Nokea
Among the major predisposing factors of cardiac disease prenatally are
- A. Rheumatic heart disease and leukaemia
- B. Ischaemic heart disease and dehydration
- C. Uncontrolled hypertension and obesity
- D. Smoking and peptic ulcer disease
Correct Answer: C
Rationale: Uncontrolled hypertension and obesity are major predisposing factors for cardiac disease.
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The AGACNP knows that when evaluating a patient with suspected acute pyelonephritis, which of the following is not a common feature?
- A. Pyuria
- B. Fever
- C. CVA tenderness
- D. Gross hematuria
Correct Answer: D
Rationale: While pyuria, fever, and CVA tenderness are common features of acute pyelonephritis, gross hematuria is less commonly associated with this condition. In acute pyelonephritis, the inflammatory process primarily affects the renal parenchyma and pelvis, leading to symptoms such as fever, chills, flank pain, pyuria (presence of pus in the urine), and CVA tenderness (tenderness over the costovertebral angle). Hematuria in acute pyelonephritis is more likely to be microscopic rather than gross.
Uterus hypotonicity is likely to lead to prolonged labor due to
- A. Incoordination of the uterus muscle fibers during a contraction
- B. Maternal exhaustion because of improper preparation for labor
- C. Weak receptors thus not strong enough to signal enough contraction
- D. Inadequate pelvis thus not able to stimulate enough uterine contractions
Correct Answer: A
Rationale: Uterus hypotonicity results in poor coordination of muscle fibers, leading to ineffective contractions.
Achalasia is a risk factor for
- A. Squamous cell carcinoma
- B. Gastroesophageal reflux disease
- C. Esophageal atrophy
- D. Malabsorption syndromes
Correct Answer: A
Rationale: Achalasia is a motility disorder characterized by the inability of the lower esophageal sphincter to relax, resulting in difficulty swallowing and impaired movement of food from the esophagus into the stomach. Patients with achalasia have an increased risk of developing squamous cell carcinoma of the esophagus. This risk is due to chronic inflammation, stasis of food in the esophagus, and increased exposure of esophageal mucosa to irritants, all of which can contribute to the development of cancer over time. Gastroesophageal reflux disease (Choice B) is less likely to be associated with achalasia because the impaired esophageal motility in achalasia results in decreased, rather than increased, reflux of stomach contents into the esophagus. Esophageal atrophy (Choice C) and malabsorption syndromes (Choice D) are not directly related to achalasia.
While reviewing the head CT scan of a patient following a motor vehicle accident, the AGACNP appreciates a crescent-shaped fluid collection. This most likely represents
- A. Acute subdural hematoma
- B. Acute epidural hematoma
- C. Acute uncal herniation
- D. Acute brainstem compression
Correct Answer: A
Rationale: A crescent-shaped fluid collection on a head CT scan typically represents an acute subdural hematoma. Acute subdural hematomas result from the tearing of bridging veins that lie between the dura mater and arachnoid mater layers of the meninges. This injury often occurs due to significant head trauma, such as a motor vehicle accident. As blood accumulates within the potential space between the dura and arachnoid layers, it forms a crescent-shaped collection that can compress the underlying brain tissue, leading to symptoms such as altered mental status, headache, focal neurological deficits, and signs of increased intracranial pressure. Treatment may involve surgical intervention to evacuate the hematoma and relieve the pressure on the brain.
Complications of unrepaired cleft lip and palate include
- A. Pneumonia and retarded growth
- B. Mental retardation and blindness
- C. Failure to thrive and deafness
- D. Impaired speech and convulsions
Correct Answer: D
Rationale: Failure to thrive and impaired speech are common complications due to feeding and developmental issues with cleft lip and palate.