceeding
- A. 1500 ml
- B. 2500 ml
- C. 1900 ml
- D. 3000 ml
Correct Answer: D
Rationale: The correct answer is D: 3000 ml. Polyhydramnios is diagnosed when the amniotic fluid volume exceeds 2000 to 3000 ml. This is because amniotic fluid serves important functions in protecting the fetus and aiding in fetal movements. Having an excessively high volume can lead to complications such as preterm labor, fetal malpresentation, and placental abruption. Choices A, B, and C are incorrect as they do not fall within the range typically used to diagnose polyhydramnios. A: 1500 ml and C: 1900 ml are below the threshold, while B: 2500 ml is at the lower end but still not exceeding the diagnostic range for polyhydramnios.